Air pollution and decreased bone mineral density among Women's Health Initiative participants
Diddier Prada, Carolyn Crandall, Allison Kupsco, Marianthi‐Anna Kioumourtzoglou, James D. Stewart, Duanping Liao, Jeff D. Yanosky, Andrea Ramirez, Jean Wactawski‐Wende, Yike Shen, Gary W. Miller, Iuliana Ionita‐Laza, Eric A. Whitsel, Andrea Baccarelli
Abstract
Background: Osteoporosis heavily affects postmenopausal women and is influenced by environmental exposures. Determining the impact of criteria air pollutants and their mixtures on bone mineral density (BMD) in postmenopausal women is an urgent priority. Methods: at participants' geocoded addresses (1-, 3-, and 5-year averages before BMD assessments). We measured whole-body, total hip, femoral neck, and lumbar spine BMD at enrollment and follow-up (Y1, Y3, Y6) via dual-energy X-ray absorptiometry. We estimated associations using multivariable linear and linear mixed-effects models and mixture effects using Bayesian kernel machine regression (BKMR) models. Findings: concentration. BKMR suggested that nitrogen oxides exposure was inversely associated with whole-body and lumbar spine BMD. Interpretation: In this cohort study, higher levels of air pollutants were associated with bone damage, particularly on lumbar spine, among postmenopausal women. These findings highlight nitrogen oxides exposure as a leading contributor to bone loss in postmenopausal women, expanding previous findings of air pollution-related bone damage. Funding: US National Institutes of Health.