Findings on the risk of bone fractures associated with long‐term fluoride exposure from drinking water have been contradictory. The purpose of this study was to determine the prevalence of bone fracture, including hip fracture, in six Chinese populations with water fluoride concentrations ranging from 0.25 to 7.97 parts per million (ppm). A total of 8266 male and female subjects ≥50 years of age were enrolled. Parameters evaluated included fluoride exposure, prevalence of bone fractures, demographics, medical history, physical activity, cigarette smoking, and alcohol consumption. The results confirmed that drinking water was the only major source of fluoride exposure in the study populations. A U‐shaped pattern was detected for the relationship between the prevalence of bone fracture and water fluoride level. The prevalence of overall bone fracture was lowest in the population of 1.00‐1.06 ppm fluoride in drinking water, which was significantly lower (p < 0.05) than that of the groups exposed to water fluoride levels ≥4.32 and ≤0.34 ppm. The prevalence of hip fractures was highest in the group with the highest water fluoride (4.32‐7.97 ppm). The value is significantly higher than the population with 1.00‐1.06 ppm water fluoride, which had the lowest prevalence rate. It is concluded that long‐term fluoride exposure from drinking water containing ≥4.32 ppm increases the risk of overall fractures as well as hip fractures. Water fluoride levels at 1.00‐1.06 ppm decrease the risk of overall fractures relative to negligible fluoride in water; however, there does not appear to be similar protective benefits for the risk of hip fractures.
关于长期饮用
水氟暴露与骨骨折风险之间关系的研究结果一直存在矛盾。本研究的目的是确定中国六个人群中骨骨折(包括髋部骨折)的普遍性,这些人群的饮用
水氟浓度从0.25到7.97 ppm不等。共有8266名年龄≥50岁的男性和女性被纳入研究。评估的参数包括
氟暴露、骨骨折的普遍性、人口统计学、病史、体力活动、吸烟和饮酒。结果证实,饮用
水是研究人群中
氟暴露的唯一主要来源。骨骨折普遍性与饮用
水氟水平之间的关系呈现U型模式。总体骨骨折的普遍性在饮用
水氟浓度为1.00-1.06 ppm的人群中最低,显著低于暴露于饮用
水氟浓度≥4.32 ppm和≤0.34 ppm的人群(p < 0.05)。髋部骨折的普遍性在饮用水氟浓度最高(4.32-7.97 ppm)的人群中最高。这一数值显著高于饮用水氟浓度为1.00-1.06 ppm的人群,该人群中髋部骨折的普遍性最低。结论是,长期饮用含氟≥4.32 ppm的水会增加总体骨折和髋部骨折的风险。饮用水氟浓度为1.00-1.06 ppm时,相对于水中几乎不含
氟的情况,降低了总体骨折的风险;然而,对于髋部骨折的风险,似乎没有类似的保护作用。