Environmental substances associated with osteoporosis

• Published in: European journal of public health Vol. 30; no. Supplement_5
• Main Authors: Elonheimo, H, Lange, R, Tolonen, H
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.09.2020
• Subjects: Arsenic; Biomedical materials; Biomonitoring; Bisphenols; Bone mineral density; Cadmium; Chemicals; Disease; Economics; Epidemiology; Exposure; Fractures; Fragility; Health care expenditures; Heavy metals; Lead; Literature reviews; Mercury; Mercury (metal); Metals; Osteoporosis; Phthalates; Polycyclic aromatic hydrocarbons; Post-menopause; Public health; Risk; Side effects; Systematic review
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckaa166.085

Background Osteoporosis is a disease adversely affecting the bone health and causing fragility fractures. Osteoporosis is affecting the lives of approximately 200 million people worldwide and causing nearly 9 million fractures annually. In the European Union the economic burden of osteoporosis and prior fragility fractures was estimated at €37 billion in 2010; the costs are predicted to double by the year 2050. The disease takes both personal and economic toll by causing significant disability and increasing health-care costs as the population ages. There is evidence, that certain environmental substances may increase the risk of osteoporosis. Methods In the framework of the European Human Biomonitoring Initiative (HBM4EU) a set of 18 priority substances and substance groups were selected to be further studied. Within HBM4EU a scoping document has been prepared for each of the substance groups. Based on a review of the recent literature, a scoping review of substances which might be associated with osteoporosis was prepared. Results The literature research revealed that there is a possible link of osteoporosis and heavy metals such as cadmium and lead. Additionally, for phthalates and per- and poly-fluoroalkyl substances (PFASs), a potential association was observed. Especially women in perimenopausal and postmenopausal stage have been identified as being at greater risk of harmful effects. Other substances such as bisphenols, arsenic, mercury and polycyclic aromatic hydrocarbons (PAHs) are suspected to have adverse effects on bone health but the evidence is still incomplete. Conclusions Although there is some evidence that these environmental substances have an adverse effect on human health, more research is needed. Some of the evidence is inconsistent, and there is a lack of extensive epidemiological studies. Since people are exposed to many substances simultaneously, there is a need to initiate studies which attempt to clarify the possible combined effects. Key messages Exposure to cadmium, lead, phthalates and PFASs may adversely affect bone health and increase a risk of osteoporosis. An inverse association of chemicals and bone mineral density is often detected. The growing concern of chemical exposure requires initiating of epidemiological studies on the subject. Multidisciplinary action for safeguarding citizenś health in Europe and worldwide is needed.