New study shows 50% increase in hip fractures due to fluoride
With disturbingly high rates of hip fractures in Australia, this new Swedish study confirms the osteoporotic damage caused by the long-term ingestion of fluoridation chemicals and presents yet another major warning to all fluoride proponents.
“In 2015–16, there were an estimated 18,746 new hip fractures in Australia, a crude rate of 199 hip fractures per 100,000 population aged 45 and over.”
“Broadly, risk factors for hip fractures are those that lead to decreased bone density and strength, and increased likelihood of falls.”
AIHW “Hip fracture incidence and hospitalisations in Australia; 2015–16.” (Published 23/10/2018)
Hip fractures in Australia
According to the Australian Institute of Health and Welfare, in 2015–16, there were an estimated 18,746 new hip fractures in Australia, a crude rate of 199 hip fractures per 100,000 population aged 45 and over.
In September 2017, Neuroscience Research Australia (NeuRA), reported that in 2016 there were close to 22,000 hip fractures in Australia with an estimated cost of $908 million.
This means the rate of hip fractures in Australia are amongst the highest in the world.
“With Australia’s ageing population, the number of hip fractures each year is estimated to rise to more than 30,000 in the next five years at a cost exceeding $1 billion,” said Professor Jacqueline Close, Geriatrician and Co-Chair of NeuRA’s Australian and New Zealand Hip Fracture Registry.
One in three Australian adults aged 50 and over dies within 12 months of suffering a hip fracture. Older adults have a five-to-eight times higher risk of dying within the first three months of a hip fracture compared to those without a hip fracture. A study by Lobo et al (2018) found that the incidence rate of hip fractures was three times higher for women than for men.
Apart from the enormous pain and suffering involved directly, a hip fracture results in a loss of physical function, decreased social engagement, increased dependence and a significantly lower quality of life. Many Australians who experience a hip fracture are relocated from their home into a residential aged care facility.
Ultimately, a hip fracture results in a rapid decline in an older person’s health and outcomes are poor.
Hip fractures obviously place considerable financial burden on the Australian health-care system. But in addition to direct health system costs, hip fractures also involve substantial indirect costs associated with with formal and informal care and lost productivity and participation.
Our governments should therefore be doing everything they can to reduce this major health issue.
The 2011 Australian Burden of Disease Study reported that hip fracture burden generally increased with age – almost 30,000 disability-adjusted life years (DALYs) were attributable to hip fractures among those aged 65 and over, compared with more than 3,000 in those aged 45–64 (see chart opposite). The DALY is a summary measure (in years) of healthy life lost through premature death or through living with ill health due to illness or injury.
The Swedish study
A recently published study from Sweden (Helte et al 2021), found at least 50 per cent higher rates of hip bone fractures in post-menopausal women who consumed drinking water containing up to 1mg/L of fluoride.
This large, high-quality study involved a cohort of more than 4,000 older Swedish women and extended for 13 years – from 2004 to 2017. The largest source of exposure was from naturally occurring fluoride in drinking water, at concentrations at or below 1 mg/L – within the range of Australia’s fluoride concentration. Their total exposures also fell within the same range as women living in fluoridated parts of Australia.
In the 1990s several extensive Randomized Controlled Trials (RCT) were conducted with a hypothesis of giving relatively high doses of fluoride in order to decrease the risk of fracture for those with osteoporosis. Those studies found that instead of causing a decreased fracture risk, the fluoride actually caused an increased risk, especially for hip fractures. Attempts to use fluoride as a medication against osteoporosis, as a result, were abandoned.
Researchers concluded that although fluoride can increase bone mineral density (BMD), it simultaneously decreases bone quality and bone strength and therefore increases the risk of fractures. This new Swedish study involved much lower doses than the RCTs, but the women had much longer exposures, which appear to have the same effects as high-dose short-duration exposures. Emilie Helte and her research team also found that the Swedish women with higher fluoride exposure had slightly higher BMD, but also higher fracture rates despite the higher BMD.
The quality of this study
This study overcomes limitations of most of the previous epidemiological studies, some of which found no increased risk of bone fractures. But many previous studies had relatively crude group-level exposure measures, whereas this study involved individual-level exposures and was also the first to measure urine fluoride concentration, which provides a more accurate estimate of total fluoride intake.
Not only was fluoride exposure measured more carefully than most previous studies, this study also controlled for an extensive variety of potential confounding factors, including age, weight, smoking history, physical activity, alcohol intake, calcium intake, Vitamin D supplements, estrogen use, and other factors. No previous studies have controlled for so many potential confounding factors.
To better address long-term exposure, extended residential histories of drinking water fluoride concentration and estimates from detailed dietary questionnaires were used as a second exposure measure.
Fluoride’s effect on our bones
In our article Fluoride and our bones, we highlight the stream of scientific evidence showing that long-term ingestion of fluoridation chemicals damages our skeletal system. In that article we also highlight NHMRC’s blatant and irresponsible disregard of the published science and their indolent attitude not to undertake any relevant studies at least on a precautionary basis.
In a 1991 report, The Effectiveness of Water Fluoridation, NHMRC’s Working Group appropriately recommended that measurements of fluoride levels in bone be collected as part of a study. In its recommendation, they wrote:
“If skeletal fluorosis is occurring in Australians, it is likely to be slight, and it will most likely occur in those who drink large amounts of water, or whose renal function is impaired. Studies on bone fluoride collected at autopsy in selected individuals could provide needed reassurance that the current policy is not resulting in hazardous levels of bone accumulation.” – The Effectiveness of Water Fluoridation; 1991
If the Working Group had taken professional and objective measures and instigated a clinical study to examine bone-fluoride levels in Australians consuming water and processed foods containing fluoridation chemicals – as of course they should have done – this would have been the first fluoride harms-related study conducted by NHMRC. If this had been implemented, today we would have a reliable study to evaluate one important aspect of harms directly due to the ingestion of fluoridation chemicals.
THIRTY YEARS LATER, however, not only has this particular recommendation been completely ignored or conveniently avoided, there has still not been one single harms-related study conducted by NHMRC, other than dental fluorosis.
The bioaccumulation of fluoride
As we cover in detail in this article, fluoride is bio-accumulative, especially in our bones, building up steadily over many years. It can reach levels above 1000 parts per million (ppm) in people living in areas with water fluoride of around 1 mg/L – the maximum level of most of the women in this Swedish study.
