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TheCoolinator TheCoolinator is offline
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Join Date: Mar 2010
Location: Mean Streets of New York
Old Aug 21st, 2010, 11:49 AM       
Fluoride & Bone Fracture: Human Clinical Trials (back to top)
Bayley TA, et al. (1990). Fluoride-induced fractures: relation to osteogenic effect. Journal of Bone and Mineral Research 5(Suppl 1):S217-22. (See abstract)
Dambacher MA, et al. (1986). Long-term fluoride therapy of postmenopausal osteoporosis. Bone 7: 199-205. (See abstract
Gerster JC, et al. (1983). Bilateral fractures of femoral neck in patients with moderate renal failure receiving fluoride for spinal osteoporosis. British Medical Journal (Clin Res Ed) 287(6394):723-5. (See abstract)
Gutteridge DH, et al. (2002). A randomized trial of sodium fluoride (60 mg) +/- estrogen in postmenopausal osteoporotic vertebral fractures: increased vertebral fractures and peripheral bone loss with sodium fluoride; concurrent estrogen prevents peripheral loss, but not vertebral fractures. Osteoporosis International 13(2):158-70. (See abstract)
Gutteridge DH, et al. (1990). Spontaneous hip fractures in fluoride-treated patients: potential causative factors. Journal of Bone and Mineral Research 5 Suppl 1:S205-15. (See abstract)
Haguenauer D, et al. (2000). Fluoride for the treatment of postmenopausal osteoporotic fractures: a meta-analysis. Osteoporosis International 11(9):727-38. (See abstract)
Hedlund LR, Gallagher JC. (1989). Increased incidence of hip fracture in osteoporotic women treated with sodium fluoride. Journal of Bone and Mineral Research 4:223-5. (See abstract)
Inkovaara J, et al. (1975). Prophylactic fluoride treatment and aged bones. British Medical Journal 3(5975):73-4. (See abstract)
Kleerekoper M, et al. (1991). A randomized trial of sodium fluoride as a treatment for postmenopausal osteoporosis. Osteoporosis International 1(3):155-61. (See abstract)
Meunier PJ, et al. (1998). Fluoride salts are no better at preventing new vertebral fractures than calcium-vitamin D in postmenopausal osteoporosis: the FAVOStudy. Osteoporosis International 8: 4-12. (See abstract)
National Research Council. (2006). Musculoskeletal Effects. In: Fluoride in Drinking Water: A Scientific Review of EPA's Standards. National Academies Press, Washington D.C. (See chapter)
O'Duffy JD, et al. (1986). Mechanism of acute lower extremity pain syndrome in fluoride-treated osteoporotic patients. American Journal of Medicine 80: 561-6. (See abstract)
Orcel P, et al. (1990). Stress fractures of the lower limbs in osteoporotic patients treated with fluoride. Journal of Bone and Mineral Research 5(Suppl 1): S191-4. (See abstract)
Orcel P, et al. (1987). [Spontaneous fissures and fractures of the legs in patients with osteoporosis treated with sodium fluoride]. Presse Med. 16: 571-5. (See abstract)
Pak CY, et al. (1996). Comparison of nonrandomized trials with slow-release sodium fluoride with a randomized placebo-controlled trial in postmenopausal osteoporosis. Journal of Bone and Mineral Research 11(2):160-8. (See abstract)
Pak CY, et al. (1995). Treatment of postmenopausal osteoporosis with slow-release sodium fluoride. Final report of a randomized controlled trial. Annals of Internal Medicine 123: 401-8. (See abstract)
Riggs BL, et al. (1990). Effect of Fluoride treatment on the Fracture Rates in Postmenopausal Women with Osteoporosis. New England Journal of Medicine 322:802-809. (See abstract)
Rubin CD, et al. (2001). Sustained-release sodium fluoride in the treatment of the elderly with established osteoporosis. Archives of Internal Medicine 161(19):2325-33. (See abstract)
Schnitzler CM, et al. (1990). Bone fragility of the peripheral skeleton during fluoride therapy for osteoporosis. Clinical Orthopaedics (261):268-75. (See abstract)
Schnitzler CM, Solomon L. (1985). Trabecular stress fractures during fluoride therapy for osteoporosis. Skeletal Radioliology 14(4):276-9. (See abstract)
Fluoride & Bone Fracture: Epidemiological Studies (back to top)
Studies reporting association between fluoridated water (< 1.2 ppm fluoride) & hip fracture.(back to top)
a) Cooper C, et al. (1990). Water fluoride concentration and fracture of the proximal femur. Journal of Epidemiology and Community Health 44: 17-19.
b) Cooper C, et al. (1991). Water fluoridation and hip fracture. Letter. Journal of the American Medical Association 266: 513-514. (A reanalysis of data presented in 1990 paper). (See letter)
Danielson C, et al. (1992). Hip fractures and fluoridation in Utah's elderly population. Journal of the American Medical Association 268(6): 746-748. (See abstract)
Hegmann KT, et al. (2000). The effects of fluoridation on degenerative joint disease (DJD) and hip Fractures. Abstract # 71 of the 33rd annual meeting of the Society for Epidemiological Research. American Journal of Epidemiology S18. (See abstract).
Jacobsen SJ, et al. (1992). The association between water fluoridation and hip fracture among white women and men aged 65 years and older; a national ecologic study. Annals of Epidemiology 2: 617-626. (See abstract)
Jacobsen SJ, et al. (1990). Regional variation in the incidence of hip fracture: US white women aged 65 years and olders. Journal of the American Medical Association 264(4): 500-2. (See excerpt)
a) Jacqmin-Gadda H, et al. (1995). Fluorine concentration in drinking water and fractures in the elderly. Journal of the American Medical Association 273: 775-776 (letter). (See letter)
b) Jacqmin-Gadda H, et al. (1998). Risk factors for fractures in the elderly. Epidemiology 9(4): 417-423. (An elaboration of the 1995 study referred to in the JAMA letter). (See abstract)
Keller C. (1991) Fluorides in drinking water. Unpublished results. Discussed in: Gordon SL, Corbin SB. (1992). Summary of Workshop on Drinking Water Fluoride Influence on Hip Fracture on Bone Health. Osteoporosis International 2: 109-117. (See excerpt)
Kurttio PN, et al. (1999). Exposure to natural fluoride in well water and hip fracture: A cohort analysis in Finland. American Journal of Epidemiology 150(8): 817-824.(See abstract)
May DS, Wilson MG. (1992). Hip fractures in relation to water fluoridation: an ecologic analysis. Unpublished results. Discussed in: Gordon SL, Corbin SB. (1992). Summary of Workshop on Drinking Water Fluoride Influence on Hip Fracture on Bone Health. Osteoporosis International 2: 109-117. (See excerpt)
Suarez-Almazor M, et al. (1993). The fluoridation of drinking water and hip fracture hospitalization rates in two Canadian communities. American Journal of Public Health 83: 689-693. (See abstract)
The authors of this study conclude there is no association between fluoridation and hip fracture. However, their own data reveals a significant increase in hip fracture for men living in the fluoridated area. According to the study, "although a statistically significant increase in the risk of hip fracture was observed among Edmonton men, this increase was relatively small (RR=1.12)."
b) Studies investigating association between water-fluoride levels higher than fluoridated water (2 to 5 ppm) & bone/hip fracture.(back to top)
Alarcon-Herrera MT, et al. (2001). Well Water Fluoride, Dental fluorosis, Bone Fractures in the Guadiana Valley of Mexico. Fluoride 34(2): 139-149. (See study)
Li Y, et al. (2001). Effect of long-term exposure to fluoride in drinking water on risks of bone fractures. Journal of Bone and Mineral Research 16(5):932-9. (See abstract)
Sowers MR, et al. (1986). The relationship of bone mass and fracture history to fluoride and calcium intake: a study of three communities. American Journal of Clinical Nutrition 44:889-98. (See abstract)
Sowers M, et al. (1991). A prospective study of bone mineral content and fracture in communities with differential fluoride exposure. American Journal of Epidemiology 133: 649-660. (See abstract)
Sowers M, et al.(2005) Elevated serum fluoride concentrations in women are not related to fractures and bone mineral density. Journal of Nutrition 135:2247-52. (See abstract)
c) Studies reporting no association, or a negative association, between fluoridated water & hip fracture.(back to top)
(Note that in 3 of these 9 studies, an association was found between fluoride and some form of fracture - i.e. distal forearm. See notes and quotes below.)
Arnala I, et al. (1986). Hip fracture incidence not affected by fluoridation. Osteofluorosis studied in Finland. Acta Orthopaedica Scandinavica 57: 344-348. (See abstract)
Cauley J. et al. (1995). Effects of fluoridated drinking water on bone mass and fractures: the study of osteoporotic fractures. Journal of Bone and Mineral Research 10(7): 1076-86. (See abstract)
Feskanich D, et al. (1998). Use of toenail fluoride levels as an indicator for the risk of hip and forearm fractures in women. Epidemiology 9(4): 412-6.(See abstract)
While this study didn't find an association between water fluoride and hip fracture, it did find an association - albeit non-significant 1.6 (0.8-3.1) - between fluoride exposure and elevated rates of forearm fracture.
Hillier S, et al. (2000). Fluoride in drinking water and risk of hip fracture in the UK: a case control study. The Lancet 335: 265-2690. (See abstract)
Jacobsen SJ, et al. (1993). Hip fracture incidence before and after the fluoridation of the public water supply, Rochester, Minnesota. American Journal of Public Health 83: 743-745. (See abstract)
Karagas MR, et al. (1996). Patterns of fracture among the United States elderly: Geographic and fluoride effects. Annals of Epidemiology 6 (3): 209-216. (See abstract | See critique of study)
As with Feskanich (1998) this study didn't find an association between fluoridation & hip fracture, but it did find an association between fluoridation and distal forearm fracture, as well as proximal humerus fracture. "Independent of geographic effects, men in fluoridated areas had modestly higher rates of fractures of the distal forearm and proximal humerus than did men in nonfluoridated areas."
Lehmann R, et al. (1998). Drinking water fluoridation: Bone mineral density and hip fracture incidence. Bone 22: 273-278. (See abstract)
Madans J, et al. (1983). The relationship between hip fracture and water fluoridation: an analysis of national data. American Journal of Public Health 73: 296-298. (See abstract)
Phipps KR, et al. (2000). Community water fluoridation, bone mineral density and fractures: prospective study of effects in older women. British Medical Journal 321: 860-4. (See abstract | See Study | See BMJ letter responding to study| See critique of study )
This study reported a decreased incidence of hip fracture in fluoridated areas. However, as with Feskanich (1998) and Karagas (1996), the study also found an association between fluoridation and other types of fracture - in this case, wrist fracture. "There was a non-significant trend toward an increased risk of wrist fracture."
See also:
Bernstein DS, et al. (1966). Prevalence of osteoporosis in high- and low-fluoride areas in North Dakota. Journal of the American Medical Association 198: 499-504. (See abstract & critique)
Lee JR. (1993). Fluoridation & hip fracture. Fluoride 26(4): 274-277. (See paper)
National Research Council. (2006). Musculoskeletal Effects. In: Fluoride in Drinking Water: A Scientific Review of EPA's Standards. National Academies Press, Washington D.C. (See chapter)
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