WATER FLUORIDATION AND FRACTURES IN OLDER WOMEN

在过去的45年里，有很多关于 公共供水加氟的健康问题。 最近的生态研究表明， 氟化和髋部骨折重新引发了争论（Jacobsen等人， Danielson等人）。 然而，这两项研究都是在 总体水平，并受到生态谬误。 为了 准确评估社区水氟化 和骨质疏松性骨折，研究必须对个人进行 混杂因素水平，如激素替代疗法和实际 可以测量氟化物暴露。 本研究的目的是 评价氟化作用与骨质疏松性骨折之间的关系 同时控制所有已知的混杂变量。 研究 人口将包括参加NIH支持的多学科研究的妇女， 骨质疏松性骨折研究中心（SOF）。 1986- 1988年， 超过9，700名女性（大于或等于65岁）入组 在四个地点的SOF研究中;波特兰，OR; Monogahela Valley，PA; 马里兰州的巴尔的摩和明尼苏达州的明尼阿波利斯。 大约有7,500名妇女 在五年内参加四次广泛的考试。 的SOF 数据库包含所有已知混杂变量、骨 多个地点的矿物质密度和断裂率。 的数据库 Monogahela山谷还包含有关氟化物暴露的信息， 从1950年到1990年，每个参与者的供水系统。 期间 在这项研究过程中，关于水系统中氟化物暴露的数据将 从参加波特兰特种作战部队的妇女中收集， 巴尔的摩和明尼阿波利斯研究中心。 巴尔的摩和明尼阿波利斯 分别自1952年和1957年以来被氟化，而波特兰和 莫农加希拉山谷的大部分地区没有氟化。 首要目标 这项研究的目的是确定氟化物暴露状况是否 与骨折发生率、骨矿物质密度和/或 一旦混杂变量，个体水平的骨丢失率 是受控制的。 鉴于USPHS促进水的氟化， 在1.0 ppm，以防止龋齿，消费这种水的效果 需要澄清的问题。

For the past 45 years, there has been a great deal of debate regarding the health issues surrounding the fluoridation of public water supplies. Recent ecological studies demonstrating a positive association between fluoridation and hip fracture have rekindled the debate (Jacobsen et al., Danielson et al.). Both of these studies, however, were conducted at the aggregate level and are subject to the ecologic fallacy. In order to accurately evaluate the association between community water fluoridation and osteoporotic fractures, research must be conducted on the individual level where confounders such as hormone replacement therapy and actual fluoride exposure can be measured. The purpose of this study is to evaluate the association between fluoridation and osteoporotic fractures while controlling for all known confounding variables. The study population will consist of women enrolled in the NIH supported multi- center Study of Osteoporotic Fractures (SOF). During 1986-88, slightly more than 9,700 women (greater than or equal to 65 years) were enrolled in the SOF study at four sites; Portland, OR; the Monogahela Valley, PA; Baltimore, MD; and Minneapolis, MN. Approximately 7,500 women have taken part in four extensive examinations over a five-year period. The SOF database contains information on all known confounding variables, bone mineral density at multiple sites, and fracture rates. The database for the Monogahela Valley also contains information on fluoride exposure via water systems for each of the participants from 1950-1990. During the course of this study, data on fluoride exposure from water systems will be gathered from the women participating in SOF at the Portland, Baltimore, and Minneapolis study sites. Baltimore and Minneapolis have been fluoridated since 1952 and 1957 respectively, while Portland and the majority of the Monongahela Valley are not fluoridated. The primary goal of the study will be to determine if fluoride exposure status is associated with fracture incidence rates, bone mineral density, and/or the rate of bone loss on the individual level once confounding variables are controlled for. Given that the USPHS promotes fluoridation of water at 1.0 ppm to prevent dental caries, the effect of consuming such water on osteoporotic changes needs to be clarified.