Abstract

OBJECTIVE:

To test the effect of water fluoridated to 1 ppm on the incidence of hip fractures in the elderly.

DESIGN:

Ecological cohort.

SETTING:

The incidence of femoral neck fractures in patients 65 years of age or older was compared in three communities in Utah, one with and two without water fluoridated to 1 ppm.

PATIENTS:

All patients with hip fractures who were 65 years of age and older over a 7-year period in the three communities, excluding (1) those with revisions of hip fractures, (2) those in whom the hip fracture was anything but a first diagnosis, (3) those in whom metastatic disease was present, or (4) those in whom the fracture was a second fracture (n = 246).

OUTCOME MEASURE:

Rate of hospital discharge for hip fracture.

RESULTS:

The relative risk for hip fracture for women in the fluoridated area was 1.27 (95% confidence interval [CI] = 1.08 to 1.46) and for men was 1.41 (95% CI = 1.00 to 1.81) relative to the nonfluoridated areas.

CONCLUSIONS:

We found a small but significant increase in the risk of hip fracture in both men and women exposed to artificial fluoridation at 1 ppm, suggesting that low levels of fluoride may increase the risk of hip fracture in the elderly.