EVALUATION OF ENVIRONMENTAL AND SOCIOECONOMIC FACTORS CONTRIBUTING TO FRAGILITY FRACTURES IN INDIANS

Abstract

Objective: Osteoporosis causes fragility fractures that also occur in patients with bone mineral density (BMD) in the normal or osteopenic range, suggesting role of risk factors that are unrelated or partially related to BMD. The study aims at highlighting the link between 3 conditions, that are environment and occupation related risk factors and that are widely prevalent in India, and development of fragility fractures. Methods: A Case Control study was done by recruiting 110 Cases with history of recent fragility fractures and 84 Controls with no history of recent fractures. 3 study parameters, village dwelling, conventional farming, and poverty, were chosen the presence or absence of which were documented in participants. This was followed by an ODDS ratio analysis. Results: The Odds of village dwellers, conventional farmers, and socioeconomically poor individuals to develop fragility fractures were both significant and large. Conclusion: Urbanization is a risk in the development of fragility fractures. However, this study points that village dwelling in India is associated with the development of fragility fractures. Similarly, Odds of farmers exposed to pesticides and agrochemicals to develop fragility fractures is large and significant. Pesticides and agrochemicals act as endocrine disruptors and bone health is closely linked to endocrine system. Fragility fractures among farmers may be due to endocrine disrupting properties of pesticides and agrochemicals. Socioeconomic deprivation is a known risk in the development of osteoporosis. This study too highlights that the odds of individuals living in poverty to develop fragility fractures is significant and large.