Pollution as an Emerging Risk Factor for Osteoporosis
In addition to well-known factors like poor diet, lack of exercise, and smoking, new research suggests that pollution could also increase the risk of osteoporosis, a condition that weakens bones and makes them more prone to fractures, the Washington Post reports.
Experts are now exploring how air pollution, heavy metals, and chemical contaminants may contribute to the deterioration of bone health.
Osteoporosis, which affects around 10 million Americans aged 50 and older, is more common in women, particularly after menopause when rapid bone loss occurs due to a decrease in estrogen. While the condition is traditionally associated with lifestyle choices and genetics, studies are increasingly linking it to environmental factors, such as pollution.
Research has revealed that exposure to particulate matter in the air, such as PM2.5 (tiny particles from vehicle emissions and industrial pollution), can nearly double the risk of osteoporosis. In one study, even low levels of air pollution were found to have an impact on bone health, increasing hospital admissions for bone fractures. Nitrogen oxides, another pollutant emitted by vehicles and industrial activities, have also been shown to accelerate bone density loss, particularly in postmenopausal women.
Heavy metals like lead and cadmium, which are found in food and water due to industrial contamination, can also contribute to poor bone health. Lead exposure from sources like old paint or contaminated water pipes has been linked to reduced bone mineral density, while cadmium, which accumulates in bones, has been associated with a significantly higher risk of osteoporosis.
“Pollution is a neglected risk factor for osteoporosis because we have long focused on lifestyle factors, hormones, and genetics,” says Tuan Van Nguyen, an epidemiology professor at the University of New South Wales, Australia.
Studies have shown that these contaminants may disrupt bone metabolism, lead to chronic inflammation, and even cause vitamin D deficiency—factors that all contribute to weakened bones.
Another emerging concern is the class of chemicals known as “forever chemicals” or PFAS, which are commonly found in household products like nonstick cookware, water-resistant clothing, and food packaging. PFAS exposure has been linked to a higher risk of fractures and weakened bone health. A study conducted in Ronneby, Sweden, where residents had been exposed to high levels of PFAS through contaminated water, found that the risk of hip fractures was 12% higher in those with the highest exposure.
While the evidence is not yet definitive, experts suggest several mechanisms by which pollution might harm bones. One theory is that exposure to air pollution could disrupt bone metabolism by triggering inflammation, impairing the body’s ability to maintain bone density. Other studies have found that pollutants such as PM2.5 might increase the activity of bone-resorbing cells, called osteoclasts, while decreasing the activity of bone-forming cells, known as osteoblasts.
Although the effects of pollution on bone health are typically smaller than those of lifestyle choices such as smoking, pollution remains an unavoidable risk factor, especially as climate change exacerbates air pollution through wildfires and flooding. As society faces these environmental challenges, experts stress the importance of taking proactive measures to protect bone health, such as increasing physical activity, maintaining a balanced diet, and avoiding smoking and excessive alcohol consumption.
“We should be vigilant about keeping our bones healthy… We cannot escape pollution, but we can manage other factors that contribute to osteoporosis,” says Diddier Prada, an environmental epidemiologist at Icahn School of Medicine at Mount Sinai.