Association of air particulate pollution with bone loss over time and bone fracture risk: analysis of data from two independent studies Diddier Prada,

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Association of air particulate pollution with bone loss over time and bone fracture risk: analysis of data from two independent studies Diddier Prada, PhD, Jia Zhong, ScD, Elena Colicino, PhD, Antonella Zanobetti, PhD, Prof Joel Schwartz, PhD, Nicholas Dagincourt, MSc, Shona C Fang, PhD, Itai Kloog, PhD, Joseph M Zmuda, PhD, Prof Michael Holick, PhD, Prof Luis A Herrera, PhD, Prof Lifang Hou, PhD, Prof Francesca Dominici, PhD, Prof Benedetta Bartali, PhD, Prof Andrea A Baccarelli, PhD The Lancet Planetary Health Volume 1, Issue 8, Pages e337-e347 (November 2017) DOI: 10.1016/S2542-5196(17)30136-5 Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 1 Population and concentrations of fine air particulate pollution in the northeast-mid-Atlantic USA Medicare population by zip code (A) and average PM2·5 concentrations per zip code between 2003 and 2010 (B). PM2.5=fine particulate matter less than 2·5 μm. The Lancet Planetary Health 2017 1, e337-e347DOI: (10.1016/S2542-5196(17)30136-5) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 2 Long-term exposure to PM2·5 and risk of hospital admission for bone fractures (A) Scatter plot of the multivariable-adjusted residuals from the standard regression model (not including PM2·5) versus level of exposure to fine particulate matter less than 2·5 μm (PM2·5). Blue line corresponds to zero partial residual value. (B) Spline for the multivariable-adjusted association between PM2·5 exposure and number of hospital admissions of Medicare enrollees per zip code, from 2003 to 2010. Horizontal dotted line represents zero effect. (C) Density plot of exposure to PM2·5 in the Medicare analysis. The vertical dotted line in B and C represents the primary annual PM2·5 standard of 12 μg/m3 mandated by the US Environmental Protection Agency. The Lancet Planetary Health 2017 1, e337-e347DOI: (10.1016/S2542-5196(17)30136-5) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions