Fluorine Concentration in Drinking Water and Fractures in the Elderly

To the Editor. —Although it was initially hypothesized that fluorine could protect against hip fractures, three recent studies have reported an increase in the risk of hip fractures in communities exposed to fluoridated water,^1-3 and a fourth suggested no association between water fluoridation and hip fractures.⁴ Among these studies, three were ecological and did not take into account major individual risk factors.^2-4 In the only study using individual data,³ the fluorine concentrations were high (1 mg/L in the control communities and 4 mg/L for the higher-fluorine community).

We report results of a population-based study of the relationship between concentrations of fluorine and calcium in drinking water and risk of hip fractures or fractures at any site. Results reported herein are based on the sample of the

Paquid study⁵ of normal and pathological aging, which comprised 3777 subjects aged 65 years or older living at home