What's your risk of breaking a bone?

Researchers from the University of Southampton have led a study into the risks of an individual experiencing a fracture in their lifetime.

The team undertook an analysis of the UK Clinical Practice Research Datalink (CPRD), which contains anonymised electronic health records for approximately 7% of the UK population. The occurrence of a fracture between 1988 and 2012 was determined from the CPRD for all individuals <18 years of age, and used to calculate fracture incidence rates for age, sex and ethnicity.

Writing in the journal Bone, the researchers noted that there were marked differences in fracture rates according to where individuals lived. The highest fracture rates were in Scotland and Northern Ireland, where rates were around 50% greater than those in London.

In men, fracture rates were noticeably greater in areas of socioeconomic deprivation. The researchers suggest this may reflect greater exposure to trauma through manual work, together with potentially greater rates of smoking and other adverse lifestyle factors.

The overall fracture rate was higher for women over the age of 50 years old (155 per 10,000 persons per year) compared to men over the age of 50 (72 per 10,000 persons per year). White men and women had substantially greater fracture rates than Asian individuals, while black people had the lowest fracture rates — under half the rates in white individuals.

“Our study has provided insights into factors that may influence fracture rates across different sections of the population,” said Professor Nicholas Harvey, co-leader of the study. “Further work will be needed to fully understand what underlies these differences; for example, variations in diet, lifestyle, body build, employment and genetic factors may all contribute.”

The study was funded by the National Osteoporosis Society (NOS), which is working in partnership with health professionals across the UK to ensure everyone has access to fracture liaison services. According to NOS Clinical and Operations Director Fizz Thompson, the study should act as a “wake-up call” to NHS decision-makers who have the power to prevent fractures.

“They can begin to solve this problem by having the right services and staffing in place to systematically identify those at high risk of breaking bones, assess them for osteoporosis and start them on treatment,” Thompson said.

“If they don’t act decisively to prevent future fractures, local hospitals and GPs will continue to see fracture after fracture, at great cost to the NHS and even greater cost in quality of life.”

Professor Cyrus Cooper, a co-author on the study, said the research “forms part of a larger program of work addressing risk factors for fracture across the life course”.

“These findings will be built upon in a wider program of analyses to document the burden of osteoporotic fracture in the UK and will have important messages for public health planning in future years,” he said.