Skip to main content
SpringerLink
Log in

Systematic review of the association between climate and hip fractures

  • Review Paper
  • Published:
International Journal of Biometeorology Aims and scope Submit manuscript

Abstract

This study aims to systematically review epidemiological studies that evaluate the relationship between meteorology and the incidence of hip fracture (HF). After a search in Scopus, PubMed, and Embase, two independent authors assessed the relevance of studies and extracted data for description. From each study, we extracted the geographic and temporal scope, design, study variables (meteorological and related to HF), statistical analysis, and estimated associations. Of a total of 134 works, 20 studies were selected. All use an ecological design but one case-crossover. Most studies have been conducted in northern latitudes. The analysis methodology did not take into account the temporal structure of the data in 10 studies (regression and linear correlations); the rest used Poisson regression (7) and ARIMA model (3). Most studies showed significant positive associations with rainfall, especially in the form of snow: HF relative risk (RR) on days with precipitation vs. days without precipitation that ranged from 1.14 (95 % confidence interval (CI)1.04 to 1.24) to 1.60 (95 % CI 1.06 to 2.41), the temperature, with RR by one degree Celsius decline from 1.012 (95 % CI 1.004 to 1.020) to 1.030 (95 % CI 1.023 to 1.037), and wind (3) RR FC windiest days vs. calm days: 1.32 (95 % CI 1.10 to 1.58) to 1.35 (95 % CI 0.88 to 2.08). This review shows that analytic methods are very heterogeneous and poorly adapted to the temporary nature of the data. Studies confirm a certain seasonality, with more fractures in winter and meaningful relationships with meteorological conditions typical of this season.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Aaron JE, Gallagher JC, Nordin BE (1974) Seasonal variation of histological osteomalacia in femoral-neck fractures. Lancet 2:84–85

    Article  CAS  Google Scholar 

  • Atherton WG, Harper WM, Abrams KR (2005) A year’s trauma admissions and the effect of the weather. Injury 36:40–46

    Article  CAS  Google Scholar 

  • Bastow MD, Rawlings J, Allison SP (1983) Undernutrition, hypothermia, and injury in elderly women with fractured femur: an injury response to altered metabolism? Lancet 1:143–146

    Article  CAS  Google Scholar 

  • BCMA B. C. M. A. (2013) Osteoporosis: diagnosis, treatment and fracture prevention, p 17. Retrieved from http://www.bcguidelines.ca/pdf/osteoporosis.pdf

  • Beynon C, Wyke S, Jarman I et al (2011) The cost of emergency hospital admissions for falls on snow and ice in England during winter 2009/10: a cross sectional analysis. Environ Health 10:60

    Article  Google Scholar 

  • Bischoff-Ferrari HA (2012) Vitamin D and fracture prevention. Rheum Dis Clin North Am 38:107–113

    Article  Google Scholar 

  • Bischoff-Ferrari HA, Orav JE, Barrett JA, Baron JA (2007) Effect of seasonality and weather on fracture risk in individuals 65 years and older. Osteoporos Int 18:1225–1233

    Article  CAS  Google Scholar 

  • Bischoff-Ferrari HA, Can U, Staehelin HB et al (2008) Severe vitamin D deficiency in Swiss hip fracture patients. Bone 42:597–602

    Article  CAS  Google Scholar 

  • Bischoff-Ferrari HA, Dawson-Hughes B, Whiting SJ (2011) Vitamin D supplementation and fracture risk. Arch Intern Med 171:265

    Article  Google Scholar 

  • Bulajic-Kopjar M (2000) Seasonal variations in incidence of fractures among elderly people. Inj Prev 6:16–19

    Article  CAS  Google Scholar 

  • Burget F, Pleva L, Kudrna K, Kudrnová Z (2012) Incidence of proximal femur fractures in relation to seasons of the year and weather. Acta Chir Orthop Traumatol Cech 79:140–143

    CAS  Google Scholar 

  • Caniggia M, Morreale P (1989) Epidemiology of hip fractures in Siena, Italy, 1975–1985. Clin Orthop Relat Res 131–138

  • Carter MI, Hinton PS (2014) Physical activity and bone health. Mo Med 111:59–64

    Google Scholar 

  • CASPe. Critical Appraisal Skills Programme Español. http://www.redcaspe.org/drupal/. Accessed 3 June 2013

  • Chesser TJS, Howlett I, Ward AJ, Pounsford JC (2002) The influence of outside temperature and season on the incidence of hip fractures in patients over the age of 65. Age Ageing 31:343–348

    Article  Google Scholar 

  • Chiu KY, Ng TP, Chow SP (1996) Seasonal variation of fractures of the hip in elderly persons. Injury 27:333–336

    Article  CAS  Google Scholar 

  • Cinar N, Harmanci A, Yildiz BO, Bayraktar M (2014) Vitamin D status and seasonal changes in plasma concentrations of 25-hydroxyvitamin D in office workers in Ankara, Turkey. Eur J Intern Med 25:197–201

    Article  CAS  Google Scholar 

  • Crawford JR, Parker MJ (2003) Seasonal variation of proximal femoral fractures in the United Kingdom. Injury 34:223–225

    Article  Google Scholar 

  • Dennison E, Mohamed MA, Cooper C (2006) Epidemiology of osteoporosis. Rheum Dis Clin North Am 32:617–629

    Article  Google Scholar 

  • Douglas AS (1993) Seasonality of hip fracture and haemorrhagic disease of the newborn. Scott Med J 38:37–40

    CAS  Google Scholar 

  • Frihagen F, Pleva L, Kudrna K, Kudrnova Z (2011) Ice and snow in Oslo gave a marked increase in distal radius fractures, but not hip fractures. Osteoporos Int 22:S169–S170

    Google Scholar 

  • Furelos M, Colino AL, Trobajo JE, Quevedo LA (2001) Hip fractures, seasonal variations and influence of climatological parameters. Rev Ortop Traumatol 45:384–388

  • Jacobsen SJ, Sargent DJ, Atkinson EJ et al (1995) Population-based study of the contribution of weather to hip fracture seasonality. Am J Epidemiol 141:79–83

    CAS  Google Scholar 

  • Kanis JA, Borgström F, Compston J et al (2013) SCOPE: a scorecard for osteoporosis in Europe. Arch Osteoporos 8:144

    Article  CAS  Google Scholar 

  • Katsouyanni K, Schwartz J, Spix C et al (1996) Short term effects of air pollution on health: a European approach using epidemiologic time series data: the APHEA protocol. J Epidemiol Community Health 50(Suppl 1):S12–S18

    Article  Google Scholar 

  • Lau EM, Gillespie BG, Valenti L, O’Connell D (1995) The seasonality of hip fracture and its relationship with weather conditions in New South Wales. Aust J Public Health 19:76–80

    Article  CAS  Google Scholar 

  • Lauritzen JB, Schwarz P, McNair P et al (1993) Radial and humeral fractures as predictors of subsequent hip, radial or humeral fractures in women, and their seasonal variation. Osteoporos Int 3:133–137

    Article  CAS  Google Scholar 

  • Levy AR, Bensimon DR, Mayo NE, Leighton HG (1998) Inclement weather and the risk of hip fracture. Epidemiology 9:172–177

    Article  CAS  Google Scholar 

  • Lin H-C, Xiraxagar S (2006) Seasonality of hip fractures and estimates of season-attributable effects: a multivariate ARIMA analysis of population-based data. Osteoporos Int 17:795–806

    Article  Google Scholar 

  • Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:477–501

    Article  CAS  Google Scholar 

  • Lofthus CM, Osnes EK, Falch JA et al (2001) Epidemiology of hip fractures in Oslo, Norway. Bone 29:413–418

    Article  CAS  Google Scholar 

  • Mirchandani S, Aharonoff GB, Hiebert R et al (2005) The effects of weather and seasonality on hip fracture incidence in older adults. Orthopedics 28:149–155

    Google Scholar 

  • Modarres R, Ouarda TBMJ, Vanasse A et al (2012) Modeling seasonal variation of hip fracture in Montreal, Canada. Bone 50:909–916

    Article  Google Scholar 

  • Modarres R, Ouarda TBMJ, Vanasse A et al (2014) Modeling climate effects on hip fracture rate by the multivariate GARCH model in Montreal region, Canada. Int J Biometeorol 58:921–930

    Article  Google Scholar 

  • Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269

    Article  Google Scholar 

  • Morency P, Voyer C, Burrows S, Goudreau S (2012) Outdoor falls in an urban context: winter weather impacts and geographical variations. Can J Public Health 103:218–222

  • Morgan SL (2013) Dietary supplements and medical foods for osteopenia and osteoporosis. J Clin Densitom 16:394–401

    Article  Google Scholar 

  • Morgenstern H (1995) Ecologic studies in epidemiology: concepts, principles, and methods. Annu Rev Public Health 16:61–81

    Article  CAS  Google Scholar 

  • Murray IR, Howie CR, Biant LC (2011) Severe weather warnings predict fracture epidemics. Injury 42:687–690

    Article  Google Scholar 

  • (NAMS), N. A. M (2010) Management of osteoporosis in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause (New York, NY) 17(1):25–54. doi:10.1097/gme.0b013e3181c617e6

    Article  Google Scholar 

  • Parker MJ, Martin S (1994) Falls, hip fractures and the weather. Eur J Epidemiol 10:441–442

    Article  CAS  Google Scholar 

  • Parker MJ, Twemlow TR, Pryor GA (1996) Environmental hazards and hip fractures. Age Ageing 25:322–325

    Article  CAS  Google Scholar 

  • Pasco JA, Henry MJ, Kotowicz MA et al (2004) Seasonal periodicity of serum vitamin D and parathyroid hormone, bone resorption, and fractures: the Geelong Osteoporosis Study. J Bone Miner Res 19:752–758

    Article  CAS  Google Scholar 

  • Romley JA, Jena AB, O'Leary JF, Goldman DP (2013) Spending and mortality in US acute care hospitals. Am J Manag Care 19:e46–e54

    Google Scholar 

  • Rothman KJ (2012) What is causation? In: Rothman KJ (ed) Epidemiology: an introduction. Oxford University Press, Oxford, p 282

    Google Scholar 

  • Schneider EL, Guralnik JM (1990) The aging of America. Impact on health care costs. JAMA 263:2335–2340

    Article  CAS  Google Scholar 

  • Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA 283:2008–2012

    Article  CAS  Google Scholar 

  • Tenías JM, Estarlich M, Fuentes-Leonarte V et al (2009) Short-term relationship between meteorological variables and hip fractures: an analysis carried out in a health area of the Autonomous Region of Valencia, Spain (1996–2005). Bone 45:794–798

    Article  Google Scholar 

  • Turner RM, Hayen A, Dunsmuir WTM, Finch CF (2011) Air temperature and the incidence of fall-related hip fracture hospitalisations in older people. Osteoporos Int 22:1183–1189

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Research Support Unit, La Mancha Centro General Hospital, Avenida Constitución 3, 13600, Alcázar de San Juan, Spain

    Carmen Román Ortiz & José María Tenías

  2. Spanish Consortium for Research on Epidemiology and Public Health, (CIBERESP), Barcelona, Spain

    José María Tenías, Marisa Estarlich & Ferran Ballester

  3. Higher Center for Public Health Research (Centro Superior de Investigación en Salud Pública), CSISP, Valencia, Spain

    Marisa Estarlich & Ferran Ballester

  4. University of Valencia, Valencia, Spain

    Ferran Ballester

Authors
  1. Carmen Román Ortiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. José María Tenías
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marisa Estarlich
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ferran Ballester
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to José María Tenías.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Román Ortiz, C., Tenías, J.M., Estarlich, M. et al. Systematic review of the association between climate and hip fractures. Int J Biometeorol 59, 1511–1522 (2015). https://doi.org/10.1007/s00484-014-0945-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00484-014-0945-y

Keywords

Search

Navigation