Considering the increase in air pollution in recent years, delving into this topic to understand the cross paths between the harmful effects of air pollution and bone health is urgent. However, a recently published systematic review points to the existence of inconsistent associations between air pollution and osteoporosis risk, which could be explained by the heterogeneity in the characteristics of the subjects participating in the related studies published 16.ĭespite the fact that scientific evidence suggests the relationship between lung diseases and osteoporosis, currently no special attention is paid to air quality as a potential bone health problem. Since then, studies in this line have increased notably over the last few years, indicating that prolonged exposure to air pollution is linked to a decrease in bone quality 12- 14, and considered osteoporosis and fractures a modifiable risk factor 15. In the 1980s, the first studies were published that showed an association between air quality and bone quality, observing a significantly higher incidence of fractures in city dwellers compared to those residing in rural areas 9- 11. Likewise, there is strong scientific evidence that relates poor air quality in different work environments with the development of different respiratory diseases 7, 8. The relationship between air pollution and environmental lung diseases has been reported in numerous studies 4- 6. Air pollution has been shown to have a direct impact on health, causing various adverse effects 4. In 2015, the costs derived from pollution-related morbidity and mortality reached 21 billion dollars worldwide and an estimated number of premature deaths between 6 and 9 million people in 2060 due to outdoor air pollution 3.
The consequences derived from air pollution have a high economic and social impact. On the other hand, one of the most important risk factors for mortality at the population level is air pollution. The classic risk factors associated with the development of osteoporosis are age, a history of previous fracture or family history of osteoporosis, and prolonged estrogen deficiency 2. Osteoporosis is currently defined as "a systemic skeletal disease characterized by decreased bone mass and a structural alteration of the bone tissue that determines a decrease in bone resistance resulting in a significant increase in fragility and susceptibility to fractures" 1.
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