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STUDY OBJECTIVE: The aim of the study was to examine the relationship between water fluoride concentration and the incidence of hip fracture, since evidence on this is at present inconsistent. DESIGN: Numbers of hospital admissions for fractures of proximal femur were obtained from hospital activity analysis data for the years 1978-1982. The fracture rates were compared with water fluoride concentrations in 39 county districts of England and Wales (fluoride concentrations had been measured in these districts between 1969 and 1973 as part of the British Regional Heart Study). PATIENTS: During the study period, 4121 men and 16,272 women aged 45 years and over were discharged from hospital after hip fracture. RESULTS: Poor correlations were found between discharge rates and both total (r = 0.16, p = 0.34) and natural (r = 0.01, p = 0.95) water fluoride concentrations. CONCLUSIONS: Water fluoridation to levels of around 1 mg/litre is unlikely to reduce hip fracture incidence markedly in this country.

Original publication




Journal article


Journal of epidemiology and community health

Publication Date





17 - 19


MRC Environmental Epidemiology Unit, Southampton General Hospital, United Kingdom.


Humans, Hip Fractures, Fluorides, Calcium, Patient Discharge, Fluoridation, Aged, Middle Aged, England, Wales, Female, Male