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MRC study in NE of England finds no increase in hip fracture among people exposed to water fluoride levels around 1 ppm (2000)

Comparison of hip fractures rates among men and women in Hartlepool and other parts of Cleveland

A study by researchers at the Medical Research Council’s Epidemiology Unit at the University of Southampton found no increased risk of hip fractures among people living in an area with water containing around 1 ppm of naturally occurring fluoride (Hartlepool) compared with those from areas with lower fluoride concentrations in their water (other parts of Cleveland). (1)

The MRC team interviewed just over 500 men and women aged 50 and over who had been admitted to one of three hospitals in the North East of England for hip fractures during a 17-month period.  All were asked about their lifetime residential history, height, weight, usual physical activities, alcohol consumption, smoking, recent medication and dietary sources of calcium and fluoride.

A second group of people were randomly selected from lists of patients registered with NHS general practitioners in the North East, who were matched up with the first group for age and gender. Around 500 were asked the same set of questions as the individuals who had been seen in hospital.

Residential histories of those taking part were checked against water company records of fluoride levels in order to estimate average exposure during their first 20 years of life and during the 20 years leading up to the study.

The MRC team found no statistically significant difference in hip fracture risk between individuals generally exposed during their lives to fluoride levels of around 1 ppm in their water and those exposed to lower levels.  They concluded that fracture risk should not, therefore, be a reason for withholding the introduction of water fluoridation to reduce dental caries.

1. Hillier S, Cooper C, Kellingray S, Russell G, Hughes H, Coggon D (2000): Fluoride in drinking water and risk of hip fracture in the UK: a case-control study. The Lancet, 355: 265-269.


“We found no evidence of any increase in the risk of hip fracture from fluoride in drinking water at concentrations of about 1 ppm.”

“Our findings should be generalisable to other places, and we conclude that fluoridation of water to1 ppm is not likely to have any important effect on the risk of hip fracture, and that concerns about this potential hazard should not be a reason for withholding the measure.”