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Comment & Response
November 9, 2020

Factors Associated With the Declining Trends of Hip Fractures—Reply

Author Affiliations
  • 1Clinical Trials and Outcomes Branch, National Institute for Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland
  • 2Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2021;181(2):296. doi:10.1001/jamainternmed.2020.6474

In Reply In their Letter in response to our Original Investigation,1 Fuller-Thompson and Munro provide an interesting insight that improvements in environmental factors, specifically the phase out of leaded gasoline, could have contributed to the reduction in hip fractures observed in the United States and Canada. The role of lead is biologically plausible and important for the future: lead paint continues to be a source of lead exposure in Massachusetts and the rest of the United States.

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