The Association of Cold Ambient Temperature With Fracture Risk and Mortality: National Data From Norway-A Norwegian Epidemiologic Osteoporosis Studies (NOREPOS) Study.

Norway is an elongated country with large variations in climate and duration of winter season. It is also a high-risk country for osteoporotic fractures, in particular hip fractures, which cause high mortality. Although most hip fractures occur indoors, there is a higher incidence of both forearm and hip fractures during wintertime, compared with summertime. In a nationwide longitudinal cohort study, we investigated whether cold ambient (outdoor) temperatures could be an underlying cause of this high incidence and mortality. Hospitalized/outpatient forearm fractures (International Classification of Diseases and Related Health Problems, 10th Revision [ICD-10] code S52) and hospitalized hip fractures (ICD-10 codes S72.0-S72.2) from 2008 to 2018 were retrieved from the Norwegian Patient Registry. Average monthly ambient temperatures (degrees Celsius, °C) from the years 2008 to 2018 were provided by the Norwegian Meteorological Institute and linked to the residential area of each inhabitant. Poisson models were fitted to estimate the association (incidence rate ratios [IRRs], 95% confidence intervals [CIs]) between temperature and monthly incidence of total number of forearm and hip fractures. Flexible parametric survival models (hazard ratios [HR], 95% CI) were used to estimate the association between temperature and post-hip fracture mortality, taking the population mortality into account. Monthly temperature ranged from -20.2°C to 22.0°C, with a median of -2.0°C in winter and 14.4°C in summer. At low temperatures (<0°C) compared to ≥0°C, there was a 53% higher risk of forearm fracture (95% CI, 51%-55%) and 21% higher risk of hip fracture (95% CI, 19%-22%), adjusting for age, gender, calendar year, urbanization, residential region, elevation, and coastal proximity. When taking the population mortality into account, the post-hip fracture mortality in both men (HR 1.08; 95% CI, 1.02-1.13) and women (HR 1.09; 95% CI, 1.04-1.14) was still higher at cold temperatures. There was a higher risk of forearm and hip fractures, and an excess post-hip fracture mortality at cold ambient temperatures. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

High winter loads of Oestrid larvae and Elaphostrongylus rangiferi are associated with emaciation in wild reindeer calves.

The Oestrid flies Cephemyia trompe and Hypoderma tarandi and the nematode Elaphostrongylus rangiferi are important parasites of Rangifer spp. The larvae of Oestrid flies develop in the throat (C. trompe) and skin (H. tarandi) of their host during winter while E. rangiferi develop in the CNS. Oestrid pupation, and development of E. rangiferi larvae from first- (L1) to infective third- stage in the environment during summer are highly temperature dependent. We investigated the possible negative effects of these parasites on the winter body-condition of wild reindeer calves. Two year-classes (generations) of calf, born in a warm (2014) and cold (2015) summer respectively, were examined for changes in body condition between autumn and spring, in relation to the parasite load determined in the spring. The body condition in the autumn was assessed as carcass weight, while the body condition in the spring was assessed as carcass weight, supplemented by an evaluation of fat reserves in various bodily locations. Oestrids were counted directly whereas the E. rangiferi quantification was based on faecal counts of L1 larvae. The abundance of infections for Oestrids and E. rangiferi were significantly greater in the 2014 generation than in the 2015 generation. The mean carcass weight decreased between autumn and spring for the 2014 generation but increased in the 2015 generation. Emaciation in the spring was documented (fat reserve evaluation) in 42% and 7% of calves in the 2014 and 2015 cohorts, respectively. There was a significant correlation between high parasite load and the probability of emaciation. The mean summer temperature in 2014 was 2.6 °C higher than the mean for 2015, and 1.0 °C higher than the mean for the last 30-years. Our findings suggest that following a warm summer, high loads of Oestrids and E. rangiferi may cause emaciation and potentially deaths among the calves.