Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Hansard source

Thursday, 20 October 2011 was World Osteoporosis Day, and I am very delighted to assist in helping raise the awareness of this disease and the impact it has on millions of Australians in this place. I am also proud to highlight the work of Osteoporosis Australia and some of the simple steps that they recommend to prevent the disease from developing.

Osteoporosis is a disease where bones become fragile and brittle, as we all know. As a result, they fracture more easily than normal bones and even a minor bump or very small tap or fall can cause a serious fracture. Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace the minerals, including calcium, in them, leading to a loss of bone thickness or bone mass or density. Any bone can be affected by osteoporosis but the most common sites are bones in the hip, spine, wrist, ribs, pelvis and upper arm. Osteoporosis usually shows no signs or symptoms until a fracture happens, and this is why osteoporosis is often called the ‘silent disease’. In Australia, there are over 1.2 million people with osteoporosis. Half of all women and one-third of men over 60 years of age in Australia will have a fracture due to osteoporosis at some stage. Every five to six minutes, someone in Australia will be admitted to hospital with an osteoporotic fracture. This is expected to rise to every three to four minutes by 2021 as the population ages and the number of osteoporotic fractures increases. Fractures due to osteoporosis can lead to changes in posture—for example, developing a stoop, commonly known as a dowager's hump, in the back—muscle weakness, loss of height and bone deformity of the spine. Fractures can lead to chronic pain, disability, loss of independence and even premature death.

Figures published in 2007 suggested that approximately 25 per cent of those who sustain a hip fracture die within 12 months of sustaining that fracture. Of those who do not die following their hip fracture, 50 per cent require long-term help with routine activities and cannot walk unaided and 25 per cent require full-time nursing home care. The costs associated are substantial and many are met by the taxpayer through our healthcare system. An osteoporotic fracture places a significant burden not only on those living with the disease through the constant pain they must bear every single day but also on their families, friends and communities.

Prevention is really important because, whilst there are treatments for osteoporosis, there is no cure. For that reason alone it is very important that all governments of all persuasions work harder to bring about more awareness of this disease. A recent study revealed that, while the Australian public has a reasonable understanding of calcium's role in promoting good bone health, 49 per cent, only one in three people surveyed, recognised the need for regular exercise and seven per cent cited vitamin D, sunshine, as being important. So these are some of the messages that we can get out there. Worryingly, one in five respondents could not nominate a single risk factor for osteoporosis.

Low bone density is an osteoporosis risk factor and a clear sign that preventive action needs to be taken. This refers to when bone mineral density, known as BMD, is lower than the normal BMD level but still not low enough to be classed as osteoporosis. As with osteoporosis, women have a higher chance of having a lower BMD than men. It affects a staggering 5.4 million Australians. In the over-50s population 14.8 per cent have osteoporosis, while 51.8 per cent have osteopenia. Fragility fractures are not confined to people with osteoporosis. They commonly occur in people with osteopenia. Intervening at the right time and taking preventive measures may stop many Australians with this disease from developing the next stage, which is osteoporosis.

Osteoporosis is a degenerative disease that affects men and women. Women are more susceptible than men due to the rapid depletion in oestrogen levels during the menopause. Men also lose bone mass as they age, but this generally happens later in life. The risk factors for osteoporosis include having a family history of osteoporosis and repetitive fractures; certain medications, such as corticosteroids, which are commonly used for asthma; some conditions like rheumatoid arthritis, an overactive thyroid and a whole range of other things. There are also lifestyle factors such as smoking or excessive alcohol consumption, diets lacking in calcium, lack of exposure to sunlight, lack of exercise and, for women, early menopause. For men, impotence, lack of libido and other symptoms of low testosterone levels are risk factors. There are risk factors that you can change. For example, physical activity is something we can all do and should do more of. Other things we can change are smoking, high alcohol intake, low calcium intake, low vitamin D levels, and low or high body weight. There are risk factors that you cannot change. Being female, for example, means you are at higher risk because women develop thin bones sooner than men. Genes, menopause, age, certain medical conditions and a range of other things cannot be changed.

It is clear that Australians need more information about risk factors and about the prevention of this disease. A recent study found that 49 per cent of Australians understood the need for calcium but only one-third understood the need for exercise and only seven per cent knew that lack of vitamin D, which is sunshine, is a risk factor. Around 20 per cent of Australians believe that osteoporosis is part of ageing and cannot be changed. In fact, there are three ways you can maintain your bone health: a diet rich in calcium, safe levels of vitamin D exposure through sunlight, and doing regular weight-bearing exercise. Calcium combines with other minerals to give bones their strength. Our bodies cannot make calcium so it has to come from our diet. It is easiest to get calcium from dairy, tinned salmon, sardines and calcium-enriched foods, but smaller amounts can also be found in nuts, bread, cereals and some fruits and vegetables, which I hope all members of this House are consuming on a regular basis.

Vitamin D is essential to strengthen the skeleton. Without it calcium is unable to be fully absorbed into the body. As Australia has such a high level of sun exposure, Australians are often overcautious about the effects of exposure, and so we should be. This overcaution could lead us to not receiving adequate levels of this very important vitamin D. So it is important for people to understand that, while overexposure to the sun can be detrimental to our health, so can underexposure. A study of women living in south-east Queensland, Victoria and Tasmania found that respectively 40 per cent, 37 per cent and 67 per cent of respondents experienced vitamin D insufficiencies during the winter and spring. In Australia the best source of vitamin D is from a safe level of direct sunlight. Vitamin D can also be found in small amounts in a few foods like salmon and eggs. Exercise is important in building and maintaining healthy bones. Weight-bearing exercise such as jogging, tennis and skipping increases the bone mass and also improves balance, which can lead to a reduced fracture rate.

If we were able to reduce the burden of fractures caused by osteoporosis by around 20 per cent, it would significantly reduce both the direct costs of health care and the indirect health costs to families and the economy. Even if just calcium intake and vitamin D levels were addressed, the direct cost of osteoporosis in Australia could be lowered by up to $432 million per year. I congratulate Osteoporosis Australia on all the work they do to help educate the public and to raise awareness about this disease so that rates of osteoporosis and its social and economic cost can be reduced in the future. Since being founded in 2000, the not-for-profit organisation has accomplished a great deal, bringing awareness, education and advocacy for osteoporosis. It is committed to supporting and funding research into prevention, diagnosis and management with the input of some of Australia's leading experts on their medical and scientific committee. I hope that their work will be supported by all members in this place now and into the future.

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