Close residential proximity to major highway increases mortality risk in ILD
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Key takeaways:
- In this study, 82 out of 413 patients with ILD lived less than 200 m from a major highway.
- Researchers reported a shorter median overall survival time in the group closer to vs. farther from a major highway.
BOSTON — Among patients with interstitial lung disease, the risk for mortality rose if they lived less than 200 m from a major highway, according to data presented at the CHEST Annual Meeting.
“Environmental and socioeconomic factors now emerge as critical considerations in patient care,” Neha Kaushik, MD, internal medicine resident in the division of pulmonary and critical care at NorthShore University Health System, told Healio. “The findings suggest that living closer to highways may accelerate disease progression and worsen survival rates. This means clinicians must think beyond traditional clinical markers like lung function or oxygen dependence and incorporate environmental assessments into patient care.”
Kaushik continued, “It underscores the importance of asking the right questions during patient consultations: Where do your patients live? Are they exposed to heavy traffic-related air pollution? These insights can help clinicians offer more tailored advice, advocate for lifestyle adjustments and work with policymakers to develop safer living conditions. Ultimately, this adds a new dimension to personalizing care, offering more proactive strategies for preventing further deterioration in ILD patients and improving long-term outcomes.”
Kaushik and colleagues analyzed 413 patients (median age, 73 years; 53.5% women; 80.6% white) with ILD (41.4% with idiopathic pulmonary fibrosis) to find out how living distance from major highways is related to overall survival.
Notably, less than one third of the patient population reported smoking tobacco (29.8%) and needing oxygen (29.1%), according to the abstract.
Most of the total cohort (n = 331) lived 200 m or farther from a major highway, but the remaining 82 patients lived less than 200 m from a major highway.
Researchers reported a shorter median overall survival time in the group closer to vs. farther from a major highway (87 months vs. 99 months), as well as a significant increased risk for mortality (HR = 1.43; P = .009).
“One of the most surprising findings was how significantly living within 200 meters of major highways could impact lung health, especially in patients with ILD,” Kaushik told Healio.
In addition to closer proximity to major highways, four other factors significantly raised the risk for mortality in multivariable Cox regression, according to the abstract:
- age (HR = 2.86; P < .001);
- baseline oxygen requirement (HR = 1.81; P < .001);
- IPF (HR = 1.58; P < .001); and
- baseline diffusing capacity of the lungs for carbon monoxide less than 80% (HR = 1.36; P = .04).
Researchers noted that adjustment for sex, race, tobacco smoking and baseline FVC did not change any of the above findings.
“Despite no detectable difference in ambient air pollution levels (PM2.5 and several of its major sub-components) between patient residences, proximity to highways still emerged as a strong factor affecting survival,” Kaushik told Healio. “This suggests that additional factors beyond PM2.5 might be responsible, with likely culprits including traffic-related air pollution (TRAP). TRAP consists of ultrafine particles, nitrogen oxides, sulfur oxides, carbon monoxide and more. These elements could disproportionately affect people living closer to highways.”
Looking ahead, Kaushik said future studies should delve into the “sociome.”
“While the role of social determinants of health is well-established — often considered more influential than biological factors — this view lacks the depth needed to truly understand their dynamic interplay,” Kaushik told Healio. “Rather than isolating these determinants such as simply measuring distance from major highways, future studies must explore how social, environmental and biological factors converge within each individual.
“This means moving away from broad generalizations and developing methods to quantify the nuanced interaction between our unique genetic makeup and external influences,” Kaushik added. “Such an approach will provide a more comprehensive understanding, enabling researchers to identify more targeted, personalized interventions that improve outcomes across a range of conditions.”
Although this study focused specifically on patients with ILD, environmental factors can impact many types of patients, Kaushik told Healio.
“Whether it’s respiratory diseases, cardiovascular conditions or even mental health, proximity to environmental hazards like highways could have far-reaching effects,” she said. “For health care professionals, this study reinforces the need to think holistically about patient care — incorporating lifestyle, environment and socioeconomic contexts into clinical decision-making.
“Additionally, it highlights the urgency for policy change, advocating for cleaner urban planning, reduced traffic pollution and greater attention to public health measures aimed at reducing environmental risks,” Kaushik continued. “Ultimately, addressing these factors is not just about improving care for ILD patients but about safeguarding the health of communities at large.”
For more information:
Neha Kaushik, MD, can be reached at neha.kaushik219@gmail.com.