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Staab-Weijnitz, C.* ; Lehmann, M.

Environmental exposure and the ageing lung.

In: Respiratory Physiology: New Knowledge, Better Diagnosis. 2025. 259-276 (ERS Monog. ; 2025-April)

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Ageing leads to a decline in lung function, with vital parameters like FEV1 and FVC decreasing from 35 years of age, and a sharper drop in FEV1 after 65 years of age. Structural changes include reduced bronchiole density, enlarged alveoli and increased lung rigidity due to collagen build-up. Ageing also impairs the respiratory response to hypoxaemia and hypercapnia, and reduces mucociliary clearance. Cellular hallmarks such as telomere shortening, mitochondrial dysfunction and chronic inflammation contribute to lung ageing. Air pollution, a key risk factor for respiratory diseases like COPD, further exacerbates lung decline, particularly in older adults, due to oxidative stress. Pollutants cause oxidative damage and protein modifications, and may accelerate cellular senescence. While mechanistic insights remain limited, the impact of air pollutants on lung health is clear. Future research should address emerging threats like microplastics and the role of lifestyle and genetic factors, as political efforts to improve air quality continue.

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