Understanding Lung Health

The lungs — two sponge-like structures that sit behind our ribs — are responsible for ensuring we have enough oxygen in our body to function normally.

“Just like a sponge soaks up water from a spill, the lungs absorb oxygen from the air we breathe,” says Dr. Lori Shah, a pulmonologist at NewYork-Presbyterian/Columbia University Irving Medical Center.

Dr. Shah spoke with Health Matters about how to keep our lungs healthy, lung symptoms to watch for, advice for flu season, and insights into who may be most at risk for developing lung disease.

What do the lungs do?

Lungs, the main organs of our respiratory system, are responsible for taking in oxygen when we inhale and releasing carbon dioxide when we exhale. Carbon dioxide is a gas produced in our body’s cells that is a waste product that our bodies do not need.

How do healthy lungs work?

Oxygen and carbon dioxide travel from our nose and mouth, past our voice box, and then down the trachea- a passageway that begins at the neck and connects to the lungs. Inside each lung are tube-like structures called bronchi and bronchioles, which end in tiny air sacs called alveoli. We have about 150 million alveoli in our lungs. These alveoli and the adjacent blood vessels are where oxygen and carbon dioxide are exchanged, and then oxygen is transported to our organs.

What are signs your lungs aren’t functioning properly?

Think of your body like a car and oxygen like its gas. When your body is at rest and you are not doing physical activity, your organs do not require as much oxygen and you might not even notice if your lungs are not working normally. 

However when we move, our bodies require more oxygen, just like when you are driving and you need to press the pedal to give the car more gas. If your lungs are not functioning properly, they will not be able to absorb the oxygen you need quickly enough during activity.  This can lead to your oxygen level dropping and symptoms like shortness of breath, fatigue, drowsiness, and a fast heart rate. You may also experience something called cyanosis, which occurs when your lips, fingertips, and toes turn blue due to a lack of oxygen in the body. It is like if your gas tank is empty, the car cannot run properly.

Poor lung function may also lead to higher levels of carbon dioxide in the body, which can cause symptoms like drowsiness, headaches, rapid breathing, and confusion.

What are health conditions that affect the lungs?

The lungs are a very common place for people to get infections, such as the flu, respiratory syncytial virus (RSV), or COVID. Bronchitis — inflammation of the bronchial tubes — can also affect the lungs.  A more serious infection includes pneumonia, which causes the air sacs to fill up with fluid or pus. Infections should be treated by a doctor with medications such as antivirals or antibiotics.

There are also chronic, or long-term, conditions that can harm the lungs, including:

• Asthma and chronic obstructive pulmonary disease (COPD) affect the airways in the lungs and make it hard to breathe.
• Pulmonary fibrosis impacts the alveoli, the air sacs in the lungs, which can cause scarring in the lungs over time. These chronic conditions have their own specific treatments, and may require treatment with steroids, if the condition worsens.

What are common signs of asthma?

Asthma symptoms include wheezing, coughing, shortness of breath and/ or chest tightness. These symptoms can be managed with the help of medications including inhalers, which help ease the inflammation and open up the airways, resulting in easier breathing. During times of significant difficulty, steroids can be used as well.

Who is at higher risk for developing lung disease or poor lung function?

People who smoke or are exposed to secondhand smoke, chemicals, fumes, or asbestos are more likely to develop lung disease.

Some people are born with lung diseases that they inherit from their parents or other family members. For example, cystic fibrosis is a genetic, inherited disease cause by a mutation in a gene that controls the stickiness of mucus.

If someone has poor lung function, what should they do?

It depends on what kind of lung disease they have. First, we recommend making lifestyle changes, such as quitting smoking, avoiding secondhand smoke, and exercising regularly. They should consult with a pulmonary physician to ensure the correct diagnosis, medication management and routine follow up.

People with advanced lung disease may need supplemental oxygen. While not a cure, oxygen helps the lungs do their job. If a person does not get better despite lifestyle changes, medications, or other treatments, the next step may be to see a lung transplant team to determine if they are a candidate for lung transplant surgery.

How can we keep our lungs healthy?

To keep your lungs in good health, we recommend several healthy habits, such as not smoking or vaping. It’s also important to be mindful of secondhand smoke, which can be just as dangerous as firsthand smoking.

You also want to maintain a healthy body weight and stay active with aerobic exercise, such as walking, biking, swimming, or dancing.

Another protective measure is to get vaccinated to prevent respiratory infections, such as COVID and the flu. You can talk to your doctor about what vaccines you need and where you can get them.

Also, if you suspect someone around you may be sick, or if you live in an area with a lot of air pollution, take precautions and wear a mask to protect your lung health.