Lung health over a lifetime: detecting poor lung health early to help prevent disease in later life

A summary of research published in The Lancet

A new series of lung health pathways have been identified which could pave the way for healthcare professionals to map lung health across a lifetime.

Published in The Lancet, this landmark paper outlines how lung health pathways can help us understand how our lung health develops and changes depending on the environment we live in. We can then take steps to prevent chronic lung conditions (such as chronic obstructive pulmonary disease (COPD)) and keep our lungs healthy.

The pathways could also be used to spot those at higher risk of lung disease at an earlier stage, resulting in earlier diagnosis and more treatment options for lung conditions.


The lungs begin developing while a baby is growing in the womb. This development continues throughout childhood and into the teenage years. Lung health reaches its peak as we become adults and then begins to get worse gradually as we get older.

There are many things that can have an impact on how the lungs develop, including smoking, early childhood infections and air pollution. Some people also have more chance of developing lung conditions because of the genes they were born with, which they inherited from their parents.

What does this new paper look at?

Experts have begun to piece together the different factors affecting lung health. They have mapped a range of pathways, or trajectories, from childhood to adulthood, looking at what happens to our lungs over time. People who are on a lower pathway are likely to experience poorer lung health and have a higher risk of developing a chronic lung condition. They are also more likely to develop other conditions, such as heart problems or mental health conditions. However, currently there are no regular check-ups on our lung health in childhood.

By identifying these pathways, healthcare professionals hope that we can find the people who are more likely to experience poor lung health at an earlier stage. This means that steps could be taken to slow the development of lung disease, or even prevent it, and treatment for these conditions could start earlier.

How have these pathways been identified?

For the last 50 years, healthcare professionals have collected information on how the lungs work using lung function, which is usually  measured through spirometry tests. A spirometry test measures how healthy your lungs are and can be used to help diagnose and monitor lung conditions. During the test, you breathe out as much air as you can, as hard as you can, into a device called a spirometer.

The collected data has helped experts map the normal range of healthy lungs and how they change over time.

Why is this important?

Authors of this new paper have developed a Lung Function Tracker tool that is freely available online and could be used by healthcare professionals across the world in a similar way to height and growth charts used for decades to map children’s growth. The new paper also covers the challenges and opportunities for how this concept could be used in healthcare settings. This is a significant step forward in the field of lung health and could protect and improve lung health, while also promoting healthier growth and ageing globally.

What can we do to prevent lung disease?

There are five key areas that we can focus on to keep our lungs healthy. These include breathing clean air, being smoke free, being active, keeping up to date with vaccinations and fighting climate change. These themes are covered by the ELF and ERS Healthy Lungs for Life campaign. The campaign was used as an example in the paper of a campaign aimed at encouraging people to change behaviours to improve their health.

Erik Melén, Professor of Paediatrics and co-author on the paper, believes the lung health pathways show the importance of looking after our lungs from a very early age: “There are steps everyone can take to look after their lungs. Having moments in time that we all have our lung function tested would allow us to understand and care for our lung health better. These pathways could pave the way for improved lung health across the population and healthier ageing.”

Professor Rosa Faner, co-first author adds: “For lung conditions like COPD that currently do not have a cure, identifying the children and young adults at risk of developing these conditions can be key to prevent them. By shedding more light on the way the lungs develop, lung trajectories can also pave the way for research into new treatments of these conditions.”

Read the original research paper:

Lung function trajectories: relevance and implementation in clinical practice

This paper is part of the European Respiratory Society’s CADSET project. CADSET (Chronic Airway DiSeases Early sTratification) is a clinical research collaboration working to promote clinical research in chronic airway diseases. Find out more.

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