Air Pollution, Microbial Exposure, and Lung Cancer Risk: Integrating One Health Concepts

Abstract

Lung cancer remains one of the leading causes of cancer-related mortality worldwide, with increasing evidence highlighting the role of environmental and biological interactions in its development. This review explores the complex relationship between air pollution, the human microbiome, and lung cancer within a One Health framework. While smoking remains a major risk factor, air pollution has emerged as a significant modifiable environmental contributor, particularly in urbanized and industrial regions. Pollutants such as particulate matter (PM2.5 and PM10), nitrogen dioxide, and volatile organic compounds are associated with increased lung cancer incidence through mechanisms involving oxidative stress, chronic inflammation, and genetic damage. Recent research has also identified the lung microbiome as an important factor in respiratory health. Once considered sterile, the lungs are now known to host diverse microbial communities that play a role in immune regulation and inflammatory balance. Environmental exposure, particularly polluted air, can disrupt this microbial balance, leading to dysbiosis. Such microbial alterations may contribute to impaired immune responses and enhanced susceptibility to disease. This review further highlights the mechanistic links between air pollution-induced microbial dysbiosis and lung carcinogenesis. Key pathways include chronic inflammation, immune dysregulation, oxidative stress, epigenetic changes, and alterations in the tumor microenvironment. The interaction between the lung and gut microbiome (lung–gut axis) further emphasizes the systemic impact of environmental exposures. The One Health approach provides an integrated framework to understand these interconnected systems, emphasizing the relationship between environmental health, microbial ecosystems, and human disease. However, current research remains fragmented, with gaps in longitudinal data and integrated multi-omics studies.