Turning the Lungs Inside Out: The Intersecting Microbiomes of the Lungs and the Built Environment

• Published in: American journal of respiratory and critical care medicine Vol. 202; no. 12; pp. 1618 - 1620
• Main Authors: Combs, Michael P, Dickson, Robert P
• Format: Journal Article
• Language: English
• Published: United States American Thoracic Society 15.12.2020
• Subjects: Built Environment; Defense mechanisms; Digestive system; Federal court decisions; Humans; Litigation; Lung; Manufacturing and Industrial Facilities; Microbiota; Pickleball; Respiratory Tract Diseases
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.202007-2973ED

Ignore the protestations of our colleagues in gastroenterology: when it comes to surface area, the lungs beat the gut. While out-of-date textbooks claim that the gut lumen has a surface area comparable to that of a tennis court (260 m2), some brave heretics recently used modern morphometric methods to show that prior estimates were greatly exaggerated. In the authors' words: "the total area of the human adult gut mucosa is not in the order of [a] tennis lawn, rather is that of half a badminton court": a modest 32 m2 . In contrast, no one has dared challenge Philip Hasleton's 1972 estimate of the internal surface area of human lungs, 70 m2, roughly that of a racquetball court (2). When it comes to surface area, the lungs take the prize at twice that of the gut and 30 times that of the skin. (Dermatologists have recently attempted to assert the supremacy of the skin by counting intrafollicular surface area, yet even this estimate is still only 25 m2 merely one-third of a pickleball court.)