Impaired lung function is associated with morbidity and mortality in the elderly. However, there is a paucity of data regarding the long-term effects of particulate matter (PM) on lung function among the elderly. This study evaluated the exposure-response relationship between ambient PM and different lung function indices among the elderly in Taiwan. A cross-sectional survey of individuals aged ≥65 years was conducted in Taiwan from October 2015 to September 2016. Those who attended the annual health examination for the elderly in five hospitals of varying background PM concentrations were enrolled. The long-term (2015 annual mean concentration) exposure to air pollution was estimated by the Kriging method at the residence of each subject. The association between ambient PM exposure and lung function was evaluated by linear regression modeling, with adjustments for age, sex, height, weight, educational attainment, presence of asthma or chronic obstructive pulmonary disease, smoking status, season, and co-pollutants. There were 1241 subjects (mean age, 70.5 years). The mean residential PM_2.5 and PM_2.5-10 in 2015 was 26.02 and 18.01 μg/m³, respectively. After adjustments for confounders and co-pollutants, the FVC decrease was best associated with fine particles (PM_2.5), whereas the FEV₁, FEF_25-75%, FEF_25% and FEF_50% decreases were best associated with coarse particles (PM_2.5-10). An IQR (10 μg/m³) increase in PM_2.5 decreased FVC by 106.38 ml (4.47%), while an IQR (7.29 μg/m³) increase in PM_2.5-10 decreased FEV₁ and FEF_25-75% by 91.23 ml (4.85%) and 104.44 ml/s (5.58%), respectively. Among the Taiwanese elderly, long-term PM_2.5 exposure mainly decreases the vital capacity of lung function. Moreover, PM_2.5-10 has a stronger negative effect on the function of conductive airways than PM_2.5.

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