Background: A retrospective chart review approved by the Philadelphia College of Osteopathic Medicine was conducted in two Urban Clinics in Duran, Ecuador. Hypothesis: Given the association of environmental risk factors and frequency of pulmonary illnesses and dysfunctions; we hypothesize that a single OMT treatment would improve pulmonary function tests (PFT), decrease secondary somatic changes, and enhance patient's assessment of breathing quality. Materials and Methods: Patients received a history and physical with documentation of host and environmental risk factors. A predetermined grading system was used to risk-classify patient records based on quantifying somatic dysfunction (SD) and altered PFT. Patients received standardized osteopathic structural examinations, SD was recorded, and a standard OMT protocol focusing on pulmonary homeostatic support was implemented. Results: A total of 21 charts met the inclusion criteria for this study. All patients with pulmonary complaints, including those with normal PFT, demonstrated some level of SD corresponding to pulmonary dysfunction (PD) including: pulmonary Chapman's points at intercostal spaces 2-4, facilitated segments (T1-T6), phrenic nerve-related sites (C3-C5) and disruptions in the Zink “respiratory-circulatory” alternating fascial pattern. The majority of these presented with a cough or shortness of breath. The highest-risk patients had the greatest burden of SD. Although the chart review did not indicate a direct relationship between restoration of the Zink pattern and improved PFT, the Zink pattern normalized in those with improved PFTs. Significant subjective symptom improvement was noted in 20 of 21 patients. Five of 16 patients demonstrated significant improvement in post-OMT PFT values. Conclusion: Our results suggest that OMT involving removing lymphatic flow obstructions, in conjunction with autonomic balancing, biomechanical restoration and lymphatic treatments may have a role in improving environmentally related PD. It also appears that restrictive processes respond best to this OMT protocol as demonstrated by improved post OMT PFT values in this subset. An initial decrease in FEV1 was noted when OMT was used for acute PD along with chronic obstructive processes, but more tests are needed to determine if the drop in FEV1 is temporary or due to fatigue rather than physiological change.