It is estimated that 99 % of the world population is exposed to air pollution above air quality guidelines and this is responsible for 6.7 million premature deaths annually. Lung and skin are the first organs exposed to air pollution, and this is associated with carcinogenesis, inflammation and atopic disease. Proposed mechanisms of adverse health effects in lung and skin include oxidative stress, inflammation, and loss of epithelial barrier integrity. Most knowledge has been gained using simple 2D or more complex culture models, however these cultures have important limitations, such as a lack of perfusion and stretching and lack of cell-cell crosstalk. Organ-on-chip (OoC) technology may be used to overcome limitations of the in vitro models currently used in air pollution research and opens possibilities for studying the pathways underlying adverse health effects of air pollution on immune-mediated diseases of the lung and skin using more physiologically relevant exposure experiments. In this review we discuss currently used in vitro models to study the effect of air pollution on epithelial barrier integrity and development of immune-mediated diseases and identify gaps in current knowledge on adverse health effects of air pollution. We then focus on how OoC technology can enhance mechanistic studies of the skin and lung's response to air pollution.