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They would simply die and not pass on those genes. Dear friend from kindergarten went that way. Also, and maybe more important, we have air pollution that was unthinkable 200-years ago.
To top it off, we humans were generally in better shape, and non-fat. I was having pretty bad lung problems, on the edge of full blown illness, when I started working my ass off outdoors at Lowe's. Within 2-weeks my lungs were straight again. That work also cured a few other ailments. OTOH, had to quit as I was getting my ass beat.
U gonnna have to elaborate on that
I think they just mean they weren't very good at it
Air pollution was far worse everywhere besides the extremely rural areas since the middle ages in terms of the Asthma relevant particles and noxes. Combine that with a far worse indoor climate due to mold, animals, humidity, sooth, materials and that leads to a far higher prevalence for Asthma and respiratory illnesses. Which we basically know both from contemporary literature as well as bodies found.
Unless you worked mostly outside in a very very rural area your lungs were worse off 200 years ago than they are now.