Anticipation, recognition, evaluation, and control of indoor environmental hazards impacting Syrian refugees in Lebanon

Abstract

A pilot study of indoor air quality in Syrian refugee settlements in Lebanon found indoor mould growth significantly linked with moisture and ventilation levels. A follow-up cross-sectional study was subsequently performed in 4 provinces of Lebanon. It was revealed that although non-residential shelters had the highest mean total indoor count (TIC), 3 mould genera were strongly associated with non-permanent shelters (p<.001) and occupancy was found strongly associated with some of the genera. Regarding shelter conditions, highest TIC was observed in unfinished structures. These findings suggest shelter category, condition and occupancy significantly influence indoor mould concentrations and may lead to increased respiratory health risks for Syrian refugees in Lebanon. Biomonitoring using the fractional exhaled breath nitric oxide (FENO) biomarker and clinical interpretation of results suggested potential persistent exposure to allergens. Two mitigation technologies were developed for deployment in non-permanent shelters: Solar-powered Window Air Cleaning (SWAC) and Solar-powered Wall Air Vent (SWAV). Operating at 100% outdoor air intake, the SWAC unit exceeded the ASHRAE standard 62.2 minimum requirement for an average refugee household occupancy (n=6) and total floor area (56 m2) and met equivalent outdoor air requirements for the most stringent ASHRAE standard 52.2 particle range (0.3 – 1.0 μm) operating at 50% outdoor air. The SWAV unit exceeded ASHRAE ventilation requirements for individual refugee rooms (15 m2) at average occupancy. In conclusion, this project provides a rare insight into the poor indoor air quality of refugee shelters in Lebanon. Exposures to indoor mould can increase susceptibility to respiratory health risks in this vulnerable population, already impacted by multiple factors, from poor hygiene to displacement trauma and poverty. However, the low-cost renewable mitigation technologies developed here, offer a sustainable solution to remediate poor indoor air quality in refugee shelters accommodating displaced populations not only in Lebanon, but in refugee settings globally.