Biomonitoring Environmental Exposure in Syrian Refugees in Lebanon

Over one million Syrian refugees have been residing in substandard living conditions in Lebanon for the past decade. Non-invasive biomonitoring of fractional exhaled nitric oxide (FeNO) as a pulmonary inflammation biomarker was conducted following and preceding indoor environmental assessments (which revealed elevated mould counts in informal tented settlements and non-residential shelters) to further evaluate effects of environmental exposure to indoor contaminants. Results of biomonitoring (n = 57) provided some insight regarding existing respiratory conditions and the possible implementation of minimally invasive methods to establish susceptibility profiles in Syrian refugees amid limited access to healthcare. The clinical interpretation of FeNO results suggested possible persistent exposure to allergens in addition to significant type 2 inflammation in some subjects. These findings warrant the need to expand this study, investigate other biomarkers, and attempt to correlate findings with environmental conditions to evaluate if a dose-response relationship exists.