Respiratory health status and lung function among Syrian refugees compared with the local population: a cross-sectional field study

Respiratory health disparities among refugee populations constitute an important public health concern due to adverse living conditions and environmental exposures. However, comparative evidence based on objective lung function measurements between refugee and host populations from the same setting remains limited. Respiratory symptoms were assessed using a structured interviewer-administered questionnaire, lung function by spirometry, and airway inflammation by fractional exhaled nitric oxide (FeNO) measurement. Spirometric obstruction was defined as a post-bronchodilator FEV₁/FVC ratio < 0.70. Categorical variables were analyzed using the chi-square test. Continuous variables were analyzed using ANCOVA adjusted for age, smoking status, heating type, and education level, and are presented as adjusted means with 95% confidence intervals. Multivariable logistic regression was used to identify factors independently associated with spirometric obstruction (FEV₁/FVC < 0.70). A p-value < 0.05 was considered statistically significant. Chronic cough (69.4% vs. 25.9%), sputum production (80.1% vs. 31.6%), and shortness of breath (64.4% vs. 33.6%) were more prevalent among Syrian refugees than among the local population (all p < 0.001). Percent-predicted FEV₁ (81.40% vs. 85.93%; p = 0.002) and FVC (83.20% vs. 87.65%; p = 0.003) were lower among Syrian refugees, as were FEV₁/FVC ( p = 0.027) and FEF25–75 ( p < 0.001). The prevalence of spirometric obstruction was also significantly higher in refugees. Syrian refugee status was independently associated with spirometric obstruction (OR = 2.65; 95% CI: 1.64–4.28; p < 0.001). Adverse environmental exposures and differences in living conditions may contribute to the respiratory health disparities observed among refugees. These findings underscore the need to strengthen public health strategies focused on protecting vulnerable populations and mitigating environmental risks, particularly among refugee populations.