Assessment of the Indoor Environment and Implications for Health in Roma Villages in Slovakia and Romania

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SUMMARY

Objectives: The objective of this paper is to provide information on indoor air quality and on the quality of the broader indoor environment of the houses in Roma villages in Slovakia and Romania and to discuss possible implications for health.

Methods: Indoor air was sampled in 11 houses in a Romanian Roma village and in 19 houses in a Slovakian Roma village. Levels of Carbon Monoxide (CO), Carbon Dioxide (CO2), total particulate matter (PM), temperature and humidity were measured. A questionnaire and a checklist were used to obtain additional information on the indoor environment and behavioural factors. We have sampled the same houses in winter and in summer.

Results: Levels of CO and CO2 were higher in winter in both countries as compared to summer. The limit value of 10 mg/m^sup 3^ CO was exceeded in a few cases in both countries. In general, levels of CO, CO2 and PM were higher in Romania. Further environmental and behavioural hazards such as indoor smoking, pets inside or lack of ventilation were found. The reported self-perceived quality of the indoor environment was poor in many aspects.

Conclusions: Our findings of CO, CO2 and PM levels suggest that indoor air pollution in Roma settlements has the potential to be a health threat. The fact that the inhabitants spend a relatively long time inside the houses and that a number of additional environmental and behavioural hazards were identified by our study emphasizes the importance of the indoor air quality for health and thus priority attention should be paid to these issues by health authorities and researchers. Further research is essential and study designs must consider cultural background and specific characteristics of the community, especially in order to obtain valid data on health outcomes.

Key words: indoor air quality, housing, Roma population, health, biomass fuel

INTRODUCTION

The health of the Roma minority in Central and Eastern European countries is increasingly becoming a public health concern across the region. Most of the research conducted in this area is focused on communicable diseases and genetic predispositions ( 1 , 2). However, recent research highlights the impact of the socioeconomic determinants of health in this ethnic minority living in Central and Eastern European countries such as Slovakia, Hungary or the Czech Republic. A study conducted on the Roma minority in Hungary (3) concluded that tackling the socioeconomic predictors of their poor health along with educational and health promotion interventions is necessary to improve their health. Skodova et al. (4) in her Slovakian study of social and psychosocial predictors of coronary health amongst Roma demonstrated that the socioeconomic status including housing is strongly related to worse health of Roma as compared to the non-Roma population. Rosicova et al. (5) also in a study from Slovakia identified lower education level and higher unemployment as a predictor for higher mortality rates in males of the general population and also identified data gaps in estimating income amongst the Roma population. Vokó et al. (6) in a Hungarian study identified the socioeconomic status as a strong determinant of health in the Roma population and concluded that it may explain worse health in the studied community. Koupilová et al. (7) in their review pointed out that the available studies, with few exceptions, confirm that the health of the Roma community in the Czech Republic and Slovakia is considerably poorer compared to the non-Roma population. Poor hygiene and dietary habits are factors strongly related to adverse health outcomes. Dostal et al. (8) in their study indicated significantly higher morbidity from selected communicable diseases in Roma children under 2 years of age compared to non-Roma children in the same region.

Housing is considered a strong determinant of the population health. The LARES study of the World Health Organization (WHO) (9) showed that housing conditions are related to health and well-being regardless of individual factors. …