title: Health consequences of exposure to e-waste: a systematic review.
abstract: BACKGROUND
  The population exposed to potentially hazardous substances through inappropriate and unsafe management practices related to disposal and recycling of end-of-life electrical and electronic equipment, collectively known as e-waste, is increasing. We aimed to summarise the evidence for the association between such exposures and adverse health outcomes.
  
  
  METHODS
  We systematically searched five electronic databases (PubMed, Embase, Web of Science, PsycNET, and CINAHL) for studies assessing the association between exposure to e-waste and outcomes related to mental health and neurodevelopment, physical health, education, and violence and criminal behaviour, from Jan 1, 1965, to Dec 17, 2012, and yielded 2274 records. Of the 165 full-text articles assessed for eligibility, we excluded a further 142, resulting in the inclusion of 23 published epidemiological studies that met the predetermined criteria. All studies were from southeast China. We assessed evidence of a causal association between exposure to e-waste and health outcomes within the Bradford Hill framework.
  
  
  RESULTS
  We recorded plausible outcomes associated with exposure to e-waste including change in thyroid function, changes in cellular expression and function, adverse neonatal outcomes, changes in temperament and behaviour, and decreased lung function. Boys aged 8-9 years living in an e-waste recycling town had a lower forced vital capacity than did those living in a control town. Significant negative correlations between blood chromium concentrations and forced vital capacity in children aged 11 and 13 years were also reported. Findings from most studies showed increases in spontaneous abortions, stillbirths, and premature births, and reduced birthweights and birth lengths associated with exposure to e-waste. People living in e-waste recycling towns or working in e-waste recycling had evidence of greater DNA damage than did those living in control towns. Studies of the effects of exposure to e-waste on thyroid function were not consistent. One study related exposure to e-waste and waste electrical and electronic equipment to educational outcomes.
  
  
  CONCLUSIONS
  Although data suggest that exposure to e-waste is harmful to health, more well designed epidemiological investigations in vulnerable populations, especially pregnant women and children, are needed to confirm these associations.
  
  
  BACKGROUND
  Children's Health and Environment Program, Queensland Children's Medical Research Institute, The University of Queensland, Australia.
authors.affiliation: Children's Health and Environment Program, Queensland Children's Medical Research Institute, The University of Queensland, Herston, QLD, Australia.
authors.forename: Kristen
authors.initials: K
authors.lastname: Grant
authors.affiliation: Children's Health and Environment Program, Queensland Children's Medical Research Institute, The University of Queensland, Herston, QLD, Australia.
authors.forename: Fiona C
authors.initials: FC
authors.lastname: Goldizen
authors.affiliation: Children's Health and Environment Program, Queensland Children's Medical Research Institute, The University of Queensland, Herston, QLD, Australia. Electronic address: p.sly@uq.edu.au.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Sly
authors.affiliation: Department of Public Health and Environment, World Health Organization, Geneva, Switzerland.
authors.forename: Marie-Noel
authors.initials: MN
authors.lastname: Brune
authors.affiliation: Department of Public Health and Environment, World Health Organization, Geneva, Switzerland.
authors.forename: Maria
authors.initials: M
authors.lastname: Neira
authors.affiliation: Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands.
authors.forename: Martin
authors.initials: M
authors.lastname: van den Berg
authors.affiliation: Children's Health and Environment Program, Queensland Children's Medical Research Institute, The University of Queensland, Herston, QLD, Australia; School of Population Health, The University of Queensland, Herston, QLD, Australia.
authors.forename: Rosana E
authors.initials: RE
authors.lastname: Norman
mesh_terms: D002648:Child; D002675:Child, Preschool; D003415:Crime / Q000706:statistics & numerical data; D004522:Educational Status; D059029:Electronic Waste; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D018876:Environmental Illness / Q000453:epidemiology*; D005260:Female; D006256:Hazardous Waste / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D059027:Recycling; D014754:Violence / Q000706:statistics & numerical data*
chemical_list: D006256:Hazardous Waste