Minimizing the Dermatological Consequences of Exposure to E-waste

Introduction

Amidst the rapid technological developments and shorter life cycles of electronic devices, like computers, mobile phones, and batteries, a remarkable rise in the volume of electronic waste (e-waste) has been reported globally.[1,2] The available global estimates suggest that, on average, over 60 million metric tons of e-waste is being generated, and a major proportion of these are being dumped into low- and middle-income nations due to the deficient regulatory provisions.[1] This becomes problematic when these e-wastes are improperly handled, releasing a wide range of toxic substances into the environment that contaminate air, soil, and water, becoming a major source of health risk to the exposed population groups.[2] Direct contact of these wastes with humans has resulted in the development of skin allergies, respiratory disorders (like chronic bronchitis and asthma, and an increase in the risk of lung cancer due to inhalation of toxic fumes), and neurological damage (lead exposure can cause cognitive impairment, memory loss, neurodevelopmental delays in children, and neurodegenerative diseases among elderly).[3] In addition, cardiovascular diseases (heavy metal exposure is linked with the development of hypertension, increased risk of heart attacks and strokes, etc.), chronic kidney diseases because of cadmium and lead toxicity, impairment of immune systems, and endocrine disruptions (like thyroid dysfunction, reproductive issues, and metabolic disorders) have also been reported due to exposure to e-waste.[3] The objectives of the current article are to identify various dermatological manifestations of e-waste exposure, ascertain the potential challenges in avoiding these dermatological conditions, and propose targeted solutions to overcome these challenges.

Identified Challenges

The efforts to minimize the potential dermatological risks of e-waste exposure have been linked to multiple challenges, especially in low-resource settings where improper disposal and recycling are quite common.[2,4,5,6,7,8] The most common challenge is the complete absence or poor implementation of laws targeting the disposal and recycling of e-waste.[5] For instance, owing to the weak laws or poor implementation of legal provisions governing e-waste, a significant amount of illegal waste enters low-income Asian nations (like India, Malaysia, Indonesia, etc.) and African nations (like Ghana, Nigeria, etc.).[5] This is often complemented by the lack of awareness about the health hazards, including dermatological risks, among people working in these industries, due to which many skin-related manifestations go unreported.[6]

The next major barrier is the absence of workplace safety measures (viz., no protective gear, no periodic examination, etc.), which exposes these vulnerable population groups for prolonged periods.[6,7] In addition, in many informal settings, there is an absence of local exhaust ventilation and air filtration systems, which significantly increases the exposure to heavy metal fumes generated by the open burning of e-waste.[7,8] Further, the safe handling and disposal guidelines to minimize exposure to toxic components present in e-waste are not present, which again augments the exposure and the attributed harms.[7,8] Moreover, as these chemicals accumulate in soil, water, and air, the neighboring communities remain exposed to potential hazards for a long duration.[2] In addition, most of the exposed persons and communities have limited access to dermatologists or trained healthcare personnel, resulting in misdiagnosis or the absence of treatment.[4,8,9] Finally, adopting eco-friendly technologies to recycle e-waste is still in the early stages in low- and middle-income nations due to high costs, the absence of infrastructure, and resistance from informal sectors.[1,7] The ground reality is that formal recycling comes with high costs, as regulated recycling plants need advanced technology and infrastructure, which makes it financially unfeasible in low-income nations.[1,7] On the contrary, in informal recycling, children and women are often employed to work for low wages, making it cheaper than investing in mechanized recycling processes.[7]

e-Waste Exposure and Dermatological Manifestations

The exposure to toxic substances in e-waste can result in the development of a wide range of skin conditions, especially among individuals involved in handling or recycling such waste.[3,4,9,10,11,12,13,14] In a study conducted in Sweden to assess the extent of exposure to metals among employees, it was reported that iron was the most abundant metal in the inhalable samples from the recycling workers (viz., geometric mean concentration of 98 g/m³).[10] The common manifestations include allergic contact dermatitis (due to exposure to heavy metals and plastics in e-waste) and irritant contact dermatitis because of direct skin irritation from acidic and alkaline chemicals found in e-waste.[3,10] Further, chronic exposure to arsenic and lead present in these wastes can result in the development of hyperpigmentation, while exposure to toxic fumes generated by burning plastics in e-waste can lead to skin redness and inflammation.[3,4] In fact, the findings of a systematic review highlighted the deposition of arsenic in skin, hair, and nails upon chronic exposure, which is often occupational in nature.[4] The findings of another study reported that almost 95% of the reported cases of contact dermatitis in the United States are occupational in origin.[11] Chronic exposure to chemical irritants and persistent scratching might lead to altered pigmentation, skin thickening, and cracking, which is common among people with long-term exposure to such wastes.[11]

Reports of skin dryness, irritation, skin ulceration, and chemical burns have surfaced among individuals exposed to strong acids and alkalis used in recycling e-waste.[9] In sun-exposed areas, photodermatitis has been reported among people exposed to beryllium and arsenic present in e-waste.[12] Informal burning and recycling of e-waste releases dioxin-like compounds, which have been linked with various skin manifestations like chloracne, hyperpigmentation, erythema, contact dermatitis, and skin dryness.[12] Similarly, cases of urticaria have been documented upon exposure to nickel and chromium present in e-waste. The available literature has also shown cases of brittle and discolored nails among individuals who were in contact with either heavy metals or toxic fumes generated while disposing of e-waste.[13] Finally, prolonged exposure to arsenic and dioxins has been linked with the development of non-melanoma skin cancers.[14] In a study, where more than 7000 adults were exposed to inorganic arsenic for more than 6 years, 2.2% and 1.3% of males and females, respectively, developed basal cell carcinoma.[14] The above discussion clearly justifies the need to encourage safe disposal practices to reduce the incidence of these dermatological manifestations among exposed people.[1,2,3]

Potential Strategies for Mitigation and Prevention

Acknowledging the magnitude of e-waste in developing nations, the existing challenges, and the wide spectrum of dermatological manifestations among exposed persons, the need of the hour is to adopt a multi-pronged approach involving a collaborative and concerted approach involving different sectors.[5,6,7,8,15,16,17,18,19,20,21] This begins with the strict enforcement of policies supporting the safe handling, disposal, and recycling of e-waste and imposing bans on informal recycling.[5] In the European Union, the Waste Electrical and Electronic Equipment Directive was formulated to regulate e-waste management (collection, recycling, and recovery) in its member nations.[5] In the United Kingdom, the regulatory provisions have aimed to minimize packaging requirements and restrict the use of hazardous substances.[5]

At the system level, policymakers must encourage the adoption of safer recycling methods where there is no direct skin contact with toxic materials.[4,5] Considering that this might not be performed immediately, especially in low-income nations, the primary approach should be to create awareness about the potential dermatological risks of e-waste among consumers and people involved in e-waste handling.[6,15] This awareness can be made through social media, other modes of mass media, and through workplace training sessions.[6,15] The government must initiate safe e-waste collection programs to curb the practice of unsafe dumping or burning in backyards.[8,16] In fact, some incentives might be given to people who return old electronics to manufacturers for proper disposal.[17] In Taiwan, an extended producer responsibility program was introduced with an advanced recycling fee to ensure the collection and recycling of fluorescent lamps, which eventually reduced environmental contamination.[18]

For the benefit of people who are directly involved in handling e-waste, employers should be instructed to ensure the mandatory use of personal protective equipment by the workers to prevent chemical burns, dermatitis, and absorption of harmful toxins.[5,7,10] In addition, these workers should be trained on safe handling practices (viz., avoiding direct contact, first aid for skin exposure, maintaining ventilation in the workplace, etc.) to minimize overall exposure.[7] It is vital to provide access to clean water and proper hygiene facilities in regions where e-waste is largely dealt with, and workers must be encouraged to practice washing exposed areas regularly.[7]

As far as manufacturers are concerned, they should be instructed to phase out the use of heavy metals in electronic products and to dispose of the products generated by them safely.[17,19]

To promote the detection of dermatological illness, it is advised to conduct biannual dermatological checkups for workers at e-waste recycling facilities. This more feasible approach would allow for regular screening and early detection of skin conditions while requiring fewer resources than permanent clinics.[4,10] At the same time, it is quite essential that regular skin checkups for e-waste workers and communities must be encouraged to facilitate early detection of skin toxicity.[4,10] There is a definite need to promote international collaboration to ensure the adoption of techniques for sustainable e-waste management.[20] Finally, health agencies must engage in longitudinal studies to assess the long-term impact of e-waste exposure on skin health, as this will aid in the generation of adequate evidence for the strict implementation of policies, identification of safe materials, and innovative protective methods.[19,21]

Conclusion

In conclusion, multiple dermatological conditions have been reported among people exposed to e-waste. There is an indispensable need to adopt a coordinated, multi-sectoral, and global response to significantly reduce the incidence of skin-related diseases caused by exposure to e-waste. This will essentially require strengthening of awareness activities and strict implementation of legislative norms to streamline the existing problems.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)

AI (ChatGPT version 3.5) was used for correction of grammatical mistakes.

Funding Statement

Nil.