Electronic Waste-Associated Lead Exposure and Child Neurodevelopment in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Informal electronic waste (e-waste) recycling is an increasingly important source of environmental lead exposure in sub-Saharan Africa (SSA), placing children at heightened risk during critical periods of neurodevelopment; however, the magnitude and consistency of these effects have not been systematically synthesised. We conducted a systematic review and meta-analysis of observational studies identified through searches of PubMed/MEDLINE, Scopus, Web of Science, Embase, and African regional databases from inception to 2024, assessing e-waste-related lead exposure and neurodevelopmental outcomes in children (≤18 years). Random-effects meta-analyses using standardized mean differences (SMDs) were performed, heterogeneity was assessed using the I² statistic, and study quality was evaluated with the Newcastle-Ottawa Scale. Twelve studies met inclusion criteria for qualitative synthesis, of which five (total N = 1,492 children) provided sufficient data for meta-analysis. Overall, higher e-waste-related lead exposure was associated with significantly poorer neurodevelopmental outcomes (pooled SMD = -0.42; 95% CI: -0.61, -0.23; I² = 56%). Subgroup analyses demonstrated a stronger association in SSA (SMD = -0.58; 95% CI: -0.89, -0.27; I² = 49%) compared with non-SSA low- and middle-income countries (SMD = -0.35; 95% CI: -0.54, -0.16; I² = 42%). Sensitivity analyses confirmed the robustness of findings, and visual inspection of funnel plots did not indicate substantial publication bias, although statistical power was limited. These results indicate that e-waste-related lead exposure is associated with clinically meaningful neurodevelopmental deficits in children, with evidence of a disproportionately higher burden in SSA, underscoring the urgent need for enforceable e-waste regulation and child-focused environmental health policies in the region.