Increased RPE-wearing time and hand-washing frequency associated with lower urinary pollutant levels among Hong Kong e-waste workers

Workers are exposed to hazardous chemicals from e-waste recycling. Protective measures such as respiratory protective equipment (RPE) and hand hygiene may reduce chemical exposure, but their effectiveness in the e-waste recycling industry remains underexplored. Therefore, a cross-sectional study was conducted from June 2021 to September 2022 involving 101 e-waste workers in Hong Kong during the COVID-19 pandemic to fill such research gap. Participants reported changes in RPE-wearing time and hand-washing frequency compared to pre-pandemic levels. First-spot morning urine samples were collected and analyzed for metals and organic pollutants. Associations between increased protective behaviors and urinary chemical concentrations were assessed using multivariate log-link linear regression models. The results showed that 31.7 % of workers increased RPE use (54.4 % of them wearing medical masks) and 49.5 % increased hand-washing frequency during the pandemic compared with pre-pandemic levels. Increased RPE use was associated with significantly lower urinary concentrations of nine chemicals. Increased hand-washing frequency showed even greater associations with diminished levels of 14 pollutants. Workers who increased both protective behaviors exhibited the greatest decreases in chemical burden. These associations were more pronounced among workers involved in dismantling/repairing e-waste and those employed by non-subsidized entities. In conclusion, enhanced preventive behaviors (RPE use and hand-washing frequency) are significantly associated with decreased chemical exposure levels among e-waste workers in Hong Kong. While engineering controls remain essential, these simple and cost-effective measures provide practical improvements in occupational safety and health, particularly for resource-limited settings where workers face elevated exposure risks due to primitive recycling practices in both developed and developing regions.