A/HRC/18/31 are unlikely to receive proper training on the risks associated with the handling of hazardous medical waste or protective clothing, including gloves against needle-stick injuries. They do not usually receive any vaccinations against common infectious diseases. 51. Untreated medical waste can reach the recycling industry by a number of routes. In many developing countries, where hospitals have no recycling programmes, staff at healthcare facilities often sell medical waste to waste recyclers in order to supplement their incomes. This practice allows for the reuse and recycling of a large amount of nonhazardous hospital materials, such as empty bottles and containers or aluminium from vial caps. Other materials, such as syringes, blood bags or laboratory waste, are, however, extremely hazardous, and the practice puts whoever processes these products at risk. Waste recyclers usually have no formal education and possess very little or no knowledge of the risks associated with the handling of hazardous substances or the precautions to adopt to minimize their adverse health effects. They usually use no protective gear to prevent them from exposure to the hazardous substances contained in medical waste. 3. Scavengers 52. Medical waste is also sought out by scavengers, who put themselves at great risk by collecting it. In some countries, scavengers are often seen in hospital grounds, while others collect waste from municipal dumps or at illegal landfills. In December 2007, for instance, a large number of scavengers, mainly children, were suspected to have contracted hepatitis C as a result of needle-stick injuries during the collection of used syringes and other clinical waste for recycling.18 Even in countries where there is less of a recycling industry, the practice of mixing medical waste with ordinary garbage exposes scavengers to a number of infectious diseases, such as hepatitis and tetanus, and to physical risks associated with the handling of infected needles and broken glass. C. Right to an adequate standard of living 53. The inappropriate management and disposal of hazardous medical waste may adversely affect the enjoyment of the right to an adequate standard of living. Article 11.1 of the International Covenant on Economic, Social and Cultural Rights specifies a number of rights emanating from, and indispensable for, the realization of this right, including adequate food, clothing and housing. Although it has not been expressly included in this list, the right to safe drinking water clearly falls within the category of guarantees essential for securing an adequate standard of living, particularly since it is one of the most fundamental conditions for survival.19 54. Most hospitals, health-care facilities and pharmacies are situated in the centre of cities, towns and villages, close to residential areas where people live. Owing to the lack of adequate waste management plans, on-site disposal is often the norm for many health-care establishments in developing countries. Hazardous medical waste is collected together with non-hazardous waste, and often disposed of in the backyard of hospitals. Open burning, uncontrolled dumping and incineration are the most common methods of on-site disposal. 55. The combustion of medical waste at low temperatures may release significant amounts of dioxins, furans and other toxic air pollutants through gaseous emissions and/or in bottom and fly ash. Fly ash often contains high concentrations of heavy metals, as well as small amounts of dioxins and furans, while bottom ash may contain needles, broken glass and other sharps, as well as such toxic substances as heavy metals, dioxins and furans. Incineration ash is often disposed of in nearby landfills and ash ponds. When used as 18 19 “Hospital waste spreading hepatitis”, The News International (Karachi), 24 December 2007. Available from www.thenews.com.pk/TodaysPrintDetail.aspx?ID=87554&Cat=4&dt=12/24/2007. See Human Rights Council resolution 15/9. 13