Household waste has evolved into a core urban challenge, with increased quantities of waste being generated and with more complex material compositions, often containing toxic and hazardous elements. Critical systems theory understands cities as urban metabolisms, with different material and energy flows, highlighting the circularity in production, consumption, and discard. Waste pickers in low- and medium-income countries work on dumps and landfills, sifting through highly contaminated household waste and are exposed to health hazards. This paper discusses the risk factors, hazards, and vulnerabilities waste pickers are exposed to during collection and separation of recyclables, based on the review of literature on waste and environmental health and on findings from participatory research with waste pickers conducted in Brazil. We take a social and environmental justice perspective and identify the vulnerabilities and waste-borne hazards of household waste, associated with these workers, their communities, watersheds, and the environment. Household waste, although not always per se toxic or hazardous, can become a hazard if not collected or inadequately managed. Those communities where household waste is not collected or waste collection is insufficient are the most critical places. Informal and organized waste pickers, municipal or private waste collectors/workers, small waste traders and sometimes residents, particularly small children, may be considered vulnerable if exposed to waste-borne hazards. The results include recommendations to address household waste-borne hazards and vulnerabilities, according to waste workers involved in this research.