108 adolescent detainees between 16 and 18 years of age are subjected to solitary 380 confinement as a disciplinary measure during their period of pretrial detention. 285. In this regard, the Commission emphatically reiterates that under international human rights law, including Inter-American system standards, solitary 381 confinement must not be used on children and adolescents deprived of liberty. 286. As for confining detainees in high-security modules, the Commission has established that there is no reason for such modules, regardless of the conditions of such modules, to be located in pretrial detention centers, where detainees should be 382 treated with respect to the right to the presumption of innocence. C. Impact of the excessive use of pretrial detention on prison systems 287. For several years, along with other international human rights bodies and the political bodies of the OAS, the Inter-American Commission has been noting that the most serious and widespread problem faced by the Member States with respect to prison management is overcrowding and that overcrowding is the predictable 383 consequence of the excessive use of pretrial detention, among other factors. This is illustrated in Table 1 of this report (supra para. 52), which shows the proportion of pretrial detainees to the prison population in several States of the region based on official information provided by the States. 288. Overcrowding increases levels of violence among inmates; it prevents them from having a minimum of privacy; it hinders access to basic services, some as essential as water; it spreads diseases; it creates an environment in which sanitary and hygienic conditions are deplorable; it constitutes, in and of itself, a risk factor for 380 American Civil Liberties Union (ACLU), Informational note submitted to the IACHR Rapporteur on Persons Deprived of Liberty, on May 23, 2013. In this communication, the ACLU also noted that there is no comprehensive examination of the nature and extent of the use of solitary confinement on persons in pretrial detention in the United States. With regard to the use of solitary confinement in the United States, also see, IACHR, Thematic Hearing: Human Rights and Solitary Confinement in the Americas, 147th regular period of sessions, requested by the American Civil Liberties Union (ACLU), with the participation of the SRT Juan Mendez, March 12, 2013. 381 IACHR, Principles and Best Practices for the Protection of Persons Deprived of Liberty in the Americas, Principle XXII(3); IACHR, Report on the Human Rights of Persons Deprived of Liberty in the Americas, paras. 409 and 410. 382 IACHR, Report on the Human Rights Situation in Mexico, OEA/Ser.L/V/II.100. Doc. 7 rev. 1, approved on September 24, 1998, Ch. III, para. 250. 383 IACHR, Truth, Justice and Reparation: Fourth Report on the Human Rights Situation in Colombia, 2013, Ch. VI(G); IACHR, Report of the Inter-American Commission on the Human Rights Situation of Persons Deprived of Liberty in Honduras, para. 65; IACHR, Report on the Human Rights of Persons Deprived of Liberty in the Americas, paras. 447 – 451. In this regard, also see, ILANUD, Crime, Criminal Justice and Prison in Latin America and the Caribbean: How to Implement the United Nations’ Rights and Duties Model, 2010, Elías Carranza, Crime, Criminal Justice, and Prisons in Latin America and the Caribbean: The United Nations Model, Based on Rights and Obligations, and the Need for Comprehensive Social and Criminal Justice Policies, pp. 76 and 77.