The Clean Water Act Addresses Health Issues

By Isabelle Bienen, NWNL Research Intern
(Edited by Alison M.  Jones, NWNL Director)
All photos © Alison M. Jones unless otherwise noted

Isabelle Bienen is Northwestern University junior studying Social & Environmental Policy and Culture & Legal Studies. This is the 3rd of 5 blogs Isabelle wrote as a NWNL Summer Intern on the U.S. Clean Water Act [CWA]. Her 1st two CWA blogs: CWA Beginnings -Mississippi River Basin and CWA Beginnings – Columbia and Raritan River Basins.

Jones_170617_NE_5169.jpgSign in Missouri River Basin, Nebraska

This blog in our series on the Clean Water Act [CWA] focuses on health threats of water pollution on urban, rural, indigenous, marine, flora and fauna communities. Beyond toxicity issues mentioned in the series’ earlier blogs, prevalent and serious health threats described below go further in underlining the need for the CWA.

Urban Health Threatened

Human health is threatened by polluted drinking water and dirty sanitation facilities, of which there are many more in urban than in rural environments. Unfortunately, urban environments can also include overcrowding, unhygienic conditions, unsafe drinking water and more health-related issues. In the late 1800’s to early 1900’s, the spread of disease through water was especially prevalent in urban environments, notably in cholera breakouts. During this time, scientists realized that just because water might look and smell clean, that did not mean that it was safe to drink.

Author Robert D. Morris states in his book, The Blue Death (2009), that water spreads infectious diseases through contact with contaminated fecal matter and other bacteria. Regarding urban cholera breakouts, Morris claims, “The health department staff had initially believed that the outbreak had attacked a few hundred people. As the outbreak wore on, they began to think that it might have hit as many as a thousand. No one fully grasped the power of water to spread disease” (Morris 214)1. This highlights the extent to which disease can spread via water in an urban environment, especially in major cities such as New York, Boston, Seattle, San Francisco, and Portland which do not filter their drinking water. These cities rely on protection by their watersheds natural resources and some chemical disinfectants to ensure that their drinking water remains purified.

Jones_140907_LA_0752-2.jpgMississippi River plant between New Orleans & Gulf of Mexico

An example of health threats in an urban area, discussed in the first blog of this series, is found in the stretch of Mississippi River between Baton Rouge and New Orleans with a high number of petrochemical plants. Known as “Cancer Alley,” this region is seen as responsible for numerous reported cases of cancer. In 2002, the State of Louisiana reported the second most cancer-caused deaths in the United States.

At the opposite end of the Mississippi River from  “Cancer Alley,” a 2-year Minnesota study begun in 2015 by the Minnesota Pollution Control Agency discovered urban development was causing increased levels of nitrate in the Upper Mississippi River. This study added 274 miles of the river to Minnesota’s list of  “impaired waters” that fail to meet even one water-quality standard.3  However, further upstream near the Lake Itasca headwaters of the Mississippi River, water quality was far less polluted and thus this landscape has remained far less changed.3 These studies support the need for adequate regulation of urban development and waters to protect city residents.

Rural Health Threatened

In rural environments, the causes of water pollution and extent of illness from contaminated drinking water differ from those in urban environments. Water quality in rural environments actually tends to be worse than in urban areas where drinking water is treated. It appears that rural mortality rates due to cancer are higher in rural areas.3

Jones_070627_WA_4800.jpgIrrigation water polluted by farm chemicals goes to Washington’s Columbia River

As well, water contamination from pesticides is more prevalent in rural environments. In Silent Spring, Rachel Carson addresses, “…the never-ending stream of chemicals of which pesticides are a part….”  She warned that, “Their presence casts a shadow that is no less ominous because it is formless and obscure, no less frightening because it is simply impossible to predict the effects of lifetime exposure to chemical and physical agents that are not part of the biological experience of man.4 Monitoring the amount of pesticides and other harmful toxins that enter water systems is critical due to the extent of unknown effects of toxic chemicals in water supplies have on human health.

Carson also states that if a human liver is affected by pesticides, “it is not only incapable of protecting us from poisons, but the whole wide range of its activities may also be interfered with.”4  This highlights the wide-ranging and uncertain consequences of pesticides on the human health system. It is clear that in rural communities, without treated water systems and with a high quantity of farm pesticides, unmonitored water pollution is detrimental to human health.

Health of Indigenous People Threatened

The health of North American native communities is especially at risk from polluted water since these cultures heavily rely on local water and natural foods gathered by hunting and fishing. Insufficient and low-quality water supplies are common in these communities. This causes fish and other aquatic life to die off or move to other locations, which decreases food supplies for indigenous people. Many tribes lack access to safe drinking water or water filtration systems due to their geographic location and their lower economic status. For instance, within Arizona’s Fort Apache Reservation, there is an increase in children experiencing diarrhea or stomach issues.7

Jones_121021_TX_5758.jpgSign warning of water contamination in Red River Basin, Texas

Increased effects of climate change also cause more intense rain patterns and flooding, with waste overflows bringing bacteria, viruses and algae into US water systems. This spread of toxins can deplete aquatic life, as well as infect those who drink from or swim in these waters.7 Adequate resources are needed to monitor the prevalent “nonpoint sources” of pollution in water systems of indigenous communities to ensure that their health does not continue to suffer.

Health of Marine Life Threatened

NWNL documentation of its US watersheds includes each one’s terminus – often a delta or estuary – which in most cases combine fresh and saline water. Frequently, the health of these terminal bodies of water is worsened by their river’s downstream flow of pollution. Thus, toxins delivered in fresh water impacts the health of marine life that flushes in and out of river estuaries, as well as the upstream riverine life.

Jones_090621_NJ_0979.jpgShore of a polluted area of the  Lower Raritan River, New Jersey

One of the main causes of death and relocation of marine life when toxic rivers meet an ocean, gulf or sea is hypoxic dead zones where oxygen levels are reduced. While there are various physical, chemical and biological factors that help create dead zones, a high amount of toxic nutrients is one of the main factors. When agricultural pollutants, especially nitrogen, phosphorus, and wastewater, enter bodies of water, algae grows to the point that it sinks and decomposes. That process of decomposition consumes the oxygen needed for other marine life in these bodies of water.  

Most typically, dead zones occur in bodies of water near heavy amounts of agriculture and industrial activity. The second largest dead zone in the United States is in the northern Gulf of Mexico, below the Mississippi Basin’s extensive “Grain Belt”.8 There are also dead zones in the Columbia River Basin Estuary in the Pacific Ocean, also downstream from large swaths of farm country.

A 2008 study revealed over 400 dead zones worldwide.8 However, dead zones can disappear if water pollution is heavily reduced or eliminated. This happened in 1990, following the fall of the Soviet Union when the cost of chemical fertilizers increased. Although it was an unintended consequence, a decrease in fertilizer applications shrank a large dead zone in the Black Sea.9

Aquatic Flora and Fauna Threatened

The health of native flora and fauna – terrestrial and aquatic – is at risk where there is increased water pollution. Relocations of fish populations are indicative of water quality. Lower populations of fish species provide evidence of higher levels of pollutant bacteria or decreased levels of oxygen in the area. One instance of aquatic life eliminated by water pollution has been the disappearance of oysters in the Hudson River and Raritan Bay.

By the 1920’s oysters and many other species had disappeared from the Hudson River due to environmental deterioration from 1890 on. Before that, water-filtering oysters were found in Ossining, New York, Newark Bay, Arthur Kill, Kill Van Kull, Jamaica Bay, Raritan Bay, and New Jersey shores of the Hudson.  By 1920 however, oyster populations had largely disappeared, overwhelmed by sewage pollution, harbor dredging and industrial activity that even oysters couldn’t filter or cleanse.

Jones_090515_NJ_4550.jpgSpillway for waste water runoff into the Raritan River, New Jersey

These factors created pockets of dead zones in the NY waters where Dissolved Oxygen levels had declined to a critical point of 0-2% saturation in the summer.10 In 1909 dissolved oxygen in the Hudson River was at 72%, but by 1935 it dropped to 40, and was often at zero in summer months.10 These drops clearly correspond to historical periods of increased sewage pollution.10 Although oysters are filter feeders, they too are finally affected by extreme levels of toxins and pollutants.

Indicators of Successful Water Clean-up

Typically, species like oysters that “filter feed” eventually leave areas of low-water quality.  Low amounts of filter-feeding species indicate low water quality.10 Recently, stewards for the Hudson River and Raritan Bay initiated the Billion Oyster Project to reintroduce the oysters.  (See earlier NWNL blog on Oysters Creating a Living Shoreline.) The success of their reintroduction of colonies of oyster spats is a clear indication that the quality of those urban waterways has significantly recovered from earlier extreme lows that hurt native flora, fish, and fauna populations.  The NY-NJ oyster story is a great example of the rewards of clean water recovery efforts.


  1. Morris, Robert D.  The Blue Death: The Intriguing Past and Present Danger of the Water you Drink, Harper, 2009.
  2. Pollution Issues, accessed 7/11/18, published 2006, IKB, link.
  3. Star Tribune, accessed 7/11/18, published 2017, IKB, link
  4. Carson, Rachel. Silent Spring, Houghton Mifflin, 1962.
  5. Coastal Wetlands Planning, Protection and Restoration Act, accessed 7/11/18, published 2015, IKB, link.
  6. US Environmental Protection Agency, accessed 6/20/18, published 2016, IKB, link
  7. National Ocean Service, accessed 6/20/18, published 2013, IKB link
  8. LaFasto,  Drew.  “Water Quality’s Effect on Flora and Fauna,” Atavist, accessed Summer 2018, link
  9. Biology Department of Brooklyn College, accessed 6/20/18, published 1982, IKB, link.
  10.  The Times Picayune, accessed 7/26/18, IKB, published 2018, link

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