Human health and well-being are intimately tied to ocean health, which is especially apparent in communities that have polluted coastal waters (Landrigan et al., 2020). The well-established water, sanitation and hygiene (WASH) sector is devoted to addressing and preventing illness associated with contaminated water and lack of safe sanitation.

The statistics are usually reported as number of deaths and Disability Adjusted Life Years lost (DALYs) due to diarrheal disease associated with lack of sanitation. Although the number of deaths is going down, from an estimated 2.4 million in 2008 (Prüss-Ustün et al., 2008) to 829,000 in 2016 (Prüss-Ustün et al., 2019), with more than a third occurring in children under five, numbers of deaths are still too high, representing only a portion of the burden of disease associated with wastewater pollution. Because wastewater is ubiquitous and moves easily throughout the environment, it contributes to a wide range of illness in human populations. Diseases caused by wastewater exposure include cholera, schistosomiasis, and hookworm disease, as well as illnesses related to nitrate exposure (Mara et al., 2010). The estimated DALYs lost to infectious disease, disability, and death contracted through exposure to wastewater in the ocean is estimated at 3 million years annually (Shuval, 2003). In places where wastewater pollution results in contaminated seafood, food security is also at risk. An estimated 180 million cases of upper respiratory disease and gastroenteritis each year are attributed to ingesting contaminated seafood or bathing in polluted ocean waters (Shuval, 2003; WHO, 2015). The following sub-sections illustrate the patterns of illness associated with wastewater pollution.

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