The chemicals released with water discharges from a fossil-fueled powe
r plant may present health risks through a variety of exposure pathway
s including ingestion of drinking water, fish consumption and dermal a
bsorption while swimming. The Total Risk of Utility Emissions (TRUE) m
odel provides a framework that allows one to assess the multipathway h
ealth risks associated with water discharges from power plants. The TR
UE model formulation is presented with particular emphasis on the trea
tment of water discharges. The application of the TRUE model to a coal
-fired power plant is described and the potential health risks by chem
ical and exposure pathway are discussed.