Methods for assessing the public health impact of outflows from combined sewer systems

Approximately 1,100 communities in the United States have combined sewer an d stormwater systems whose capacity may be exceeded during moderate or heav y rainfall. Outflows may occur that can deposit water with varying concentr ations of the components of sewage onto public areas, where contact with re sidents or workers is possible, potentially resulting in a range of adverse health effects. This study proposes and applies three analytic methods to evaluate the impact of such outflows on public health.