摘要：Objectives. This study investigated the scale of the public health risk from stormwater runoff caused by urbanization. Methods. We compiled turbidity data for municipal treated drinking water as an indication of potential risk in selected US cities and compared estimated costs of waterborne disease and preventive measures. Results. Turbidity levels in other US cities were similar to those linked to illnesses in Milwaukee, Wis, and Philadelphia, Pa. The estimated annual cost of waterborne illness is comparable to the long-term capital investment needed for improved drinking water treatment and stormwater management. Conclusions. Although additional data on cost and effectiveness are needed, stormwater management to minimize runoff and associated pollution appears to make sense for protecting public health at the least cost. Residents in the United States generally can depend on safe water for drinking, food production, and recreation, thanks to effective water treatment and protective environmental policies. Despite these safeguards, waterborne illnesses are prevalent and may increase because of the strain of climate change, population growth, and changing land use. 1 Expansion of urban areas is creating more impervious surfaces, such as roofs, roads, and parking lots, that collect pathogens, metals, sediment, and chemical pollutants and quickly transmit them to receiving waters during rain and snowmelt events. This nonpoint source pollution is one of the major threats to water quality in the United States 2 and is linked to chronic and acute illnesses from exposure through drinking water, seafood, and contact recreation. Impervious surfaces also lead to pooling of stormwater, increasing potential breeding areas for mosquitoes, the disease vectors for dengue hemorrhagic fever, West Nile virus, and other infectious diseases. Traditional strategies to manage stormwater and treat drinking water require large infrastructure investments and face difficult technical challenges. Reducing stormwater runoff and associated nonpoint source pollution is a potentially valuable component of an integrated strategy to protect public health at the least cost.
