The Water Quality in Rio Highlights the Global Public Health Concern Over Untreated Sewage

Introduction From the spread of the Zika virus, to the polluted waters in Rio de Janeiro, media reports have highlighted health concerns in Brazil. An editorial in the New York Times (Cox 2016), along with other media reports of high levels of sewage contamination in Rio’s recreational waters, caused wide-ranging concerns about the safety of sailing, rowing, and other open-water events at the 2016 Olympic Games (Brooks and Barchfield 2015). Such concerns seemed well grounded, because in August 2015, members of the U.S. rowing team reported stomach illness following a trial competition on a Rio lake that the team doctor suspected was due to water pollution (Mazloumsaki and Brocchetto 2015). For both Zika and water quality, media attention has focused on athletes and the role of the International Olympic Committee. However, exposure goes beyond athletes to everyone who uses water, including tourists and most importantly local residents. That much of Rio’s human sewage goes untreated is in no way unusual for urban environments, especially in lowand middle-income countries (LMICs). It is estimated that 1.5 billion people worldwide have sewage connections with no treatment (Baum et al. 2013). Even in higher-income countries where sewage is often treated to a high degree, environmental contamination from sewage occurs when treatment is bypassed, for example, during storm water overflows, which are frequent in some settings (Sato et al. 2013).