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SSOs can cause [[gastrointestinal illness]]es ([[waterborne diseases]]), beach closures and restrictions on fish and [[shellfish]] consumption.
 
=== United States= ==
==Magnitude of the problem==
Developed countries such as the [[United States]], [[Canada]], most [[Western Europe]]an nations (e.g. [[Italy]] and [[France]]), [[Australia]], [[Singapore]], [[South Korea]] and [[Japan]] are struggling with public health problems of SSO prevention. The magnitude of the problem is much greater in most developing countries.
 
===United States===
The [[U.S. Environmental Protection Agency]] (EPA) estimates that at least 23,000 to 75,000 SSO events occur in the United States each year.<ref>{{cite web |url=https://www.epa.gov/npdes/sanitary-sewer-overflows-ssos |title=Sanitary Sewer Overflows |author=<!--Staff writer(s); no by-line.--> |date=2015-11-16 |access-date=2023-02-17 |website=National Pollutant Discharge Elimination System |publisher=U.S. Environmental Protection Agency (EPA) |___location=Washington, D.C.}}</ref> EPA estimated that upgrading every municipal treatment and collection system to reduce the frequency of overflow events to no more than once every five years would cost about $88 billion as of 2004.<ref name="EPA-RTC">{{cite report |date=August 2004 |title=Report to Congress: Impacts and Control of CSOs and SSOs |url=https://www.epa.gov/npdes/2004-npdes-cso-report-congress |access-date=2023-02-17 |publisher=EPA |id=EPA-833-R-04-001}}</ref> This cost would be in addition to approximately $10 billion already invested. Although the volume of untreated sewage discharged to the environment is less than 0.01 percent of all treated sewage in the United States, the total volume amounts to several billion gallons per annum and accounts for thousands of cases of gastrointestinal illness each year.<ref name="EPA-RTC" />{{rp|Ch. 6}}
 
=== Worldwide perspective= ==
Developed European countries and Japan have similar or somewhat larger percentages of SSO events compared to the U.S.{{citation needed|date=June 2015}}
 
In [[developing countries]], most wastewater is still not treated when discharged into the environment. The [[People's Republic of China]] discharged about 55 percent of all sewage without treatment of any type, as of 2001.<ref>"[[World Bank]] Supports China's Wastewater Treatment", ''The People’s Daily'', November 30, 2001, Beijing</ref> In a relatively developed [[Middle East]]ern country such as [[Iran]], the majority of [[Tehran]]'s population has totally untreated sewage injected to the city’scity's groundwater.<ref>Massoud Tajrishy and Ahmad Abrishamchi, "Integrated Approach to Water and Wastewater Management for [[Tehran]], [[Iran]]", [[Water Conservation]], Reuse, and Recycling: Proceedings of the Iranian-American Workshop, National Academies Press (2005)</ref> In [[Venezuela]], a below-average country in [[South America]] with respect to wastewater treatment, 97 percent of the country’scountry's sewage is discharged untreated into the environment.<ref>Appropriate Technology for Sewage Pollution Control in the Wider [[Caribbean]] Region, Caribbean Environment Programme Technical Report #40 1998</ref>
 
In many countries there are obligations to measure and report SSO occurrence using real-time [[telemetry]] to warn the public, bathers and shellfishery operators.{{citation needed|date=June 2016}}