gastrointestinal illness. Further, although the impacts of acid mine drainage on stream habitat and ecology are typically measured by water pH and heavy metal concentrations, downstream effects are more subtle, difficult, and expensive to identify (e.g., through bioassessments). Thus, current water quality planning, regulation, and action to protect both public health and the environment are based largely on indirect criteria, without the benefit of human health or ecological assessments. This national condition also applies in southwestern Pennsylvania. Therefore, when considering present and potential investments and improvement projects for wastewater management and drinking water treatment, a significant investment to improve environmental and health data to demonstrate the actual impact of water quality conditions on the environment and public health would seem justified.

An important lesson learned from this examination of water quality management in southwestern Pennsylvania is that long-term control plans for combined sewer overflows (CSOs) should be designed so as to permit creative and flexible solutions that can be adjusted with knowledge and changing conditions. Current federal CSO policy could be interpreted to maximize delivery of such overflows to secondary wastewater treatment plants. Decisions to adopt such action as part of a control plan should be made in the context of a comprehensive plan for a specific management area. The comprehensive plan should consider a broad array of options that may be complementary to or alternatives of maximization of flow to secondary treatment plants. The preferred management strategy should be programmed over a reasonable time horizon to facilitate feedback from less capital-intensive elements to better inform decisions about more capital-intensive ones.

To one degree or another, existing federal and state policies support regional cooperative water quality management programs. However, most financial assistance has been directed toward projects that provide specific benefits, but which may not be optimal in a regional context. To the extent that funds available to a Comprehensive Watershed Assessment and Response Plan (“CWARP-type”) program can be applied with some flexibility, they should be directed toward achieving optimal regional benefits.

In the conduct of public affairs related to environmental quality, elected officials, their administrators, and private utility operators must consider a multitude of individual and collective concerns about strategies, costs, and local projects. In many parts of the country, these disparate concerns have delayed, significantly changed, or vetoed water quality improvement projects. The committee’s recommendation to establish a Three Rivers Regional Water Forum is an attempt to address this issue in southwestern Pennsylvania and, in concept, may be beneficial to other areas of the United States.

A 2000 survey conducted by the Pennsylvania Economy League and related national surveys (e.g., American Water Works Association Research Foundation) of public attitudes regarding water and investment indicate that there is more potential support for expenditures for water quality improvement than is generally believed by those responsible for water matters.