Rivers, lakes and groundwater are polluted mainly by two things: wastewater from homes, businesses and industry, and runoff from farms. In 2024 households generated an estimated 332 billion cubic metres of wastewater, of which only 185 billion cubic metres were safely treated. About 17% was never collected at all, and wastewater held in septic tanks was often not emptied and treated properly. Along with untreated sewage come excess nutrients (nitrogen and phosphorus), sediment, pathogens, pesticides, pharmaceuticals, heavy metals and microplastics. Nutrient pollution from farming and wastewater roughly doubled over the last century and, according to modelling studies cited by UNEP, is expected to double again by 2050.
Polluted water harms people who drink it, wash in it, fish in it or eat crops irrigated with it. A study cited by UNEP estimated that water pollution caused 1.4 million premature deaths in 2019, and 122 million people still drank untreated water from rivers, lakes and other surface sources in 2022. WHO estimates that at least 10% of the world's population eats food irrigated with wastewater. The gap is widest where incomes are lowest: low-income countries safely treat about a quarter of their household wastewater, and the poorer half of the world's countries produce only a tiny share of the water quality measurements needed to know how polluted their rivers and lakes are.