ST. LOUIS COUNTY 鈥 The creek running past Caroline McGee鈥檚 house in a picturesque Ladue neighborhood is a favorite playground for her young kids. They spend hours exploring the creek 鈥 tracking frogs, watching tadpoles and following the water.
The family had no idea overflow pipes upstream sometimes dump raw sewage into the creek during heavy rainstorms.
鈥淭hat鈥檚 really disturbing,鈥 McGee said. 鈥淎ll the neighborhood kids play down there.鈥
More than a decade after settling a federal lawsuit, and spending $3.2 billion on the plan dubbed Project Clear, the region鈥檚 sewer district has capped off more than 100 overflow pipes, or outfalls. That represents about half the work required by the settlement.
After all the scheduled work is completed at a total estimated cost of more than $7 billion, however, scores of outfalls, mostly in 51黑料 and its older suburbs, will remain, as will the sewage overflows.
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Moreover, an expected increase in the number and intensity of rainstorms means the billions spent will make less of a difference than they otherwise would, according to the Metropolitan 51黑料 Sewer District.
Clean water advocates say the region can do better. Raw sewage dumped in local creeks makes its way to the Mississippi River, where millions get their drinking water. Sewage can overwhelm treatment plants and sicken people who are exposed to pathogens in it, and it contributes to environmental dead zones downstream.
Eliminating outfalls entirely was never part of the plan, said Alan Morrissey, a former U.S. Environmental Protection Agency attorney who helped negotiate the deal with city and sewer district officials.
鈥淔undamentally, many of them didn鈥檛 understand why you had to worry about sewage going into a body of water the size of the Mississippi River,鈥 Morrissey said. 鈥淚t seems obvious to anyone who knows the harmful effects of sewage. It only takes one sick individual to really make that water dangerous, and somebody downstream may be drinking it.鈥

A warning sign is seen behind a home along Black Creek in Ladue on Tuesday, June 24, 2025. The sign alerts people about the potential for untreated sewage being present in the creek because an MSD overflow discharges into the waterway when the system exceeds capacity.
The goal was to improve water quality by cutting how much untreated sewage the outfalls dump into area streams and rivers 鈥 from roughly 13 billion gallons to 8 billion annually, according to MSD鈥檚 with the Environmental Protection Agency. That represents a volume reduction from roughly 20,000 Olympic-sized swimming pools full of raw sewage to 12,000.
MSD says any work beyond Project Clear would come with a huge cost but minimal impact on water quality. Eliminating all outfalls would cost twice what the district already expects to spend, and it would require ripping up streets across 51黑料, district spokesperson Bess McCoy said. A project that size would send rates skyrocketing when the average wastewater bill has already doubled since the federal settlement in 2012.
Few area waterways currently meet . The district鈥檚 work, however, already has improved water quality noticeably in the past decade, McCoy said, and the remaining work will curb sewage overflows to the point where streams and rivers in the district鈥檚 territory will meet those standards.
鈥淲e鈥檙e making sure that our community is healthy,鈥 she said. 鈥淲e鈥檙e making sure that our environment is healthy without costing our community way more than anyone can afford.鈥
The region still should strive for improvements, said Kathleen Logan Smith, the former executive director of the Missouri Coalition for the Environment, which sued MSD alongside the federal government over the outfalls in 2007 鈥 the catalyst for the eventual settlement.
鈥淣ature does us some big favors by taking in a lot of the overflows of our problems,鈥 Smith said. 鈥淲e just need to be focused on reducing the burden we鈥檙e loading her with.鈥

Combined sewer overflows, or CSOs, happen when a combination of stormwater and sewage overwhelms a sewer system. When the sewers are at capacity, bypass pipes, or outfalls, release untreated sewage into area waterways.
Better than in your basement
MSD, created by voters 1954, consolidated a patchwork of 79 public and private sewer systems across 51黑料 and 51黑料 County.
In 51黑料, thousands of miles of pipes carry a mixture of stormwater and sanitary sewage 鈥 the waste from bathrooms and gray water from kitchens and laundry machines 鈥 to treatment plants, where the mixture is cleaned and released into the region鈥檚 rivers. During dry weather, the system keeps sewage contained.
When heavy rains overwhelm the sewer, however, the mixture rises above a weir, or a low dam, in the sewer pipe and is dumped directly into a river or stream, typically the River Des Peres and its tributaries, or into the Mississippi River.
The event is called a combined sewer overflow.

Sean Stone, senior public affairs specialist at Metropolitan 51黑料 Sewer District, shines a flashlight on debris at the bottom of a tunnel underneath Forest Park, on Wednesday, Aug. 20, 2025. The tunnel carries excess water when nearby tunnels overflow as part of the system carrying water from the River des Peres.
As 51黑料鈥 suburbs expanded, developers installed separate sewers for sewage and stormwater. Over time, however, development and population growth sent more sewage into the system. Cracks, leaky manholes and downspouts allowed more water to find its way into the sewage pipes. And during heavy rains, the sewers were unable to handle the stormwater and sewage, both.
The solution was to build more bypass pipes to relieve the overwhelmed system: Better to send the mixture into a stream than it back up in homeowners鈥 basements, officials reasoned.
This event is called a sanitary sewer overflow.
Into the 1960s and 1970s, hundreds of the outfalls were installed across the county, from Florissant in the north to Chesterfield in the west to deep south 51黑料 County.
The outfalls dump into creeks that run through backyards, playgrounds and parks. One dumps into Black Creek near South McKnight Road in Ladue, upstream from where McGee鈥檚 kids play in the water. Another empties into a River Des Peres tributary north of Page Avenue in Hanley Hills. One in Brentwood dumps into Deer Creek.
In 1972, the federal Clean Water Act outlawed the type of outfalls built in the county, and in the 1990s, the EPA began filing lawsuits nationwide to enforce the act鈥檚 rules.
51黑料 is far from alone in using the outfalls. Thousands dot the country, mostly in the eastern half of the United States, including in Chicago, Kansas City and Indianapolis. have settled with the EPA over releasing raw sewage into waterways, according to the EPA. Hundreds more have long-term , according to the U.S. Government Accountability Office.
In the summer of 2007, state and federal environmental regulators and the Missouri Coalition for the Environment sued MSD, accusing the district of threatening public health when it released 500 million gallons of raw sewage into waterways from 2000 to 2005.
After nearly five years of negotiations, a judge approved a settlement requiring MSD to close the county鈥檚 128 outfalls, plus clean up rivers and streams by controlling the remaining outfalls.
MSD has closed 110 of the county outfalls so far, and will close the last 18 by 2033.
The EPA counts 174 active outfalls in 51黑料, including dozens along the Mississippi River, and a few older suburbs, such as Maplewood, Richmond Heights and Pagedale. MSD puts the number of active outfalls at 167 and says it will close 37 of them in the coming years, but did not identify which ones.
An $871 million tunnel
Eliminating and reducing outfalls requires multiple projects, upstream and downstream, to accommodate the increased flow of sewage.
The costs are dizzying. The federal agreement ordered MSD to spend $4.7 billion on improvements. The price tag is now expected to exceed $7.2 billion by the end of Project Clear in 2039.
In the 13 years since the court finalized the federal agreement, MSD has asked voters to approve borrowing every four years, except for 2020 when the agency delayed by a year because of the COVID-19 pandemic. To help pay for Project Clear, the average monthly residential bill has risen to $61 in 2025, from about $29 in 2012.
The massive plan is broken into hundreds of individual projects, which can take millions of dollars to complete over several years. Storage tunnels bored deep underground, meant to hold the sewage and stormwater until it can be treated, are among MSD鈥檚 costliest projects.
Take the trip 200 feet below the street in a metal transport cage where the Metropolitan Sewer District has completed a 4.3-mile long, 19-foot wide storm sewer drain that is expected to significantly reduce rainwater overflow into Deer Creek. It was completed in late 2021. Video by Christian Gooden, cgooden@post-dispatch.com
A storage tunnel runs hundreds of feet below a busy section of mid-county. It cost $146.3 million, and helps reduce sewage overflows along Deer Creek in Clayton, Richmond Heights, Brentwood, Maplewood, Webster Groves and Shrewsbury. The $84.4 Maline Creek tunnel runs under Riverview Boulevard in north 51黑料, reducing overflows there.
Construction of the $157.4 million Jefferson Barracks Tunnel is nearly done. That tunnel runs along the Mississippi River, from south of Interstate 255 to MSD鈥檚 Lemay Wastewater Treatment Plant, near the confluence with the River Des Peres.
In 2030, construction will begin on tunnels to relieve overflows along the River Des Peres and its tributaries, from Pagedale and University City to Shrewsbury. MSD will use a tunnel boring machine to install the six-mile, $871.3 million tunnel.
鈥楧ilution is the solution鈥
Even if stormwater vastly dilutes sewage, it still can overwhelm treatment plants and make people sick, said Colin Wellenkamp, an environmental scientist and Republican state representative from St. Charles.
鈥溾橠ilution is the solution to pollution.鈥 That was the mantra, that if you just added enough stormwater, or you added enough clean water or fresh water to a compromised environment, it would all be OK,鈥 Wellenkamp said.
That logic assumes pollutants will stop at a certain point, he said, and that is not the case. Sewage overflows happen repeatedly, and can expose people to pathogens, especially if they swim in the water or otherwise come into contact with it, Wellenkamp said. Dirty water can overwhelm treatment plants, too, such as when a deprived residents of Toledo, Ohio, of water for nearly three days in 2014.
Some communities along the Mississippi River draw water from more stagnant parts of the river, and if toxins build up, people get sick, Wellenkamp said. Exposure to raw sewage can cause health problems, including bacterial or parasitic infections, and intestinal inflammation.
鈥淭here鈥檚 definitely precedent of human health impact from these episodes,鈥 Wellenkamp said.

Water drips from the ceiling of a tunnel onto a stream of waste water and debris underneath Forest Park in 51黑料, on Wednesday, Aug. 20, 2025. The tunnel system carries water from the River des Peres from University City to I-44 in south city, including storm water runoff and sewer waste.
MSD does not track the volume of overflows. Instead, water quality is at the heart of the district鈥檚 agreement with the EPA, said McCoy, the MSD spokesperson.
MSD uses computer models to estimate the volume of overflows and to design improvements for reducing them. The agency then tracks water quality as a measure of how well its projects are working, according to Jay Hoskins, the district鈥檚 assistant director of engineering.
The district has seen improvements in urban streams where the illegal outfalls have been eliminated. Independent researchers have recorded similar findings.
Elizabeth Hasenmueller, a professor of earth and atmospheric sciences at 51黑料 University, just wrapped up a decade of water quality research on Deer Creek, which runs through much of 51黑料 County and empties into the River Des Peres.
Hasenmueller tracked a decrease in E. coli and reduced potassium concentrations, both indicators of less sewage in the water. She also noticed an increase in oxygen levels. Bacteria use sewage as food, and to eat it, bacteria need oxygen. When there is a lot of bacteria in the water, oxygen levels decrease, creating a dead zone where aquatic life cannot live.
Still, E. coli bacteria from sewage and pet waste in urban runoff remains a main pollutant in the region鈥檚 creeks, landing them consistently on the Missouri Department of Natural Resources鈥 list of waterways that set by the federal government.
More intense rainfall
Major floods in the region are increasing in frequency and severity, turning high waters that once were rare into events that occur every few years, according to decades of regional flood data.
The Mississippi, Missouri and Meramec rivers show long-term increases in annual peak river heights over the past century, meaning flood waters routinely reach higher than they once did in 51黑料, Hermann, Eureka and beyond.
That means MSD鈥檚 fixes 鈥 and the money from customers and taxpayers 鈥 may not go as far as officials thought when they signed off on the federal agreement in 2012. Businesses and homes will continue to flood and sewers will back up.
鈥淚f we didn鈥檛 have this more intense rainfall, would our ratepayers have a bigger benefit from the work that we have done? Yes, they would,鈥 said Hoskins, MSD鈥檚 assistant director of engineering.
Flash flooding from Coldwater Creek goes into the Hazelwood home of Jean and Rick Guinn on July 26, 2022; while backed-up sewage and River Des Peres water enters Mary Ann Gaston's basement in University City.
Still, MSD has designed its solutions to go beyond the federal requirements, Hoskins said, in the hopes of accommodating heavier rains.
For some area residents, the problem has been in front of them for decades.
Carol Stubblefield lives on Oakbrook Lane in University City. When it downpours, the intersection floods in front of her house.
Stubblefield never knew in her 20 years of living there that an outfall sits under the intersection. When she learned its purpose, she laughed.
鈥淚 could have not known that and been happy.鈥
The outfall in front of her house, however, is slated to be eliminated.
Bryce Gray of the Post-Dispatch contributed to this report.