Secondary impacts are issues of concern.
A number of large coastal municipalities in the United States discharge treated wastewater directly into the ocean, using discharge pipes that may extend several miles offshore. These ocean outfalls for municipal wastewater are found in most east coast states, but not in North Carolina. That may soon change. Wherever treated wastewater is discharged, whether it is in a river, a lake, an estuary, or the ocean, environmental impact will result. Since the capacity of the ocean for assimilation of treated wastes exceeds that of any inland waterbody, it seems reasonable for North Carolina to consider ocean outfalls as a plausible option.