As combined sewer systems and centralized wastewater treatment facilities age, many communities in the world are challenged by management of combined sewer overflow (CSO). Constructed wetlands are considered to be one of the green infrastructure solutions to CSOs in the US. Despite the wide application of constructed wetlands to different types of wastewaters, the stochastic and intermittent nature of CSO presents challenges for design and performance assessment of constructed wetlands. This paper reviews the application status of CSO constructed wetlands in the US, assesses the benefits of CSO constructed wetlands, identifies challenges to designing CSO constructed wetlands, and proposes design considerations. This review finds that constructed wetlands are effective in CSO treatment and relatively less expensive to build than comparable grey infrastructure. Constructed wetlands not only remove pollutants, but also mitigate the event-associated flow regime. The design challenges include incorporating considerations of green infrastructure into permit requirements, determining design capacity for highly variable flows, requiring pretreatment, and needing adaptive design and intensive monitoring. Simultaneous monitoring of flow rate and water quality at both the inflow and outflow of CSO constructed wetlands is required for performance assessment and needed to support design, but is rarely available.
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