Construction of hotels, recreation and other facilities often leads to an increase in sewage pollution. Wastewater has polluted seas surrounding tourist attractions, damaging the flora and fauna. For example, sewage runoff causes serious damage to coral reefs because it stimulates the growth of algae, covering corals and hindering their ability to survive. Changes in salinity and siltation due to sewage production can also have wide-ranging impacts on coastal environments.

Hotels and resorts operate half of the wastewater treatment plants in the Caribbean. However, three-quarter of these plants do not comply with a basic effluent criteria of 30 mg/l Biological Oxygen Demand (BOD) and Suspended Solids (SS) or 85% removal of BOD and SS. The Caribbean Tourism Organization (CTO) collected evidence that indicates that 80 to 90 percent of the sewage generated across the region by hotels is disposed of in near shore coastal waters without adequate treatment. In St Lucia for example, hotel wastewater plants are not working, or operating below optimal capacity resulting in certain areas of the coastline being periodically contaminated by sewage and posing serious environmental and health risks. This makes hotels one of the largest and most dangerous sources of marine pollution, and consequently a major threat to their own economic well being. To make matters worse, throughout the Caribbean region, legislative provisions to control effluent discharges are weak - or non-existent - and the enforcement capacity of agencies responsible for monitoring and enforcing the legislation is lacking.

Moreover, sewage production does not only cause loss of wildlife, decrease in aesthetic appeal, and losses in revenue for tourism but it also poses a threat to the health of humans and animals.