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Combined Sewer Overflows (CSOs) are the most important source of diffuse contamination in urban environments. Cleaner production in cities necessarily involves the reduction of both frequency and contamination linked to overflows in rain events as well as the control and minimization of its impacts in aquatic ecosystems. That would additionally lead to an increase in waste water treatment plant energy efficiency. However, there is an extended belief among sanitation managers at municipal level that impacts of CSOs in large rivers are not perceptible due to dilution effect. To dismantle this myth, the present article analyses the impacts of CSOs in the Spanish widest river, the Ebro River. The results suggest that the Ebro tends to worsen in dry season during intense rainfall, inviting to perform proper interventions to reduce CSOs along its urban stretch. (C) 2019 Elsevier Ltd. All rights reserved.