The Yangtze River Economic Belt supports over 400 million people and contributes nearly half of China’s GDP, yet decades of industrialization, urbanization, and agricultural intensification have resulted in severe contamination and pressing environmental challenges. This systematic review synthesizes three decades of peer-reviewed and governmental data to examine the spatiotemporal distribution, sources, and ecological and human health risks of major pollutants, including heavy metals, microplastics, persistent organic pollutants, and excess nutrients. While point-source emission of heavy metals such as cadmium, lead, and mercury have decreased by 35–42% since 2013 following policy interventions like the 10-Point Water Plan and the Yangtze River Protection Law, legacy contaminants in sediments and diffuse agricultural inputs continue to pose significant risks. Cadmium levels in rice still exceed food safety standards, arsenic in groundwater surpasses health guidelines, and microplastic flux into the East China Sea has reached 8.3 × 1012 particles per year. Nutrient surpluses also drive extensive algal blooms, causing substantial economic losses. This review evaluates remediation strategies such as dredging, phytoremediation, wetland restoration, and AI-enhanced monitoring, which show removal efficiencies of 60–90% at reduced costs. However, critical gaps remain in understanding chronic mixture toxicity, the long-term fate of emerging contaminants, and pollutant–climate interactions. We propose an integrated basin-wide roadmap combining zero-liquid-discharge mandates, green infrastructure, and adaptive, performance-based governance to secure the Yangtze’s ecological and economic sustainability. This framework offers a transferable model for large-scale watershed management worldwide.
Shu et al. (Fri,) studied this question.