Berry-Jo Farms, a hay and beef-cattle operation, is run by Berry Andrews, a genial 74-year-old farmer. In the late 1980s, he was struggling to make ends meet when the Orange County Water and Sewer Authority (OWASA) came around and bought up much of his property. OWASA offered to lease Andrews his land back for $1 an acre if he agreed to use municipal waste as fertilizer. After making his deal with OWASA, he sold his dairy operation and bought beef cattle. “I wouldn’t be in business today if it wasn’t for sludge,” he said. “I may be a dumb farmer, but that sludge works better than regular fertilizer and is free.”

Each year, the US produces eight million tons of dry sewage, referred to as biosolids, roughly half of which is processed and applied as a free fertilizer. Every year, Orange County, NC, alone produces and spreads about 18 million gallons of it. This mucky civilization by-product contains human excrement and has been found to include industrial runoff, oil, household chemicals, funeral-home waste and drugs. A recent Environmental Protection Agency (EPA) survey found heavy metals, PCBs, flame retardants, cocaine, antidepressants, birth-control medications and silver in treated sludge. EPA regulations for the land application of biosolids are some of the most lenient in the world, requiring wastewater-treatment plants to check for just nine of some 80,000 pollutants that can make it through processing and into sewage sludge.

“Sludge used to be nasty stuff,” Andrews said. “It was black and thick. Hell, we used to find tampon applicators in there. But they’ve really cleaned it up recently.” When asked what his neighbors thought, he said that the main complaints came from his daughters and their families, who built houses on his land. “They used to fuss about it, but they have pretty much accepted it now.” On the side of the gravel road, a faded yellow school bus propped up on cinder blocks bore a sign reading, “Rural Nutrients Education Project — a co-operative program between Berry-Jo Farms and OWASA,” a remnant from the initial public-relations push to make biosolids publicly acceptable to a squeamish public. Farther down the road, past the cattle and into the woods, sat two colossal black open-topped cylinders, the containment units for the county sludge.

Sprightly for his age, Andrews jumped onto a little catwalk staircase leading to the top of the cylinder and turned on the faucet. A thick, pressurized stream of viscous, chunky soup gurgled through the tap. He smiled. “Smells like money to me.”

Biosolids are most contentious in rural areas where urban dwellers have begun to drift out into historically poor agricultural areas. In the last ten years, people who work in Research Triangle Park and Chapel Hill have sprawled out to live in rural Orange and Alamance counties in search of peace and quiet. The macho line that the biosolids proponents frequently take is that working farmers and “real” country people know that farming is a dirty, smelly, unsure business and don’t mind spreading biosolids, while it’s the organic-minded, privileged who raise it as an issue.

Myra Dotson, a respiratory therapist, moved out to the rolling hills of Orange County in the early 1970s and bought a large tract of land in the woods with her husband. She enjoyed the peace and quiet of walking her dogs down an unpaved road into a nearby forest of swaying pine trees.

In the 1980s, after OWASA started working with Andrews, Dotson started to notice swollen spots on her skin. She went to her doctor, who told her she had MRSA — a little-understood antibiotic-resistant infection that is today responsible for 10,000 deaths a year in the US, according to the Centers for Disease Control and Prevention. One day, as a test, she walked through a freshly sludged OWASA field; she woke up the next morning with spots and boils on her legs.

Dotson said the local contractors charged with spreading sludge don’t always follow regulations: They apply it in bad weather, risking runoff pollution into local rivers and streams; they allow their cattle to graze on freshly sludged fields, though the law requires a waiting period of 30 days; they forget to post signs to warn the community that sludge has been applied. She said her well and those of her neighbors have routinely been contaminated by sludge runoff. “When you pull out the well water, it looks like Karo Syrup. It’s just nasty.” She said most of the people in her community now drink bottled water.

The EPA and state regulatory bodies have received thousands of calls and health complaints from citizens who are concerned about living in proximity to sludge fields. The EPA does not keep a record of complaints, saying there is no way to gauge their veracity. John Kiviniemi, biosolids manager for OWASA, said, “Just because something is present does not mean that it’s at a concentration that’s harmful. I can’t tell you what’s in your toothpaste, but you still brush your teeth every day.”

William Toffey, a former biosolids manager for Philadelphia, argued in a paper presented at a wastewater industry conference, that people who think that sludge is dangerous have simply succumbed to a form of environmental hysteria referred to as idiopathic environmental intolerance. Rather than allow for the possibility that biosolids might be harmful, Toffey and other biosolids proponents have gone on the offense to publicly claim that there’s something psychologically wrong with the people who think so.

No comprehensive human health study on biosolids has been conducted yet. The closest thing has been scattered health surveys of people who live near sludge fields. One study, released this March by epidemiologists at the University of North Carolina at Chapel Hill, interviewed 34 individuals living beside sludge fields in North Carolina, South Carolina and Virginia and found that more than half of them reported physical symptoms — such as nausea, respiratory problems and rashes — after sludge was applied within a mile of their homes. One respondent, a veteran with PTSD, said that sludge reminded him of waste burning in a war zone. “I’m not able to get myself to a place where I can begin to heal if they’re constantly driving me backwards … every time I’ve got to walk out of my house and smell the freaking war zone,” he said. Three-quarters of the respondents said that sludge interfered with their quality of life and seriously prohibited them from enjoying their homes and land.

There have been numerous health incidents believed related to sludge exposure. In 2002, Synagro, the largest biosolids company in the US, paid a settlement to the family of a young man, Shayne Conner, after he died mysteriously in the middle of the night, his open bedroom window 300 feet from a sludge field. (The settlement included a denial of wrongdoing.) In 2008 two Augusta, GA, dairy farmers settled out of court after a decades-long lawsuit over bad sludge that killed their cattle; the plaintiffs’ experts found thallium in the cows’ milk and PCBs, arsenic and molybdenum in high concentrations on their grazing land. The EPA fought the suit, commissioning its own studies. The judge ruled that the data used by the EPA was “unreliable, incomplete and in some cases fudged.”

Dotson runs the Sewage Sludge Action Network, a local activist group she helped found in 2009. She drives a mud-speckled hatchback with a bumper sticker that reads, “Got sewage sludge?” Despite the publishing of countless articles and books on sludge, she believes that public awareness of the health issues surrounding sludge remains niche. It is the kind of issue that citizens become invested in only if they have the misfortune of owning a house near a sludge field, she said. “For the people in the city, they’re interested and want to help — but for them, it’s just another issue.”

She has a brash self-confidence that makes her almost a caricature of a local activist whom officials and developers dread having to deal with. “The wastewater-treatment-plant people have tried to intimidate me when I go to meetings they’ve had,” Dotson said. “When we’ve had film showings, they send people to spy on us and record what we’re saying.” The Sewage Sludge Action Network screened an anti-sludge documentary at a local volunteer fire station even after they were barred from doing so by the local fire chief. “We tried to show the film at different fire stations or granges and were refused — because some of the farmers in charge of those facilities actually spread sludge.”

“In private conversation, farmers that don’t use sludge definitely look down on the guy who sludges,” Dotson said. “It’s kind of like high school, and the people who sludge are the bad kids. But in public, the farmers always have their back. The only person a farmer can trust is another farmer.”

The processing of biosolids begins with the collection of waste from homes, offices and factories, which flows through small pipes to larger pipes and finally into a local wastewater-treatment plant. There, solids are separated from the liquid. The liquid, called effluent, is discharged into rivers even though it may contain trace amounts of pharmaceuticals or heavy-duty chemicals. Up until the 1980s, many municipalities loaded solid waste onto barges and dumped it into the ocean, creating massive marine dead zones. In 1988, Congress passed the Ocean Dumping Act, requiring communities to find new systems for disposing of the sludge.

Each batch of biosolids from wastewater plants contains a unique blend of synthetics, dioxins, heavy metals, flame retardants and organic compounds, depending on the presence of industry and other polluters. One community’s output may be clean, made up primarily of human waste, while another may be laced with toxic compounds surreptitiously flushed by noncompliant industries. Wastewater plants separate sludge into two classes: Class A, which is heated and allegedly pathogen free, and Class B, which is applied wet and has not been entirely treated to remove pathogens. Kiviniemi assured me that OWASA’s product is Class A and said that he felt bad for other county wastewater systems that had more industrial output and pollutants to deal with. In bordering Alamance County, the Burlington city council recently voted to prohibit the spreading of Class B sludge within a mile of a school.

The Netherlands, Switzerland and parts of Canada have banned spreading sludge completely on the basis of its toxicity; a number of large food corporations like Dole won’t buy crops from growers who use sludge. In the United States, dozens of jurisdictions have passed legislation banning the application of sewage sludge, even though legal blowback is ruthlessly swift. In California, Los Angeles sued tiny Kern County after it passed a ban on applying sludge. Loudoun County, VA, passed a biosolids ban that was quickly overturned by the state. Chris Nidel, a public-interest lawyer in Washington, DC, who specializes in toxic tort said, “There’s half a million people in Arlington County crapping in a sewer and 20,000 people in Surry County having to take it. If you look at it, it’s not balanced. Numerically, they don’t have a voice.” On the other end, Charles Hooks, who runs a pro-biosolids public-relations organization, the Virginia Biosolids Association, said, “You can’t have a hundred little counties all passing laws that are different dealing with this. It would balkanize the state.”

Nancy and Bob Andrews live just down the road from Berry Andrews (no relation) in a modest ranch house set back in a copse of pine. They are retired and spend most of their time traveling the country in an RV, they say, because the pleasure they took in spending time at home was ruined by sludging. “We’re surrounded by sludge here. They used to plow it into the soil. Now they just spray it on the ground. OWASA owns us. Everyone thinks this stuff is so great,” Nancy said. They explained that they routinely find their well contaminated with E. coli and have spent thousands of dollars getting it tested and cleaned out. When the land next door is being sludged by an OWASA contractor, they say the smell is so bad that they have to run their air conditioner and stay inside. They closed their first well years ago after they found it contaminated with waste.

“We heard that the manager of the wastewater-treatment plant and his wife were looking for a house,” said Bob Andrews. “I bet they looked on a map and didn’t come anywhere near us. If they had to live with it, they wouldn’t like this stuff either.”

This article was reported in partnership with The Investigative Fund at The Nation Institute, now known as Type Investigations, with support from The Puffin Foundation.