Final answer:
Pathogen contamination is the most widespread and problematic issue associated with municipal sewage outfalls, primarily due to the dangers it poses to human health.
Step-by-step explanation:
Among issues associated with municipal sewage outfalls, pathogen contamination is the most widespread and problematic. This type of pollution is due to untreated sewage being a significant cause of pathogenic diseases, which can be harmful or even deadly to human health. Proper sewage treatment, including primary, secondary, and tertiary treatments, is crucial for addressing this problem. Techniques such as disinfection are important for killing bacteria and avoiding the spread of diseases. Additionally, smart infrastructure, like separate sewer systems that prevent untreated sewage from entering surface waters during heavy rains, plays a vital role in water pollution prevention.