The primary risk is exposure to raw sewage and other contaminants, which can lead to health issues for swimmers. The overflow of untreated wastewater into the rivers after rainfall increases the likelihood of encountering harmful bacteria and pollutants. While the long-term effects of exposure to materials from abandoned coal mines are not fully understood, they add to the potential risks. Residents and visitors are advised to avoid swimming in the rivers for at least 48 hours after any rainfall to minimize health hazards. Fish caught in these waters may also be affected, and consumption should follow state advisories.