The result was a severe environmental crisis. Large numbers of people died from water and air pollution, and from eating poisoned food. The first cases of all the major pollution-related diseases appeared in Japan, with hundreds of deaths recorded. Large numbers of people suffered intensely painful and debilitating diseases, children were born deformed and/or mentally disabled, and where family breadwinners were crippled serious repercussions were felt by their entire families, particularly as most victims were among the working poor (Iijima 1992). Far greater numbers suffered chronic environment-related illness and received official government recognition as pollution victims, which entitled them to relief and medical aid. This was extended to over 73,000 people by 1979 (McKean 1981: 20). There is also no doubt that many more were harmed, many seriously, than were officially compensated. Air pollution was caused directly by industrial expansion and increased car and truck use, with total emissions of sulphur dioxide and nitrogen oxides tripling during the 1960s. Water pollution was exacerbated by the increase in population and caused by untreated industrial discharges directly into watercourses; increasing use of agricultural chemicals such as BHC and DDT – introduced in 1945 and widely used until they were banned in 1972 – which eventually leached into both ground and surface water supplies; and significant increases in municipal sewage wastes. Before the 1960s most municipal wastewater systems only transported wastewater without treating it, discharging it directly into rivers. It is worth noting that outside the major metropolitan areas and even in the metropolitan suburbs, most nightsoil was still used as fertiliser in the traditional manner, so little was actually flushed into the wastewater stream. This situation began to change quickly after the 1960s with the decreasing cost and increasing use of chemical fertilisers, and the rapid decrease in demand for nightsoil. Although construction of sewerage systems and treatment plants has been a major Ministry of Construction (MoC) priority since the 1960s, by 1970 only 16 per cent of the population were connected to sewage systems, and even by 1988 the rate was still less than 40 per cent (Barret and Therivel 1991: 35). By 1998 that had increased to 64.7 per cent connected to public sewer services, leaving more than a third of houses still unconnected.