Humans can be exposed to hazardous substances in wetland ecosystems. Human health can be affected by acute or chronic exposure to toxicants, through the media of water, wetland sediments, or even air through aerosols or when sediments become desiccated and airborne, or burnt. The nature of these exposures is greatly exacerbated by human activities where pollution is involved, resulting in often complex interactions and significant challenges for environmental health practitioners. While steps can be taken to minimise the health risks resulting from such exposures, this Chapter argues that the risks can increase (sometimes dramatically) if disruption to ecosystems, and the services they provide, is profound. Two principal forms of human exposures in wetland settings are distinguished: where the type or form of exposure is determined by the service that is provided (for example when drinking water contains a pollutant), and where services are eroded, creating the conditions for exposure (for example where water purification capacities of wetlands are overwhelmed by an oversupply of nutrients, resulting in an exposure to a microbial toxin). In both cases, addressing an imbalance of ecosystem services is required to ensure any necessary interventions are effective.