High concentrations of osmium (Os) and silver (Ag) and low 187Os/186Os ratios in Boston sewage make these elements sensitive tracers of the influence of sewage on marine sediments in Massachusetts and Cape Cod bays. Pristine marine sediments have Ag concentrations more than 200 times lower than sewage sludge, Os concentrations 10-40 times lower, and 187Os/186Os ratios six times higher. Surface sediments from both Massachusetts and Cape Cod bays exhibit both high Ag concentrations and low 187Os/186Os ratios indicating the influence of sewage particles on marine sediments in this region extends some 70 km from the point of sewage release. In detail, the distribution of Os and Ag do not support a model of simple physical mixing of sewage particles with normal marine sediments. Deviations from the mixing model may be the result of fractionation of Os and Ag in the marine environment, and [or] independent temporal variations in the Os and Ag content of the waste stream. The results of this investigation suggest that osmium isotopes may be widely applicable as tracers of the influence of sewage on sediments in estuarine environments and that subtle variations in the isotopic composition of Os in the waste stream may help constrain the sources of Os and other metals delivered to the environment.