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Birch, G. F., and Olmos, M. A. 2008. Sediment-bound heavy metals as indicators of human influence and biological risk in coastal water bodies. – ICES Journal of Marine Science, 65: 1407–1413. Currently, many institutions are conducting or planning large, regional-scale ecosystem assessments of estuarine health. A full, integrated assessment of these environments requires a large suite of biological, physical, and chemical indicators, including sedimentary chemistry, ecotoxicology, benthic community structure, and bioaccumulation. This commitment is beyond the capacity of most organizations, and a simpler approach is required to accommodate limited financial resources. A case is made for the use of sedimentary heavy metals as an easy and inexpensive indicator. The advantages are that sediments identify the “pristine” condition and give baseline information against which future management strategies may be benchmarked, and that they differentiate solely human-induced change from natural variation. Sediment indicators in depositional environments are also less dynamic than those associated with water and biota. Our objective is to demonstrate that sediment-bound heavy metals data provide the spatial extent and magnitude of chemical change, as well as the risk of biological stress attributable to contamination in estuarine ecosystems. An assessment of this scheme involving seven New South Wales (Australia) estuaries suggests that sedimentary heavy-metal indicators used in a weight-of-evidence approach, with data collected during the recent Australian National Land and Water Resources Audit, enhances estuarine condition assessment.