Aquatic ecosystems are affected by man-made pressures, often causing combined impacts. The analysis of the impacts of chemical pollution is however commonly separate from that of other pressures and their impacts. This evolved from differences in the data available for applied ecology vis-à-vis applied ecotoxicology, which are field gradients and laboratory toxicity tests, respectively. With this study, we demonstrate that the current approach of chemical impact assessment, consisting of comparing measured concentrations to protective environmental quality standards for individual chemicals, is not optimal. In reply, and preparing for a method that would enable the comprehensive assessment and management of water quality pressures, we evaluate various quantitative chemical pollution pressure metrics for mixtures of chemicals in a case study with 24 priority substances of Europe-wide concern. We demonstrate why current methods are sub-optimal for water quality management prioritization and that chemical pollution currently imposes limitations to the ecological status of European surface waters. We discuss why management efforts may currently fail to restore a good ecological status, given that to date only 0.2% of the compounds in trade are considered in European water quality assessment and management.