1. Why we should be worried about our water Lily Clark ENVR 230 November 6, 2007

2. Drinking Water in the U.S.: Overview Overall, water quality has improved over the last 15 years, according to a report done by the Natural Resources Defense Council (NRDC) Quality of tap water varies greatly from city to city Most cities have good or mediocre water quality NRDC estimates that 50 million Americans drink water that is below the standards for water quality set by the EPA (1996) CDC estimates that half of the country’s water treatment systems fail to remove the parasite that killed 100 people in Milwaukee in 1993 (1996) Contaminants enter water in many ways, such as through runoff from sewage systems, runoff from roads and farms, and dumping of industrial waste

3. Regulation EPA has National Primary Drinking Water Regulations (NPDWRs) to enforce standards for public water systems Clean Water Act (CWA) of 1972 and Safe Drinking Water Act (SDWA) of 1974 passed “to restore and maintain the chemical, physical and biological integrity of the nation’s waters” Safe Drinking Water Act Amendments of 1996 introduced new prevention approaches, changes in regulation, increased funding to state and local governments and improved consumer information CDC performs and funds research and helps disseminate information regarding safe drinking water

4. Maximum Contaminant Levels (MCLs) Microorganisms Cryptosporidium Giardia Legionella Coliforms (including E. coli) Turbidity Enteric viruses Disinfectants – chlorine and chloramines Disinfection by-products – chlorite, haloacetic acids, trihalomethanes Inorganic chemicals – arsenic, cyanide, fluoride, lead, mercury Organic chemicals – atrazine, carbon tetrachloride, TCDD, PCBs Radionuclides

5. Problems with Regulation Report by the General Accounting Office in 1993 found that “most state inspection programs to ensure the safety of public water supplies are a shambles” State public health departments responsible for monitoring and reporting to the EPA on water quality However, many state inspection programs are under funded and are thus unable to test the water every three years, as recommended by the EPA Deficiencies often went unidentified and uncorrected due to bad record-keeping Less than half of the inspectors nationwide had been formally trained Lapse in regulation seen in DC lead contamination and the disease outbreak in Milwaukee

6. Health Effects Lead Permanent brain damage and decreased intellectual ability in infants and children Trihalomethanes and haloacetic acids Cancer and reproductive problems, including miscarriage All possible health effects especially dangerous for those with a compromised immune system Pregnant women, infants, children, elderly, HIV/AIDS patients, chemotherapy and cancer patients

7. Health Effects of Waterborne Pathogens Especially dangerous for the immuno-compromised (HIV/AIDS, the elderly, children, chemo patients) Cause diarrhea and acute gastrointestinal illness (AGI) Currently estimated 4.26 – 11.69 million cases of AGI annually Due to drinking water from community drinking water systems supplied by surface and groundwater sources However, most of the microbes that have caused outbreaks of waterborne diarrheal illnesses in the U.S. and their sources are unidentified

8. Threats to Water Quality Reliance on pipes that are 100 years old, on average Problems with breakage Leach contaminants and allow bacteria to breed Reliance on outdated water treatment techniques Regulatory efforts by the Bush administration Weaken regulation on source waters Stall the creation of new standards for contaminants Cut funding and environmental programs

9. How the Bush Administration’s Policies Threaten Our Drinking Water Bush administration policies in 2003 supported reducing the protection of our water sources and our drinking water Specifically, proposed scalebacks would have removed protection for headwaters, wetlands, seasonal streams and other water sources Policy would exempt protections on “isolated” waters These exemptions would have affected directly the drinking water sources for 15 U.S. cities, including Atlanta, Baltimore, D.C. and Seattle Policy rejected in 2006 In 2006, the Bush administration declared that federal workers would not be protected under whistleblower protection for reporting “water enforcement breakdowns, manipulations of science, or cleanup failures” Threatens the integrity of the CWA and SDWA by removing protection from federal employees who attempt to uncover and report honestly the state of our water quality

10. What’s On Tap: Grading Drinking Water in U.S. Cities The Natural Resources Defense Council issued a 2003 report on the quality of drinking water in 19 states

13. Process of Water Treatment Coagulation – addition of aluminum sulfate to make large particles of solids stick together Perchlorination (optional) – addition of chlorine or other oxidant to start disinfection and oxidation of chemicals If added at this early stage, can greatly increase levels of by-products Sedimentation – water mixed and left to sit to allow coagulant to take effect Filtration – run water through filters of sand or coal to remove smaller particles (unable to remove arsenic, pesticides and other chemicals) Primary chemical disinfection – usually chlorine gas or liquid Corrosion inhibitor – lime or zinc orthophosphate to inhibit ability of water to corrode city and household piping Fluoride and secondary disinfection – second dose of infectant to prevent recontamination

14. Waterborne Pathogens Vegetative bacteria and other microorganisms are killed by disinfection process of water treatment Cryptosporidium and Giardia are relatively resistant to disinfection process Many waterborne parasites are resistant to chlorination Filtration removes these parasites, however many treatment facilities have broken and failing filtration systems Acute gastroenteritis illness (AGI) is most common health problem associated with consumption of water contaminated with microbes Associations between water turbidity and AGI have been found in citywide studies performed in Milwaukee and Philadelphia AGI rates in the US can be used to estimate the risk of infectious, waterborne diseases

15. Waterborne Disease Outbreaks (WBDOs) Outbreak statistics do not accurately reflect the incidences of waterborne illness due to endemic contamination There is no surveillance system to report the incidences of endemic waterborne illness, specifically AGI, in the US Reported occurrences of WBDOs are only a fraction of the actual occurrences of AGI because endemic illnesses are not included WBDO statistics have been recorded since the 1920s through local, state and national public health departments Useful to identify risks of disease associated with source waters, public water systems and treatments Also provide information about the important waterborne pathogens and adequacy of contamination regulations

16. Disease Outbreaks Waterborne pathogens are increasing as a cause of waterborne disease outbreaks in the U.S. Between 1991 and 2002 403,000 people got sick 4,400 were hospitalized 50 died Mortality associated with WBDOs decreased from 1920 to 1990 but has risen in the last 12 years The percentage of WBDOs associated with contaminants in the public water systems have increased since 1991 Outbreak tracking does not take into account rates of endemic waterborne diseases, which can be caused by the same pathogens

18. Taken from Craun et al. “Waterborne outbreaks reported in the United States.” Journal of Water and Health. 2006.

19. Etiology of waterborne outbreaks reported in the U.S., 1991 – 2002 Etiological agentOutbreaksCases AGI7716,036 Chemical33577 Giardia252,283 Cryptosporidium15408,371 Norovirus123,361 E. coli O157:H711288 Shigella9663 Campylobacter jejuni7360 Legionella680 Salmonella3833 V. cholerae2114 Hepatitis A256 Naegleria fowleri12 Plesiomonas shigelloides160 Campylobacter and Yersinia112 E. coli O157:H7 & Campylobacter1781 Unidentified SRSV170 Total207433,947 Taken from M. F. Craun et al. “Waterborne outbreaks reported in the United States.” Journal of Water and Health. 04.Suppl 2. 2006.

20. Milwaukee, 1993 400,000 people got sick and 100 died from contaminated water Cryptosporidium was the parasite found in the water Caused death mostly in immuno-compromised populations, specifically those with HIV/AIDS

21. New York, 1999 1,000 people got sick at a county fair in upstate New York The water was contaminated with a virulent strain of E. coli Resulted in the death of one elderly man and one 3- year old girl

22. New York, 2005 Nearly 750 people got sick from a contaminated play area in a water park The water was found to be contaminated with cryptosporidium The tank from which the water park drew its water had a chlorination and a filtration system

23. U.S. Public Interest Research Group 2005 Report on CWA Compliance 3600, or 57%, of the nation’s water treatment facilities exceeded limits set by the CWA at least once in 2005 Noncompliant facilities reported 24,400 cases of exceeding CWA permits Indicates that facilities are exceeding their permits more than once, and for more than one pollutant 628 facilities exceeded their permit limits for at least half of the monthly reporting periods in 2005 On average, noncompliant facilities exceeded permit limits by four times the allowed amount On 1800 occasions, facilities reported exceeding the limits by at least six-fold

24. Recommended Actions by the Natural Resources Defense Council Investment in upgrading water systems Pipe breaks Allow in bacteria and contaminants Estimated $500 billion over the next two decades to ensure the safety of drinking water nationwide Upgrading of water treatment techniques Currently use same basic water treatment technologies from before WWI New technologies available – ozone, UV light treatment, membrane treatment, granulated activated carbon Use a combination of two or more to maximize efficiency and minimize by-products of treatment Strengthen and enforce existing health standards and create new standards for unregulated contaminants

25. Sources EPA Office of Water: http://www.epa.gov/OW/http://www.epa.gov/OW/ Health and Environmental Effects Research Laboratory: http://www.epa.gov/nheerl/articles/2006/waterborne_disease.htmlhttp://www.epa.gov/nheerl/articles/2006/waterborne_disease.html “Clinton Administration works to help protect the public health from recent infectious disease outbreaks.”: http://yosemite.epa.gov/opa/admpress.nsf/a21708abb48b5a9785257359003f0231/52a4c3f2c4d50b31852567ee00661941!OpenDoc ument http://yosemite.epa.gov/opa/admpress.nsf/a21708abb48b5a9785257359003f0231/52a4c3f2c4d50b31852567ee00661941!OpenDoc ument CDC Healthy Drinking Water: http://www.cdc.gov/Ncidod/dpd/healthywater/index.htmhttp://www.cdc.gov/Ncidod/dpd/healthywater/index.htm “Surveillance for Waterborne-Disease Outbreaks --- United States, 1999-2000”: http://www.cdc.gov/MMWR/preview/mmwrhtml/ss5108a1.htm http://www.cdc.gov/MMWR/preview/mmwrhtml/ss5108a1.htm Natural Resources Defense Council “Study Finds Safety of Drinking Water in U.S. Cities at Risk”: http://www.nrdc.org/water/drinking/uscities.asphttp://www.nrdc.org/water/drinking/uscities.asp “What’s on Tap? Grading Drinking Water in U.S. Cities”: http://www.nrdc.org/water/drinking/uscities/contents.asphttp://www.nrdc.org/water/drinking/uscities/contents.asp “Limiting Clean Water Act Protection Could Contaminate Drinking Water”: http://www.nrdc.org/media/pressReleases/030611a.asp http://www.nrdc.org/media/pressReleases/030611a.asp “Clean Water at Risk”: http://www.nrdc.org/water/pollution/cwa30/contents.asphttp://www.nrdc.org/water/pollution/cwa30/contents.asp CNN “Milwaukee learned its water lesson, but many other cities haven’t”: http://www.cnn.com/HEALTH/9609/02/nfm/water.quality/ http://www.cnn.com/HEALTH/9609/02/nfm/water.quality/ “1,800 infected; water park blamed”: http://www.cnn.com/2005/US/08/19/water.illness/index.htmlhttp://www.cnn.com/2005/US/08/19/water.illness/index.html New York Times “Outbreak of Disease in Milwaukee Undercuts Confidence in Water”: http://query.nytimes.com/gst/fullpage.html?res=9F0CE6D9143EF933A15757C0A965958260 http://query.nytimes.com/gst/fullpage.html?res=9F0CE6D9143EF933A15757C0A965958260 “Nearly 750 Are Sickened at State Park”: http://www.nytimes.com/2005/08/19/nyregion/19sick.htmlhttp://www.nytimes.com/2005/08/19/nyregion/19sick.html New York Department of Health http://www.health.state.ny.us/press/releases/2000/ecoli.htm US PIRG “Troubled Waters: An analysis of 2005 Clean Water Act compliance”: http://static.uspirg.org/reports.asp?id2=35946http://static.uspirg.org/reports.asp?id2=35946 Stormwater Authority: http://www.stormwaterauthority.org/library/view_article.aspx?id=633http://www.stormwaterauthority.org/library/view_article.aspx?id=633 Earthjustice: http://www.earthjustice.org/our_work/policy/2004/bush_administration_launches_effort_to_dismantle_clean_water_act.html http://www.earthjustice.org/our_work/policy/2004/bush_administration_launches_effort_to_dismantle_clean_water_act.html