Dr. Sharon Orrange
Primary Care Physician
Dr Orrange received her BA in Biology at the University of California San Diego and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health She received her MD from the USC Keck School of…
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LOCATION: Santa Monica, CA, USA
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  • Assistant Professor of Clinical Medicine, Division of Geriatric, Hospital and General Internal Medicine, Keck School of Medicine, University of Southern California
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Bottled water: Clean or Dirty?
28
Posted in Acute Lymphocyt... by Dr. Sharon Orrange on Oct 15, 2008


I am not one prone to hysteria and my motto with my patients and their habits has always been: most things, in moderation, are fine. I read, with interest, commentary in the October issue of The Lancet Infectious Diseases and wanted you to join in the discussion.


Most of us who buy bottled water mistakenly believe it to be safer than tap water. The packaging and long-distance transportation of mineral water in plastic or glass has been recognized as environmentally "bad" but is it also full of bacteria? Bottled water is thought of as pristine yet it appears to contain large numbers of bacteria. Here is the story as an interesting struggle is developing between the forces that regulate bottled water and the Infectious Disease community.


Two decades ago it was first demonstrated that there were high bacterial counts in bottled water. One study of 58 different samples published in 1987 revealed not only levels exceeding the European advisory level in water for human consumption but also the presence of specific organisms such as Staphylococcus epidermidis, indicating contamination by human skin.


What kind of bottled water are we talking about as having high bacterial counts?  Here is the story. It is estimated that about 25% of the bottled waters consumed in the U.S. come from municipal water supplies. Most goes through significant processing and if this is the case it is packaged as "purified" or "drinking water." For example, Aquafina is bottled at Pepsi plants using processed municipal water. Dasani is also processed municipal water with added minerals.  This is NOT the kind of bottled water we are talking about with the issue of high bacterial counts.


"Natural" water or "Natural mineral" water is the issue here. The word "Natural" is only allowed for bottled water which is derived from springs or wells where the natural chemical (mineral and trace elements) composition of the water has not been altered as a result of treatment process and this is the type of water we are now hearing may be full of bacteria. One thing to remember is that natural mineral water cannot be disinfected but this was balanced by a belief that it comes from underground sources....so is not vulnerable to bacterial contamination. Currently, enforcement of standards ensures that bottled mineral water is distinct from other categories of water which undergo extensive treatments for potability (making it safe to drink). This absence of bactericidal measures and the extended shelf life of bottled water containers largely explain the high level of bacterial counts commonly found in bottled waters.


So the question we are interested in: do the high bacteria counts pose a health problem for the general population? Have there been any outbreaks of infection attributable to the consumption of bottled mineral water?  The answer is yes, and more reports seem to be coming. In the Infectious disease literature there are reports of outbreaks in intensive care units (six recently reported in Berlin) of Pseudomonas infection caused by contaminated bottled water. The investigators of that study recommended that bottled still water be replaced by filtered tap water or sterile bottled water.


Food for thought? Some have suggested that for those of you who are immunocompromised (transplant patients, chemotherapy patients, autoimmune disease patients on immunosuppressant therapy, etc) or seriously ill it may be worth staying away from bottled "natural" or "natural mineral" water.....thoughts?


Dr O.


 



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Displaying comments 28-9 of 28
28
I m using Bottled water every time when i m in journey. In this case i didn't find never bacteria because i m using sealed and purified bottled water. Shall we find the bacteria in that sealed water bottles? Can u suggest me, shall we use good or bad?
By HealthInformation  Oct 21, 2008
27
You know what is the best way to test your own tap water? Can you make your own homemade kit? WIth all this biological warfare and internet security threat at high levels what is the best way to home test.
By anderla  Oct 20, 2008
26
I recenly listened to a discussion with Jeffrey Smith (Water scientist with Water wise who goes around the world testing water). He spoke about the contaminatients in bottled/tape water and about the process of purifing and transporting water which destroys minerals and emzymes in it making it 'dead' and therefore more open to bacteria.

He said that the water that soaked deep into the ground then into streams contains minerals and emzymes and is living or mature water but still needed filteration for bacteria.

A PiMag system tries to duplicate this process by filtering the water but the added mineral stones replace missing minerals and emzymes necessary to the body which also helps the absorbption of water into the cells.

My sons pediatrician recommends this PiMag water system from www.nikkenwellness.com.au which was supported by this water scientist. I have not yet purchased one but am researching water filters etc. at the moment.
By Friend4  Oct 20, 2008
25
One more thing about boil water notices. It is usually issued when pressure drops below 20 psi which gives possible cause of back-siphonage which is very rare. Another reason is no pressure due to water line breaks which expose the water line for repairs. Boil water notices are precautionary procedure, not definite bateria contamination. We just ask not to drink the water, it is ok for bathing, washing and so forth. If you forget and brush your teeth, then rinse your mouth. Don't panic. Old Water Treatment Operator.
By mswitzer  Oct 19, 2008
24
Ok, spring water is accessible to animals so contamination is possible
Bottled water depends if the municipality water is treated from surface water or well water. Surface water treatment do not remove most of the chemicals and drug residuals from people flushing medicine down the toilet. If you knew the bottled water came from a well water source, you should be fine. Most people buys bottled water where the well water source is used because of the natural concentration of hydrogen sulfide which gives the water a rotten egg smell. That is the second reason for chlorine is to neutrialize the smell. Old water treatment operator
By mswitzer  Oct 19, 2008
23
yes sometimes bottled water is better. I live in a small city where there is always a boil water aleret. Just the week they found bacteria so high on Friday and waited till Saturday afternoon to call on it. In the meantime I had washed all my dishes and scrubbed the kitchen on Fri. Now I find that the bacteria is on everything and I have to start over. not to mention the computer and door knobs. I don't know much about ecolei but I'm fumed. I don't need to get sick nor my fanily.
By tinkerbella13069  Oct 18, 2008
22
Thank you for the infor. I'll pass this on to my elderly mother who drinks these types of bottled water. I had heard in passing from a water intitute something on that order,but since I wasn't directly involved in the conversation, I didn't ask for clarification. VERY INTERESTING!
By seeking2  Oct 18, 2008
21
Hey Ghur4
good work by you...I hope thats true that the UV light source does its job....most of the recent outbreaks in Intensive Care Units reported in the recent literature (peer-reviewed journals not just random articles) are in the last 1-2 years so psuedomonas and other bacteria are still an issue in some (and Im sure not all) "natural mineral" waters....its for sure something to think about if you are immunocompromised.
Dr O.
By DrOrrange  Oct 18, 2008
20
I keep trying to remember where I read it but a recent article like a week ago said that things made out of plastic some were more dangerous. The article said inside of a triangle on the bottles has a number inside of it. The lower number the better less possibilities of chemicals leaching into the contents. Specifically they said ones with the number 7 was bad. The worst plastic made. Because it does leach badly. The chemicals used to make the higher numbered plastics are very toxic to us. My hubby read it too. HE IS ASLEEP RIGHT NOW BUT I WILL POST WHERE WE READ IT. It also talked about cans and some chemical used to preserve or something that was worrisome. I will get more details about that also. This was from a reputable source. Careful of what we read so not easily mislead.
Rhea
By tiredtiredtired  Oct 18, 2008
19
Another thing to consider is the safety of the plastic bottles themselves. My Hep C doc told me to eliminate ANY liquids from plastic as they contain plasticizers (sp) that seep into the water. I was told that the best way to consume liquids is through metal and then glass as a second.
By new2this  Oct 18, 2008
18
I have heard that some bottled water just bottles up regular old city water and sells it like that. The recent news coverage that states that bottled water contains as much if not more of the "natural" chemicals in tap water is pretty much confirmation of that. Either way water should be sterilized before drinking, in my opinion. Natural water has just as much risk of being contaminated as bottled water, considering the untrackable amount of pollution nowadays. And as a side note, aspartame (mentioned in one of the comments) is a farce and while it may assist sugar levels it does not assist health-wise...research aspartame & fluoride to gain your own views on it.
By PumpkinJ  Oct 18, 2008
17
Coming from New Orleans, it was never a good idea to drink the tap water due to chemical contamination and who knows what else lives in the water coming from the mouth of the Mississippi! While it is called the mouth of the river it is actually the bottom of the river and all that is deposited from the north down through the states ends up in our waterways. So that said, we have always had bottled water as the norm. I now find it difficult to ever drink from tap wherever I live. I do however mostly get distilled water and I do recycle the jugs and I keep a few small bottles of my own that I refill and use daily. It seems that everytime we think we are safe, we find out that we are not, so what is the solution? Maybe if we can ever become environmentally friendly dwellers of this earth it will not be so hazardous to live on.
By desrtrse  Oct 17, 2008
16
I always have my doubts over reports that set out to prove processed foods and drinks are safer than natural ones. Forgive me for being sceptical, but in these cases there is usually someone along the line that will profit from this, eg. the aspartame fiasco. How independent are these reports?
By dallin  Oct 17, 2008
15
I get bottled water once in a while but take my own well water to work and then pour it into one of the bottles so I can have it with me all the time. The water at work smells like chorine most the time and to me taste bad. But then I/m use to well water which is godd and cold.
By Kathy253  Oct 17, 2008
14
Here is a good idea for those who want to be sure of what they are drinking; Install a reverse osmosis water filtration system in your home. There are affordable compact versions available that fit right under the kitchen sink, they come with everything you need (except the tools!) to install. You connect them to the cold water pipe before your existing faucet. The kits come with their own special faucet that you install beside the existing one(s) the cold water is drawn through a sediment filter, then into the r.o. filter, then out to the faucet. The r.o. process filters out extremely fine particles, even bacteria, and is the same process used (on a larger scale) by many bottlers of water.
Tob.
By Tob  Oct 17, 2008
13
My daughter is so into the bottled water idea. However, we have nice, crispy clean water here and I think bottled water is not as good tasting. I usually just fill up the empty bottles with tap water and put the cap back on and refrigerate. She has no idea...
By Cybercatxq  Oct 17, 2008
12
Dr. O, thank you for raising this discussion. I hope you will keep it alive as you discover more information. I have never stopped drinking tap water, since I have never had a personal problem... even though our Atlanta water is traveling through some very old pipes. But I am so glad to have the info regarding purified bottled water. I thought it was a step down from spring water.

Since 2006, I had had a feeding tube which was surgically placed directly into my stomach. I do keep bottled water with me with I am out and about or traveling. Even as clean as I keep my tube and stoma, it seems there is always a fungus lurking. I just want to sort out what is the best healthwise and is manageable. I'll look forward to hearing more from you.
By MarieTwinTubes  Oct 17, 2008
11
Donnatello: Poland Spring Water is one of the "natural spring waters" so yes it may contain high bacteria counts. Natural spring waters are NOT subject to the processes that the purified waters are and thus are the subject of this blog

Solson: you are right...thats why we have to change tap water filters.
By DrOrrange  Oct 16, 2008
10
Even filters carry bacteria.
By solson  Oct 16, 2008
9
Regarding drinking water and your article, what about poland spring?
By Donnatello  Oct 16, 2008
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