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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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Bottled water: Clean or Dirty?
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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Got a Question?
As a 14 year survivor of multiple myeloma (incurable blood cancer) I consider daily water intake to be essential to my health. I installed a home water filtration system about five years ago. As you can see from the beating-myeloma.org forum, bottled water is a much debated topic.
http://beating-myeloma.org/forum/t...
So, yes, lots of clean water daily. But bottled water may be problematic. I believe that some tap water is problematic as well due to heavy metals, chlorine and fluoride. Therefore, filtered water is the answer most of the time. Thanks.
David Emerson
http://beating-myeloma.org/