Drinking Water (19 page)
Put another way, the demand for safe drinking water is not what has changed over time. That has been a constant in every society. What has shifted is our
relationship
to water, driven by our changing conceptions of threats to health and what makes drinking water unsafe. Our views about safe drinking water are shaped by a continuous co-evolution of norms and knowledge. Over time, as
we learn more about the nature of waterborne diseases and the trade-offs of choosing particular water sources over others, our norms for identifying, protecting, and treating drinking water change as well. But this takes time and can lead us down false paths.
The miasmatic theory of disease taught us to avoid water that smelled but gave no reason to be concerned about pollution near the water source. John Snow’s insights into the transmission of cholera and the subsequent rise of the germ theory alerted us to the dangers posed by unseen killers and the need for filtration and chlorination to ensure safe water.
There are particular historical junctures when the very identity of safe water becomes contested. It is at these moments that we find John Snow at the Broad Street Pump, chlorination of municipal water, bans on communal cups at drinking fountains, the tragedy over arsenic-contaminated wells in Bangladesh, and the debate over endocrine disruptors today. At these moments, concepts as basic as the causes of disease and the rules over provision of water become unstable and eventually untenable, replaced by new assumptions, laws, and policies. But such change does not come easily or quickly.
Pushing against change is the stickiness of social norms. As we discussed earlier, people in Yorubaland identify their drinking water sources from a set of rules, the most important of which is that the water should come from a clear, flowing stream. While one can understand that this norm could be very practical—for example, reducing the microbial problems associated most with standing water—it posed a riddle for the anthropologist Eva-Marita Rinne.
The villagers in Yorubaland have been told that drinking from flowing water can cause disease. They have been told of the benefits of point-of-use strategies—using chemicals, filtration, and boiling to disinfect their water. Some use these treatment practices, but not many. Their norms have not changed. Why do they continue drinking unsafe water?
Rinne cannot really explain. She suggests that poverty plays a role, since not everyone can afford the treatment options. She suggests passivity, since people do not “regard themselves capable of solving environmental health problems, but rather they rely on the
local governments.” She finally suggests a catch-all explanation of tradition, concluding that rules for drinking water sources result from “common experience of past generations, the visual evidence of how safe water looks, and of everyday life practices of ensuring safe water.” The basic explanation of why they drink unsafe water is, quite simply, that on balance, they have always thought the water was safe enough. Occasional illness or worse is just part of life.
And part of the answer turns on the relative nature of safety. It is understandable that a miserable lost explorer, parched and wandering in the desert, might happily drink out of a fetid pool of water to slake his thirst. In that case, to paraphrase the famed economist Adam Smith, water clearly would be far more valuable than diamonds, even unclean water. For the desperately parched soul, such water would have been safe enough, even though you or I would probably not even use it to wash our car. Drinking water, even if teeming with microbes, is always a safer option than death from dehydration.
In Yorubaland, Bangladesh, and many other parts of the world today, the determination of whether the water is “safe enough” is not as straightforward as it is for a dying explorer. Determining safety turns on a complicated balance of threats to health, opportunity costs of collecting cleaner water (time spent gathering water versus time spent for other important needs such as earning money or collecting firewood), and social pressures. What should a villager in Bangladesh do with a red-painted well nearby and a green well more than an hour’s walk away? How can one decide the best option—drinking from surface water with the known risk of waterborne disease, drinking from the green well but losing several hours each day to gather the water, or drinking from the nearby red well and accepting the possibility of arsenic poisoning sometime in the future?
This fundamental challenge is equally true in the developed world as well. We assume we know what safe water is. Part of our view is technocratic. As expressed in the Safe Drinking Water Act or standards set by the World Health Organization, our focus is on biophysical assays of water, maximum contaminant levels, and economic and technical feasibility of treatment. The norms of water safety are determined for us by scientists in lab coats somewhere.
Yet this veneer of knowledge can mask significant uncertainty. As the cases of arsenic, pharmaceuticals, and fracking make clear, exactly what we should regulate and how stringently are no easy matters, especially when money for our water systems is so hard to come by. And we can expect the number of poorly understood challenges to increase.
T
AKING THESE CONSIDERATIONS TOGETHER, WE NEED TO FIND A WAY
to discuss more honestly and openly what we mean by safe drinking water. There are three fundamental points that should underpin this discussion.
The first is that safety is a relative concept. We would all be safer if we drove in semiamphibious tanks, yet some people—indeed many—choose to drive motorcycles or tiny cars that will crumple in a crash. They prefer to spend their money for benefits other than car safety, and these are perfectly rational decisions. Just as with the Bangladeshis, people living in Yorubaland, and us, safety ultimately is a judgment about choices. We can reduce the level of arsenic in drinking water to five parts per billion or even lower, but choosing this comes at a price, particularly high for many small water systems in the West. It is hard to disagree with someone who says they want safe water from their tap and, to an impressive degree, the water from our taps today justifiably is regarded as safe by most people. Is it totally safe, in the sense of risk-free? No. But it is not at all clear that this would be a desirable goal.
The second point is that we water drinkers must ultimately rely on the judgment of experts and accept that they don’t have all the answers. Few consumers, indeed, have the technological savvy to test their water for arsenic,
Cryptosporidium
, endocrine disruptors, and the myriad other potential threats to our water, much less at concentrations of parts per million. One can use household water filters, and these will remove some pollutants but surely not all. Do emerging contaminants pose serious threats to our drinking water, to our safety? Our current understanding does not provide cause for alarm; hence they are largely unregulated. But our current understanding
is also admittedly incomplete. Because we thought our water was safe before, does this mean we have no need to worry, or have we uncovered an unseen harm that must now be addressed for our safety and that of our children?
The key point to keep in mind is that just because a poison or carcinogen is in our drinking water does
not
mean it poses a significant hazard. The August 2011 cover of
Reader’s Digest
, for example, certainly captured readers’ attention with the bright red warning that our water “
MAY CONTAIN: ROCKET FUEL, BIRTH CONTROL PILLS, ARSENIC, AND MORE SHOCKING INGREDIENTS
.” While this may be both accurate and alarming it is, at the same time, misleading. There is reason to believe that traces of many compounds are harmless below certain levels. Arsenic’s mere presence in a glass of water does not mean you’re poisoning yourself by drinking it. The equally key rejoinder, though, is that low levels do not necessarily mean
no
harm. Some compounds are harmful at any level.
We ultimately have no choice but to trust the decision by our government’s regulators that the water coming out of our tap and the bottled water we buy at the store are, in fact, safe to drink. But many of us are unsure whether to trust government authorities when it comes to drinking water. A 2009 survey of environmental problems found that the top concern was water—59 percent of those polled worried “a great deal” about pollution of drinking water. An additional 25 percent worried “a fair amount.” This explains in part the popularity of bottled water and its branding strategy. Effective ads for bottled water are all about the natural, pure essence of the clear liquid. Aquafina, Pepsi’s successful bottled water brand, could not make this clearer. The product’s slogan, spelled out in big letters on the label, reads, “Pure Water.” But, as we shall see in
Chapter 6
, this is by no means a given because the regulatory standards for bottled water are less demanding than those for tap water.
There is no question that our ability to understand the risks posed by drinking water has dramatically improved over the centuries. Measuring traces of contaminants in parts per trillion is now possible. We also have a far deeper understanding of the toxicology of drinking water contaminants. But in some cases—indeed, many
cases—our sophisticated tools of risk assessment, toxicology, and cost-benefit analysis of drinking water contaminants are indeterminate. They provide numbers, but with significant error bars or extrapolation from trace levels. The experts unavoidably, necessarily, operate with significant uncertainty. In the face of such uncertainty, should the EPA rely on public perceptions of safety when these, too, can seem fallible or irrational? We know far more than John Snow ever did about what makes water unsafe but must still grapple with imprecision more than we like when forced to make decisions. And this ignorance is both humbling and unsettling.
The last point is that certain things are not in doubt. We, as a society, need to realize that providing safe water requires funding to pay for it. This means rebuilding our aging water infrastructure. It means increasing funding for enforcement of the Safe Drinking Water Act and making the tough political calls to sue local authorities that are violating the law. And it means holding accountable agency officials who are not protecting the public’s health. All easier said than done, but until we act as “citizen drinkers,” using our political process to demand a sustained focus by government officials on provision of safe drinking water, the problems of lax regulation and enforcement will continue.
C
AN DRINKING TOO MUCH WATER KILL YOU
?
As part of its
Morning Rave
program, the disc jockeys on the Sacramento radio station KDND were talking up the latest racy on-air contest, “Hold Your Wee for a Wii.” The idea was simple enough. The person who drank the most water without urinating would win a Nintendo Wii video game console. Twenty-eight-year-old Jennifer Lea Strange was ready to go. She told the woman beside her that she really wanted to win the game for her two kids. After the first few rounds of drinking eight-ounce bottles of Crystal Geyser water, Jennifer was going strong, watching as one bloated contestant after another dropped out. After downing close to two gallons of water in three hours, though, Jennifer just could not take another sip. She finished a frustrating second. Once in the car, she felt more than frustration. She called her boss, saying she had a terrible headache and was heading home. She was found there several hours later. The cause of death was determined to be “water intoxication.”
Hilary Bellamy trained for months to run the Marine Corps Marathon in Washington, D.C., steadily working up the endurance through daily runs to make it through 26.2 miles on the day of the race. Her goal was 5:45, a steady pace of 13 minutes a mile. At the halfway point she was on pace, slowing a little by the 18 mile mark. Every two miles there were water stops where cups of water or a sports drink were handed to runners. Hilary made sure to stay hydrated and drank steadily. By mile 19 she was having trouble, complaining of a headache and blurry vision. At mile 20 she collapsed in the arms of her husband, there to cheer her on with her three-year-old daughter and nine-month-old son. Rushed to the hospital, Hilary died two days later.
Jennifer and Hilary both died from a condition known as hyponatremia. Drinking too much water causes salts in the blood to become too diluted, and water floods into cells. This is a particular problem with neurons in the brain, which do not have the space to expand. The result is swelling of the brain, which can lead to coma, seizures, brain damage, and even death. As Paracelsus famously expounded, the dose determines the poison. Water is the vital ingredient for life, but extremes on either side are dangerous. If you don’t drink enough water you will die of thirst. If you drink too much, you can die of hyponatremia.
B
LACKSTONE
, M
ASSACHUSETTS, IS A SMALL TOWN OF NINE
thousand people on the border with Rhode Island. It’s named after William Blaxton, an Englishman who sailed to the New World in 1623, just two years after the Pilgrims arrived on the
Mayflower
. Blaxton made his mark in history as a famous first settler—the first European settler in Rhode Island, the first settler in what would become known as the city of Boston. The Blackstone River meanders through the south part of town. Its place in history is assured by powering the first textile mill in the United States in 1790, a date marked by many as the start of the Industrial Revolution. The town of Blackstone made history for quite a different reason the evening of March 28, 2006.
That night, there was a break-in at the town’s water tower. Climbing over a twelve-foot-high security fence topped with barbed wire, the group of intruders methodically pried open a two-inch steel door, smashed an electrical panel, scaled the water tower, and kicked in the fiberglass cover on top, exposing the town’s water supply. The next morning, officials discovered the damage and found a bucket with an unknown substance nearby. They naturally assumed the worst—that terrorists had poisoned the town’s drinking water supply—and responded immediately. The water system was shut down while the 1.3 million gallon water tower was flushed. The town’s schools, restaurants, and laundromats were closed. Fire trucks with loudspeakers drove down streets telling people not to use the water. Notices were put in mailboxes with the stark warning
“Important!!!!!!! Do not use the drinking water for any purpose.” Residents threw out anything that might contain the tainted water —ice cubes, baby formula, even cooked pasta.
