Table of Contents

Bottled water basics ....................................... pg.2

Advice for people with severely compromised immune systems (Sidebar) ............................. pg2

Know what you’re buying .............................. pg.3

Taste considerations ........................................ pg.4

Bottled water terms (Sidebar) ..................... pg.4

Begin by reading the label ............................. pg.5

Type of water and source ............................... pg.5

Contaminants and methods of treatment .... pg.6

Common bottled watertreatments (Sidebar) ........................................ pg.6

Certification ........................................................ pg.7

Contact information ......................................... pg.8

FDA bottled waterstandards (Sidebar) .......................................... pg.8

Bottled water basics

Bottled water is the fastest growing drink choicein the United States, and Americans spend bil-lions of dollars each year to buy it (BeverageMarketing Corporation, 2004) Some peopledrink bottled water as an alternative to otherbeverages; others drink it because they prefer itstaste or think it is safer than their tap water.

Whether it travels through a pipe to your home orcomes packaged in a bottle, safe drinking water isessential to good health. All our drinking watercomes from similar sources, either from sources wecan see, such as rivers and lakes, or from sourceswe can’t see, such as underground aquifers.

In the same way that tap water’s taste and qualitymay vary from place to place, so too does bottledwater’s taste and quality vary among and evenwithin brands.The taste and quality of both bot-tled water and tap water depend on the sourceand quality of the water, including its naturalmineral content and how, or if, the water is treated.

Drinking water (both bottled and tap) can rea-sonably be expected to contain at least smallamounts of some contaminants.The presence ofcontaminants does not necessarily indicate thatthe water poses a health risk. For example, min-erals such as magnesium and calcium give watera distinctive flavor, and are essential to the body.At high levels, however, these and other contami-nants, such as pesticides or microbes from humanwastes, can cause adverse effects or illness.

To make sure that all water is safe to drink, theU.S. Environmental Protection Agency (EPA) andthe U.S. Food and Drug Administration (FDA) setdrinking water standards. EPA sets standards for tap

Advice for people withseverely compromisedimmune systems

Some people may wish to takespecial precautions with the waterthey drink. In particular, peoplewith immune systems that areweakened by AIDS, chemothera-py or transplant medications aremore vulnerable to microbial con-taminants in drinking water suchas Cryptosporidium.

Cryptosporidium is a microscopicparasite that lives in the intestine ofinfected animals and humans. Itpasses in the stool in its dormantoocyst form.The oocyst is protect-ed by an outer shell that allows itto survive outside the body forlong periods of time and makes itvery resistant to chlorine-baseddisinfectants. It occurs mainly insurface water sources, such aslakes,streams and rivers. In healthyadults,Cryptosporidium can cause ill-ness,but for people with weakenedimmune systems, it can causesevere illness and even death.

Those who wish to take extrameasures to avoid waterbornecryptosporidiosis can bring theirdrinking water to a boil for a fullminute. Boiling water is themost effective way of killingCryptosporidium.As an alterna-tive to boiling water, people maytake the following measures:

Use a point-of-use filter

Consider using point-of-use (per-

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sonal use, end-of-tap, under sink)filters that remove particles onemicrometer or less in diameter.Filters that use reverse osmosis,those labeled as “absolute onemicron filters,” or those labeled ascertified by an American NationalStandards Institute (ANSI) -accredited organization toANSI/NSF Standard 53 for “CystRemoval” provide the greatestassurance of removingCryptosporidium.As with all filters,follow the manufacturer’s instruc-tions for filter use and replace-ment.

Use bottled water

Check the label or call the bottlerto find out how bottled water istreated. The following bottledwater treatments protect against Cryptosporidium: reverse osmosis,distillation,ultraviolet light,or filtra-tion with an absolute one micronfilter.Bottled waters derived fromprotected well and spring watersources are less likely to be con-taminated by Cryptosporidium thanthose containing untreated munic-ipal drinking water from less pro-tected sources such as rivers andlakes.

Those who choose to take theseprecautions should rememberthat they can be exposed towaterborne pathogens throughwater used for brushing teeth,making ice cubes, and washingfruits and vegetables – not justthrough water they drink.

water provided by public water suppliers; FDA setsstandards for bottled water based on EPA standards.Bottled water and tap water are both safe to drink ifthey meet these standards, although people withseverely weakened immune systems or other specifichealth conditions may wish to further treat their waterat home or purchase high quality bottled water.

FDA regulates bottled water as a packaged foodunder the Federal Food, Drug and Cosmetic Actand has established standards of identity andquality for bottled water. FDA has also establishedgood manufacturing practice requirements forprocessing and bottling drinking water.

EPA encourages all Americans to learn more aboutthe quality of their drinking water, both tap waterand bottled water, before deciding whether todrink tap water, bottled water, or both. If yourwater comes from a public water system, the bestway to learn more about tap water is to read yourwater supplier’s annual water quality report. Ifyour water comes from a household well, EPA rec-ommends testing the water regularly for bacteria,nitrates, and other contaminants.The best way tolearn more about bottled water is to read its label,or contact the producer directly.

Know what you’re buying

Bottled water is much more expensive, per gallon,than tap water. Because of this, consider whetheryou are buying it as a healthy alternative to bottledbeverages, for its taste, or for other reasons.

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Bottled Water Terms

The following terms are fre-quently used on bottledwater labels to describe thewater’s characteristics,sources, and methods oftreatment.

Artesian water, groundwater, spring water, wellwater - water from an under-ground aquifer which may ormay not be treated. Wellwater and artesian water aretapped through a well. Springwater is collected as it flowsto the surface or via a bore-hole. Ground water can beeither.

Distilled water - steam fromboiling water is recondensedand bottled. Distilling waterkills microbes and removeswater’s natural minerals, giv-ing it a flat taste.

Drinking water – waterintended for human consump-tion and sealed in bottles orother containers with noingredients except that it mayoptionally contain safe andsuitable disinfectants. Fluoridemay be added within limita-tions set in the bottled waterquality standards.

Mineral water - Groundwater that naturally contains250 or more parts per millionof total dissolved solids.

Purified water - water thatoriginates from any sourcebut has been treated to meetthe U.S.Pharmacopeiadefinition ofpurified water.Purified water isessentially freeof all chemicals(it must notcontain morethan 10 partsper million oftotal dissolvedsolids), and mayalso be free ofmicrobes iftreated by dis-tillation or reverse osmosis.Purified water may alternatelybe labeled according to howit is treated.

Sterile water - water thatoriginates from any source,but has been treated to meetthe U.S. Pharmacopeia stan-dards for sterilization.Sterilized water is free fromall microbes.

Note: Carbonated water,soda water, seltzer water,sparkling water, and tonicwater are considered softdrinks and are not regulatedas bottled water.

Taste considerations

Many people preferbottled waterbecause of its taste.The taste of all waterhas to do with the wayit is treated and thequality of its source,including its naturalmineral content.Mostbottled water comesfrom a ground watersource,where waterquality varies less fromday to day, or is treat-ed and immediately bottled. Bottled water from a ded-icated source or plant may have a more consistenttaste than tap water,which mostly comes from sur-face sources and must travel through pipes to reachhomes.

One of the key taste differences between tap waterand bottled water is due to how the water is disinfec-ted.Tap water may be disinfected with chlorine, chlo-ramine,ozone,or ultraviolet light to kill disease-causinggerms.Water systems use these disinfectants chlorineand chloramine because they are effective and inex-pensive, and they continue to disinfect as water travelsthrough pipes to homes and businesses. Bottled waterthat is disinfected is typically disinfected using ozone orother technologies such as ultraviolet light or chlorinedioxide.Ozone is preferred by bottlers, though it ismore expensive than chlorine, because it does notleave a taste and because bottlers do not need toworry about maintaining disinfectant in water sealedin a container.Untreated water,whether from a bottleor from a tap,will have the characteristic taste of itssource.

Begin by reading the label

To learn about the quality of bottled water,begin by reading the label. In addition to thevolume of water, any pertinent nutritional claims,and any contact information for the bottler, thelabel may include the type of bottled water, itssource, and the way in which it is treated. Formore specific information, you may need tocontact the bottler directly.

Type of water and source:

Bottlers use standard identifiers, prescribed byFDA regulations, to describe their water (Bottledwater terms, pgs 4 and 5), but the meanings

may be different than you expect.These terms refer toboth the geological sources of the water and thetreatment methods applied to the water.Theterms don’t necessarily describe the geographiclocation of the source or determine its quality.

For instance,“spring water” can be collected at thepoint where water flows naturally to the earth’s surfaceor from a borehole that taps into the undergroundsource.Other terms used on the label about thesource, such as “glacier water” or “mountain water,”are not regulated standards of identity and may notindicate that the water is necessarily from a pristinearea. Likewise, the term,“purified,” refers to processesthat remove chemicals and pathogens.“Purifiedwater” is not necessarily free of microbes – though itmay be.

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Common Bottled WaterTreatments

Distillation - water is boiled,and the steam is condensedto remove salts, metals, min-erals, asbestos, particles, andsome organic materials.

Microbes are killed, includingCryptosporidium.

Micron Filtration - water isfiltered through screens withmicroscopic holes.The small-er the filter holes, the morecontaminants the filter canremove. Good filters canremove most chemical con-taminants and microbes.Filter holes are measured inmicrons. (The period at theend of this sentence is 500microns.) When considering

filter size, look for anabsolute (the largest hole),not nominal (the averagehole) rating. An absolute onemicron filter is needed toremove Cryptosporidium.

Ozonation - water is disin-fected using ozone, whichkills most microbes, depend-ing on dosage applied.

Reverse Osmosis - water isforced under pressure topass through a membrane,leaving contaminants behind.This process removes allmicrobes, minerals, color, tur-bidity, organic and inorganicchemicals.

Ultraviolet (UV) light -water is passed through UVlight, which kills mostmicrobes, depending ondosage applied.

Bottled water must be tested and meet regulatory stan-dards before it can be sold in the U.S. (See page 8 fordetails.) Bottled water, like tap water, can come from aground water source, such as a well or spring,or a sur-face water source, such as a river or stream.Most bot-tled water comes from a ground water source.Groundwater is typically less vulnerable to contamination thanwater from surface sources.However,ground water canstill contain naturally high amounts of certain contami-nants, including radioactive elements,arsenic,andnitrates,or be vulnerable to contamination from humanactivities, such as industrial waste, faulty septic systems,and underground gas or chemical tanks.

Some bottled water comes from surface watersources.This water typically comes from a publicwater system and receives additional treatment, suchas filtration and disinfection, before it is bottled.

Bottlers must list on the label the type of bottled water(such as spring water,mineral water,or drinking water). Ifthe water comes from a public water system and has notbeen treated to meet FDA’s definition of “purified”or“sterile”water,the label must state that the source is froma community water system.

Contaminants and methods oftreatment:

If you are concerned about a particular contaminant inyour drinking water, consider the following questions: Isthe source water likely to contain the contaminant? Hasthe water been treated to remove the contaminant?

Water that originates from a protected ground watersource is less likely to contain certain contaminants(such as disease-causing microbes), but not all groundwater is protected, and no water is guaranteed to becompletely free of contaminants.

The best way to know if the water you are drink-ing is free from the contaminant(s) you are con-cerned about is to contact the bottler and ask forthe latest testing results and whether the waterhas been treated to remove the contaminant.

Many public water systems add fluoride to theirwater;most bottlers do not. If bottled water is fluoridat-ed, it must indicate so on the label, though bottledwater and tap water can contain naturally occurringfluoride.Check with your public water system or bottlerto find out if the water you drink contains fluoride.

Certification

Neither EPA nor FDA certify bottled water.However,consumers may notice a logo or seal from two otherorganizations on the label.

The International Bottled Water Association (IBWA) is a tradeorganization for water bottlers.IBWA members must meet theorganization’s “model code”and are subject to annual inspec-tions by an independent third party.Bottlers belonging toIBWA frequently indicate membership on their labels.

NSF International - Bottled water certified by NSF under-goes additional testing by unannounced annual plantinspections.NSF certifications mean that the bottlercomplies with all applicable FDA requirements, includ-ing good manufacturing practices.

Underwriters Laboratories,Inc.(UL) is an independentaccredited testing and certification organization thattests bottled water to FDA, state,and IBWA model coderequirements.

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If you use a water cooler, remember toclean and sanitize it regularly accordingto the manufacture’s instructions.

FDA Bottled WaterStandards

Any bottled water sold ininterstate commerce in theUnited States including prod-ucts that originate overseasmust meet the following mini-mum federal standards (checkwith your health departmentto see what bottled waterstandards exist for brandsproduced, bottled, and soldentirely in one state):

Bottled water must meet FDAstandards for physical, chemi-cal, microbial, and radiologicalcontaminants.When EPA sets anew standard for a contami-nant in tap water, FDA mustestablish a new standard forthe same contaminant in bot-tled water or find that EPA’snew standard is not applicableto bottled water.

Bottlers must include thename of the product and typeof water; the name and addressof the manufacturer, packer, ordistributor; and the net con-tent on their labels.

New bottled water sourcesmust be approved by a state orlocal jurisdiction. Bottlers mustalso test their sources and fin-ished bottled water products

at least once a week for micro-biological contaminants and atleast once a year for physical,chemical, and radiological con-taminants.

If bottled water is found tobe adulterated or hazardousto health, it is subject to FDAenforcement action, such asseizure of domestic productsand refusal of entry ofimports.

Bottlers must operate theirplants in accordance withFDA’s good manufacturingpractices to ensure that theirbottled water products aresafe and produced under safeand sanitary conditions.

Contact EPA for standardsfor the tap water providedby public water systems, orsee www.epa.gov/safewater/mcl.html.

For more information on bottled water:

Contact the bottler directly, ask for its latest testingresults, and compare these results with EPA’s tap waterstandards (www.epa.gov/safewater/mcl.html) or FDA’sbottled water standards to determine its quality.

Food and Drug AdministrationCenter for Food Safety and Applied NutritionOutreach and Information Center5100 Paint Branch ParkwayHFS-555College Park,MD 20740-3835www.cfsan.fda.gov(888) SAFEFOOD; (888) 723-3366

International Bottled Water Association1700 Diagonal Road, Suite 650Alexandria,VA 22314www.bottledwater.orgibwainfo@bottledwater.org(800) 928-3711

NSF InternationalP.O. Box 130140Ann Arbor,MI 48113-0140www.nsf.orginfo@nsf.org877-8-NSF-HELP; (877) 867-3435

Underwriters Laboratories, Inc.110 South Hill StreetSouth Bend, IN 46617www.UL.com/waterwater@us.ul.com(800) 332-4345

For more information about tap water:

To learn about the quality of your tap water, contactyour water supplier and ask for the annual consumerconfidence report.This report will list what contami-nants have been detected in the water, and how thoselevels compare with EPA’s standards.

EPA’s Safe Drinking Water Hotline1 (800) 426-4791www.epa.gov/safewater - includes drinking waterstandards, state certification officers for water testing,and information for household well owners.

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