Public Health Water

What’s in Your Water?

The quality of water delivered to your home by the local water department will vary in purity based on the source of the water (rivers, wells, etc.), the processes used to purify the water, and the system of pipes used to deliver the water to your tap.

In most public water systems, these three factors all change to some degree as the years go by.  Fortunately, in most public water systems, these variations are carefully monitored with adjustments made as needed.  Of course, the Flint Michigan water supply story reminds us that from time to time around the country, water quality can unexpectedly deteriorate.  Problems like those in Flint Michigan are unlikely in Huntsville, given that we have a better source of water, far fewer sources of lead, and a water department with an excellent record of monitoring our water.

In an area where the population is growing, there will be an increased demand for water from a shrinking supply of good quality water.  In all water systems, pipes age, and as they age, have the potential for contaminating water in ways that are difficult to thoroughly test.  As for what’s in the public water supply and the processes used to purify water before it enters the system of pipes used for distribution, well, that’s routinely monitored along lines required by Federal and State law.  For a list of contaminants known to exist in the Huntsville Utilities’ water delivery system, view the report, “2019 Annual Water Quality Report.”  Before trying to make sense of the report, be forewarned that without a degree in biochemistry and public health, you may not be the wiser after reading the report.  While Huntsville Utilities routinely receives awards for the quality of their operations, these awards are for overall quality and not specifically for water at your tap.  Testing every water tap in the city would be a formidable task, comparable with daily checking every road and driveway in the city for potholes.

Water provided to homes and businesses in the Huntsville area is tested extensively for contaminants that are thought to be harmful.  The potential problem is that almost all safe levels are based on best guesses.  As you might expect, no one is likely to sign up for a water trial to see how long they can ingest a particular contaminant before prematurely dying. As a result, there will always remain many unknowns when estimating the safe level of contaminants in water.   Further complicating an assessment of safe contaminant levels is the tolerance of individuals vs. the average effect on a large population.  For example, people that are immune-compromised such a person with cancer, a person with an organ transplant, or an HIV/AIDS compromised person could be at increased risk from tap water.  The elderly and infants can also be at increased risk.

Given that the best tap water available will usually contain chlorine, fluoride, some microbial contaminants, inorganic contaminants, pesticides, herbicides, organic chemicals, and radioactive contaminants, you may wonder what you can do to protect your health.  There are two answers to this question.  First, you can assume you are average and that laws governing water testing laws are adequate to protect an average person.  Of course, this is an assumption clouded by many ongoing controversies about the safe levels of contaminants.  For many of the newer industrial contaminants, there is insufficient information to make more than an educated guess about their long term impact on health.  On the other hand, if skeptical that water testing is settled science with adequate answers for your future health, consider drinking bottled water or further purifying your tap water.

If bottled water happens to be your choice, then you need to do some research first.  In one survey, almost 20 percent of bottled water didn’t indicate where the water came from, and an additional 32 percent did not disclose any information on treatment or purity of water.  Just so you know, some of the worst brands of bottled water featured words like ‘natural,’ ‘purified,’ ‘spring water,’ or ‘premium water.’  By one estimate, 40% of bottled water is tap water with no further purification.  Before paying 100 or 1000 times more for bottled water than tap water, you might want to check into what you are buying.  Then, there is the added dilemma that almost all bottled water is bottled in single-use plastic bottles.  In addition to the environmental issues associated with disposing of billions of single-use containers, there is also the potential for plastic to leach into the water.  This leaching effect can be significantly magnified for water bottles left in hot cars.  Although these contaminants from plastic bottles are in very small amounts, some are known to be in a class of chemicals that have the potential to cause cancer, affect reproduction, and disrupt the endocrine system.  While the amount ingested from plastic bottles alone probably isn’t an issue, these chemicals now occur in so many places that minimizing them, when possible, now seems prudent.

The alternative to bottled water is to further purify tap water or whatever water source you have available.  Like bottled water, water filtration products can also be challenging to evaluate.  Most products claim to filter out the contaminants people are familiar with and make no mention of the many other contaminants that are rarely in the news.  While there may be many fine filtration products available, few products that I looked into provided what I considered high-quality filtration, laboratory test data to back up their claims, and low cost.

When searching for a home water purification system, two products made my final cut.  Both ended up being gravity-type water purifiers.  The devices both work the same way, with only minor variations in their appearance, size, and purification ability.

Both products (ProPur and Berkey) were similar in construction with a stainless steel top tank to hold the unfiltered water and a stainless steel bottom tank to collect the purified water.  The filter(s) reside in the top tank with the bottom tank having a small spigot to dispense the purified water.

The difference between the two products included the initial cost, the cost for replacement filters, and the expected cost per gallon of purified water.  While both products could have met my needs, I ultimately chose a model made by ProPur that included fluoride filtering without a supplemental filter.  However, the best choice for me might not be the best choice for you.  Removing fluoride is a controversial issue, and unless you understand the issue well enough to get fluoride from another source, then best to not filter it out.  Later, I’ll offer a few thoughts about the advantages and disadvantages of having fluoride in the public water supply.

Other points in favor of the ProPur model included lower filter maintenance and a sales price on eBay for a “slightly blemished” model.  After two months, I still had not found the blemish.  However, the ProPur model did not have the lowest overall cost per gallon of water.  Such are the dilemmas when tradeoffs have to be made.

Rather than go into the minor differences in the purification specifications between the ProPur product I chose and the competing Berkey product, I’ll let you read a review, “Countertop Gravity Water Filters: Which is Best?“  As you will notice, minor differences exist.  Most importantly, both products provide excellent filtration with 95% to 99% filtration for most contaminants.

As mentioned previously, the ProPur and Berkey products are similar in design.  Interestingly, this similarity allows for using the ProPur filter in the Berkey and vice versa.  Another similarity is the ability to use up to four filters in parallel if faster filtration is needed.  The number of filters used is a matter of personal need and has no effect on the quality of the purification.  If planning to use only one filter, be sure to order extra plugs to close the filter holes in the top tank that aren’t used.

For home use, I chose the ProPur BIG model (9.25” diameter x 21.5” high) that holds 2.75 gallons of filtered water.  This choice was based on expected home water usage and available space in the kitchen.  With an advertised filtration rate of 1/2 gallon an hour and storage of 2.75 gallons, it was an adequate arrangement to produce sufficient purified water so long as I occasionally added water to the top tank.

After using the ProPur system for two months, the advertised purification rate of 1/2 gallon an hour was discovered to be somewhat different from what was expected.  When the top tank was full, the filtration rate seems to be closer to 2 gallons per hour and when the top tank was low on water, the filtration rate slows to a snail’s pace.  The good news was that if the bottom tank of purified water runs out unexpectedly, enough for a glass of water can be made in a few minutes by topping off the top tank.  After running out of water a few times, it became obvious that as the flow rate from the bottom tank spigot slowed, it was time to pour water into the top tank.  For those that need a visual cue, an external water level indicator is available as an add-on.

I previously mentioned the cost of purified water as a factor in making a purchasing decision.  The ProPur Big comes with two filters that are rated at 700-1200 gallons of water per filter, depending on the quality of water being filtered.  Replacement filters cost about $65 each.  Not counting the initial cost of the tanks, that yields a potential long-term purification cost of between 5 and 9 cents per gallon.

At our current usage of purified water, of 2-3 gallons per day, one filter may supply a year’s worth of drinking water.  One year is also the recommended life of the ProPur filter.  In contrast, the Berkey filters can purify up to 3000 gallons of water and can last up to three years but require more filter maintenance.  At an estimated cost of 2-3 cents per gallon, the Berkey filters win on the basis of cost if fluoride removal is not desired.  If fluoride removal is desired, an add-on filter has to be purchased, which brings the cost per gallon for the Berkey filter up to about the same cost per gallon as the ProPur filter.

With regard to beneficial minerals like magnesium, potassium, and calcium, the Berkey filter doesn’t filter these out but does remove most heavy metals such as lead and mercury as well as sedimentary minerals.  In contrast, the Propur filter reduces calcium (about 81%), removes no magnesium, and removes only about 2.5% of potassium.  The Propur also does a little better at removing heavy metals (100% of lead.)  Given that the best source of essential minerals (including fluoride) is fruits and vegetables, the slight filtration of some minerals from water is not a significant factor.

While filtered tap water will give the longest filter life for both types of filters, in a pinch, you could filter water from almost any source except saltwater.  For disaster planning, a gravity-fed purifier that requires no power to operate certainly has merit.

If you choose to buy a gravity-fed type water purifier, the dilemma of where to place it may be your biggest challenge.  If you have counter space near the sink, that will be your best choice. The unit will have to be filled, and the closer to the water tap, the better. As an alternative, many of the stands used for large water bottle dispensers can also be used to hold a gravity-fed type water purifier.

            Nancy Neighbors, MD

Should Water be Fluoridated?

            There is little doubt that a small amount of fluoride helps teeth resist cavities.  The question of how much is questionable given that fluoride has benefit for developing healthy teeth and at the same time, has been implicated as a possible cause for ADHD, cancers, and underactive thyroid.  In the United States, most communities fluoridate water because it is the least expensive way to assure that all segments of the population receive fluoride.  While fluoridating the public water supply benefits many, it’s not the best solution for everyone. For more about the advantages and disadvantages of fluoridated water, learn more from the following articles.

            The fluoridation of water is controversial because it pits the public need for better teeth against the public need to reduce certain diseases.  Unfortunately, in this situation, there does not appear to be one answer that’s right for everyone.

            Given that fluoride is naturally occurring or added to many plant based foods, a person would need to eat an unusual diet to not get enough fluoride.  Other common sources of fluoride include mouthwashes, toothpaste, and food cooked in Teflon coated pans.  With so many sources of fluoride, the likelihood of getting too much fluoride is now a greater possibility for most people than getting too little fluoride. Just keep in mind that for most people, eliminating refined sugar and refined carbohydrates has far more value in reducing cavities than fluoridated water offers.  In any case, before giving up on fluoridated water, share this article with your dentist and then discuss what is right in your situation.

What About Reverse Osmosis Water Filter?

            Reverse osmosis water filters can provide even better filtering of water contaminants than gravity type water filters.

            In some situations, their higher costs may be appropriate.  Electrical pumps used in the reverse osmosis process, of course, makes the water filters dependent on power that might not be available in emergency situations.

            For more about the advantages and disadvantages of reverse osmosis water filters, read “Aquatru vs. Royal Berkey Water Filter Systems Review.”

Have an Insight to Share?

            Perhaps you have investigated home water purifiers and have information to share.  I’d be delighted to hear your story and pass along any wisdom you have to share in a future guest column.

Guilty as Charged

            For those that have visited the office recently, you may have noticed that I still have bottled water available for patients.  In time, I would like to change over to a water purifier for office use.  For now, the logistics of using a water purifier at the office are a work in progress.  Not everyone has a refillable water bottle, and for some, bottled water is easier to manage than a cup of water.  For now, my redemption for using single-serve bottled water containers rests on making sure all bottles discarded at the office get recycled, and my hope that you will recycle the bottles you take home.

By Nancy Neighbors, MD

... Dr. Neighbors provides a blend of traditional family medicine and evidence-based lifestyle medicine in Huntsville, Alabama. When indicated, lifestyle change is recommended as the first line of therapy.

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