What to do about Bottled Water?

by Jonathan Weinkle, MD, Resident, Medicine-Pediatrics, UPMC Presbyterian-Shadyside and Children's Hospital of Pittsburgh of UPMC

Soft drink companies spend millions promoting water beverages: sport waters, vitamin waters, and fitness waters in a variety of flavors with and without sweeteners, along with spring waters, mineral waters, and distilled waters. There is even water with nicotine added for smokers to drink on long plane rides and during meetings to keep their cravings at bay. We buy billions of dollars worth of these products every year. However, despite healthy-sounding names like "sport," "fitness," and "vitamin," there is serious concern about what these products do to our bodies and how their creation and disposal affect our environment.

The concerns about bottled water boil down to three major questions: 1) is the water safe? 2) what does it cost the environment to make it?; and 3) are there health benefits to or risks from drinking bottled water vs. other beverages?

Bottled Water Is Not Cleaner than Tap Water

Aging sewer systems, like the system in Pittsburgh, sometimes overflow into major drinking water sources after storms and floods. In one local effort, The Allegheny River Stewardship Project, led by Center for Environmental Oncology of UPCI Co-Director of Assessment and Control, Conrad Dan Volz, PhD, MPH, is working with concerned citizens of the Alle-Kiski Valley river communities, to determine the sources and types of river pollutants by monitoring the levels and biological effects of toxins that concentrate in fish in our local rivers.

Preliminary results demonstrated that fish caught at the Highland Park and Braddock dams and Point State Park in Pittsburgh contained estrogens (xenoestrogens). Although the specific pharmaceuticals have not been identified, the hypothesis is that these and other estrogenic chemicals may be entering the river through sewer overflow pipes and sewage treatment discharges from plants such as Alcosan.

The presence of sewer overflow in the river can cause different kinds of contamination. Chemical contaminants including arsenic, nitrites, xenoestrogens, and other prescription drugs continue to be found in our tap water (see accompanying article). Overflow, or effluence, can also cause periodic outbreaks of parasites like giardia and cryptosporidium resulting in widespread illness.

Despite the possibility of chemical, bacterial, and protozoic contamination, municipal tap water in most places in the U. S. is probably safer than bottled water, because the law requires it. Municipal water supplies must comply with very detailed regulations on water quality with substantial penalties for violating them. Bottled water regulations are actually more lenient, though the "clean" image projected by their advertisements and the sealed bottles create a false sense of security. Few bottled water sources are as pristine or uncontaminated as the commercials would have us believe. In fact, in recent years, some bottled products have proven to be merely re-packaged tap water.

Multi-layered charcoal filters are widely available and can remove much of the chemical and biological (i.e. bacteria and parasites) contaminants. Installing reverse osmosis systems, distillation, or purchasing filters for faucets or buying filtered pitchers are some of the most effective steps consumers can make to assure that they are drinking the safest water possible. Buying a filter for your shower head is also an effective step in lowering your exposure to toxins which may be absorbed through the skin. Programs are needed to recycle used filters such as those developed in some European nations.

Bottled Water Creates Pollution

Bottled water comes in recyclable bottles. The conscientious consumer can quench her thirst, then either take the bottle home or find a nearby recycling collection bin and send that bottle on its way to becoming a cafeteria tray, toboggan, or fleece jacket. Does this solve the pollution problem? No, unfortunately, because both the manufacturing of plastic bottles and recycling leave a heavy carbon footprint, consuming resources and energy. Millions of barrels of oil are needed to make the plastic, and electricity is consumed in the production, bottling, and labeling of them. Also, fuels are consumed, and toxic exhausts are emitted in the transportation of the bottles. Many of the highest-end bottled waters, with names like San Pellegrino, Evian, and Perrier, come from sources in Europe.

Once the bottles are in the recycling bin, they need to be transported back to a facility, sorted, melted down, and re-manufactured. Each step in this process expends energy and contributes to global warming and our dependence on fossil fuels. In contrast, the water out of the municipal tap is drawn, purified, and pumped locally. Water travels to your house through pipes that can last for decades. You can refill a glass as often as you'd like, and clean it for reuse at a fraction of the energy and resource cost.

Disposable plastic water bottles are not meant for reuse, and cleaning them repeatedly in the dishwasher or sink will cause the plastic to deteriorate and leach chemical plasticizers into the water. Consumers should avoid plastic bottles labelled with #3 (PVC), #6 (Polystyrene) and #7 and only use the "safer," more recyclable bottles, #1 (PETE), #2, #4, and #5. The polycarbonate plastic Lexan, which is made of polyvinyl chloride (PVC), of plastic that is being phased out of our hospitals, has raised concerns because it may leach an estrogen-like compound called bisphenol-A (BPA) into the water. Nalgene is removing BPA from bottles as are many others. To take water with you, the best solution is to use a reusable water bottle such as ultra-lightweight stainless steel bottles. At the cost of $1 to $1.25 to purchase each bottle from the vending machine each day, the $20 reusable bottle pays for itself in less than 3 weeks.

Bottled Water Is a Healthier Choice of Beverage

Bottled water does come in handy when you don't have a reusable bottle and find yourself at a catered event or in front of a vending machine feeling thirsty. Chances are your other options all contain some combination of sugar, artificial sweeteners, and caffeine.

Sugared soft drinks contain an average of 120 calories per "serving," and most bottles today have 2-3 "servings." Each soft drink, including juices and "juice beverages," may set a person back 250-350 calories. Sugared drinks are one of the major contributors to both childhood and adult obesity and have been called "liquid candy."

Though many consumers believe that drinking sugar-free and diet soft drinks is a healthier choice, research has shown that some of the sugar substitute products are, in fact, unhealthy. In fact, artificial sweeteners appear to be appetite stimulants, and evidence is lacking to support the idea that drinking diet soft drinks actually help anyone to lose weight. Saccharine (Sweet N'Low) is linked to bladder cancer. Aspartame (NutraSweet) was approved by the FDA in 1981 despite concerns even then about its safety, and there continue to be worries that it triggers migraine headaches and is carcinogenic. The newer sweetener, sucralose (Splenda), essentially a sugar molecule altered to render it indigestible, is often used in combination with a very poorly-studied sweetener called acesulfame potassium.

Caffeine has both health benefits and hazards. Because it is a habit-forming drug, regular use can create cravings for other caffeinated products. Unlike coffee, which contains caffeine naturally, soft drinks have added caffeine in varying, unspecified amounts.

Drinking plain water (or flavored seltzer, which is unsweetened) avoids unnecessary calories and artificial stimulants. Faced with a choice between bottled water and other soft drinks, regular municipal tap water filtered by the consumer is clearly the healthier choice. "Vitamin" or "fitness" waters are unlikely to be of any extra benefit. In fact, some of the additives to sports drinks can raise blood pressure, induce rapid heart beat, or cause mood changes. Because the health claims on the label are called "structure or function" claims, the FDA requires no evidence to back them up. Do you need vitamins and minerals? It's best and safest to eat them in fresh, wholesome fruits and vegetables—washed down with a glass of filtered tap water.

Sources:

• Olson ED. 1999. Bottled water: Pure drink or pure hype?. New York: Natural Resources Defense Council.
• Rao G. 2006. Child obesity: A parent's guide to a fit, trim, and happy child. Amherst, NY: Prometheus Books.
• Scientific Panel on Food Additives, Flavourings, Processing Aids and Materials in Contact with Food. 2007. Opinion of the scientific panel on food additives, flavourings, processing aids and materials in contact with food (AFC) related to 2,2-BIS(4-HYDROXYPHENYL)PROPANE. Parma, Italy: European Food Safety Authority. 75 pp.