Physicians skeptical of ‘raw water’ health benefits, certain of its dangers

In late December, The New York Times published an article about an emerging “raw water” trend. Proponents of raw water — collected through naturally occurring springs or precipitation for consumption and household use — contend that beneficial minerals have been removed from filtered tap water and that fluoride is an unsafe chemical.

However, health concerns emerged as quickly as the trend itself. Healio spoke with health care professionals about the dangers associated with this trend. Vince Hill, PhD, MS, PE, is acting chief of the Waterborne Disease Prevention Branch at the CDC. Timur S. Durrani, MD, MPH, MBA, is associate clinical professor of medicine in the UCSF division of occupational and environmental medicine; assistant medical director of the San Francisco division of the California Poison Control System; and associate director of the Pediatric Environmental Health Specialty Unit at UCSF.

Healio: How much is known about the prevalence of the “raw water” trend?

Hill: The idea of commercializing untreated drinking water appears to be relatively new in the United States; it is certainly new to those of us at the CDC. We don’t know how many people are obtaining untreated drinking water from vendors.

We also don’t know, beyond what we’ve read in the news, who’s selling or producing untreated water.

Healio: What is the best way to describe this trend?

Hill: This is, in general terms, untreated water. I wouldn’t even call it untreated drinking water, because it’s not water that is intended for, or has been produced for, drinking.

The terminology depends on how people are collecting it and obtaining it. It appears that some people are collecting it directly from a spring; others may be condensing water vapor and producing it that way. It seems like there are very different ways for producing this water, so it’s hard to label it with one term, but I would say untreated water is the best term.

Durrani: This is more of a marketing campaign than a health effort, in my opinion. With regard to how it is being marketed, raw water is water that has not been treated or filtered. It comes from many sources, including local springs or condensation methods.

Healio: What are the risks associated with drinking untreated water?

Hill: There are many sources of water contamination, including naturally occurring chemicals and minerals like arsenic. There are local land use practices that introduce fertilizers and pesticides into the water supply; there are manufacturing processes, sewer discharges and septic tanks. There are also chemicals and organic and inorganic contaminants that can be in water. These processes may allow contaminates into ground water and spring water. It can look clear, but it can still contain toxins that cause illness.

Drinking this kind of unfiltered water can increase the risk for developing certain infectious diseases caused by germs like Cryptosporidium and Giardia, which are parasites. There are bacteria, like Shigella and Salmonella, that can be in water that isn’t treated. Norovirus, a stomach virus, is another concern. People are certainly more at risk of getting sick from drinking untreated water than from water that is treated to meet drinking water regulations.

It’s not just about the risk that people take on themselves when drinking untreated water; it could also be a potential issue for others around them. Many water-borne diseases can be spread from one person to another. This includes illnesses that cause diarrhea or vomiting. Very young people, the elderly and individuals with weakened immune systems may be more at risk for getting sicker from water-borne diseases.

Healio: What can be done to decrease the spread of this trend?

Hill: It’s important to provide people with information about drinking water that is accurate and complete. That’s where it starts. We want people to be informed.

It’s important to remind people that the United States has one of the safest public drinking water supplies in the world. Over the past 100 years, many improvements in the overall health status and lifespan of people in the U.S. can be linked to drinking water treatments and improvements in water quality.

People want the water that they use to be safe. The more people learn about the effectiveness of public water systems for providing safe water, the more they’re going to value public drinking water. There is information people can get from the health department; there are consumer confidence reports about community water systems.

Water that is treated to meet water quality regulations should be safe to use. The chemicals that are used in water treatment, like chlorines, are added to make the water safe, to remove and kill those germs that make us sick. Fluoride is added to drinking water to promote dental health. Many groups promote the idea that adding fluoride to drinking water is beneficial for oral health.

Durrani: This appears to be a fad, particularly for people who have disposable income and are under-informed about the risks of unfiltered/untreated/untested water.

As with most health fads, I think this too will pass. There will likely be people who become ill because of the marketing, which will eventually cause the fad to decrease from the mainstream, if it ever reaches the mainstream.

Disclosures: Durrani and Hill report no relevant financial disclosures.

In late December, The New York Times published an article about an emerging “raw water” trend. Proponents of raw water — collected through naturally occurring springs or precipitation for consumption and household use — contend that beneficial minerals have been removed from filtered tap water and that fluoride is an unsafe chemical.

However, health concerns emerged as quickly as the trend itself. Healio spoke with health care professionals about the dangers associated with this trend. Vince Hill, PhD, MS, PE, is acting chief of the Waterborne Disease Prevention Branch at the CDC. Timur S. Durrani, MD, MPH, MBA, is associate clinical professor of medicine in the UCSF division of occupational and environmental medicine; assistant medical director of the San Francisco division of the California Poison Control System; and associate director of the Pediatric Environmental Health Specialty Unit at UCSF.

Healio: How much is known about the prevalence of the “raw water” trend?

Hill: The idea of commercializing untreated drinking water appears to be relatively new in the United States; it is certainly new to those of us at the CDC. We don’t know how many people are obtaining untreated drinking water from vendors.

We also don’t know, beyond what we’ve read in the news, who’s selling or producing untreated water.

Healio: What is the best way to describe this trend?

Hill: This is, in general terms, untreated water. I wouldn’t even call it untreated drinking water, because it’s not water that is intended for, or has been produced for, drinking.

The terminology depends on how people are collecting it and obtaining it. It appears that some people are collecting it directly from a spring; others may be condensing water vapor and producing it that way. It seems like there are very different ways for producing this water, so it’s hard to label it with one term, but I would say untreated water is the best term.

Durrani: This is more of a marketing campaign than a health effort, in my opinion. With regard to how it is being marketed, raw water is water that has not been treated or filtered. It comes from many sources, including local springs or condensation methods.

Healio: What are the risks associated with drinking untreated water?

Hill: There are many sources of water contamination, including naturally occurring chemicals and minerals like arsenic. There are local land use practices that introduce fertilizers and pesticides into the water supply; there are manufacturing processes, sewer discharges and septic tanks. There are also chemicals and organic and inorganic contaminants that can be in water. These processes may allow contaminates into ground water and spring water. It can look clear, but it can still contain toxins that cause illness.

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Drinking this kind of unfiltered water can increase the risk for developing certain infectious diseases caused by germs like Cryptosporidium and Giardia, which are parasites. There are bacteria, like Shigella and Salmonella, that can be in water that isn’t treated. Norovirus, a stomach virus, is another concern. People are certainly more at risk of getting sick from drinking untreated water than from water that is treated to meet drinking water regulations.

It’s not just about the risk that people take on themselves when drinking untreated water; it could also be a potential issue for others around them. Many water-borne diseases can be spread from one person to another. This includes illnesses that cause diarrhea or vomiting. Very young people, the elderly and individuals with weakened immune systems may be more at risk for getting sicker from water-borne diseases.

Healio: What can be done to decrease the spread of this trend?

Hill: It’s important to provide people with information about drinking water that is accurate and complete. That’s where it starts. We want people to be informed.

It’s important to remind people that the United States has one of the safest public drinking water supplies in the world. Over the past 100 years, many improvements in the overall health status and lifespan of people in the U.S. can be linked to drinking water treatments and improvements in water quality.

People want the water that they use to be safe. The more people learn about the effectiveness of public water systems for providing safe water, the more they’re going to value public drinking water. There is information people can get from the health department; there are consumer confidence reports about community water systems.

Water that is treated to meet water quality regulations should be safe to use. The chemicals that are used in water treatment, like chlorines, are added to make the water safe, to remove and kill those germs that make us sick. Fluoride is added to drinking water to promote dental health. Many groups promote the idea that adding fluoride to drinking water is beneficial for oral health.

Durrani: This appears to be a fad, particularly for people who have disposable income and are under-informed about the risks of unfiltered/untreated/untested water.

As with most health fads, I think this too will pass. There will likely be people who become ill because of the marketing, which will eventually cause the fad to decrease from the mainstream, if it ever reaches the mainstream.

Disclosures: Durrani and Hill report no relevant financial disclosures.