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Bottled Water

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Americans spend billions of dollars every year on bottled water. People choose bottled water for a variety of reasons including aesthetics (for example, taste), health concerns, or as a substitute for other beverages.

If you have questions about bottled water, make sure you are informed about where your bottled water comes from and how it has been treated. The standards for bottled water are set by the United States Food and Drug Administration (FDA). The FDA bases its standards on the EPA standards for tap water.

  • Read the label on your bottled water. While there is currently no standardized label for bottled water, this label may tell you about the way the bottled water is treated.
  • Check the label for a toll-free number or Web page address of the company that bottled the water. This may be a source of further information.

Bottled Water & Immunocompromised Individuals

People with compromised immune systems may want to take special precautions with the water they drink. In healthy individuals, the parasite Cryptosporidium can cause illness; however, for those with weakened immune systems, it can cause severe illness and possibly death. Look for bottled water treatments that protect against Cryptosporidium, which include:

  • Reverse Osmosis
  • Distillation
  • Filtration with an absolute 1 micron filter

Fluoride and Bottled Water

Some bottled waters contain fluoride, and some do not. Fluoride can occur naturally in source waters used for bottling or be added. Most bottled waters contain fluoride at levels that are less than optimal for good oral health. 

Safety and Regulation

The FDA regulates bottled water under the Federal Food, Drug, and Cosmetic Act and sets standards for bottled water that are based on ones developed by EPA. If these standards are met, water is considered safe for most healthy individuals. The bottled water industry must also follow FDA’s Current Good Manufacturing Practices (CGMPs) for processing and bottling drinking water.

Bottled Water Outbreaks

Although bottled water outbreaks are not often reported, they do occur. It is important for bottled water manufacturers, distributors, and consumers to:

  • Protect and properly treat water before bottling
  • Maintain good manufacturing processes
  • Protect bottled water during shipping and storage
  • Prevent contamination at the point of use (after purchase by the consumer)

The presence of contaminants in water can lead to adverse health effects, including gastrointestinal illness, reproductive problems, and neurological disorders. Infants, young children, pregnant women, the elderly, and people whose immune systems are compromised because of AIDS, chemotherapy, or transplant medications, may be especially susceptible to illness from some contaminants.

Reported Outbreaks Associated with Bottled Water 

Outbreaks associated with bottled water by point of contamination:

Contamination at Water Source

  • 2000: acute gastrointestinal illness (AGI) caused by the bacteria Salmonella Bareilly

Contamination During Commercial Bottling

  • 1980: AGI caused by an unidentified agent
  • 1989: AGI caused by an unidentified agent
  • 1994: AGI caused by the bacteria 
  • 2003: AGI caused by the chemical bromate

Contamination During Shipping, Hauling, or Storage

  • 2003: AGI caused by an unidentified chemical cleaning product

Contaminated at Point of Use

  • 2000: AGI caused by the bacteria Shigella sonnei Type D
  • 2003: AGI caused by an unidentified agent
  • 2010: AGI and esophagitis caused by an unidentified agent (suspected chemical)

Unknown Point of Contamination

  • 1973: AGI caused by an unidentified agent
  • 1999: AGI caused by an unidentified agent
  • 2001: AGI caused by the chemical ethylbenzene
  • 2004: AGI caused by gasoline byproducts
  • 2007: AGI caused by an unidentified agent

The Food and Drug Administration (FDA) regulates the safety of bottled water. If you suspect an illness resulting from the consumption of bottled water, you should contact your local public health department.