Bottled vs tap water revisited

Issue: BCMJ, vol. 51 , No. 5 , June 2009 , Pages 191 Letters

Drs Copes, Evans, and Verhille[1] write compellingly on the evils of bottled water (not environmentally friendly) and the blessings of municipal water, but their discussion does seem a bit one-sided.

There is no doubt that water in urban British Columbia is bacterially and virally safe, but outbreaks of Cryptosporidia parvum[2] and others parasites[3,4] are well established. And one does not have to look far for examples of other municipal water outbreaks.[5]

As much as municipal water at the origins may be extremely safe and available with a high degree of confidence, this does not always speak to the quality of water at the tap, particularly in older buildings. Often tap water carries precipitate, grit, rust, and microbial contamination that come from old plumbing. While filter systems can address many of these problems, they are fine until they leak, putting many days of residual debris into a single glass of water. Drinking fountains in public places have largely disappeared, in part because of the expense of cleaning them to remove the evidence of their co-use as public spittoons. Bottled water in the workplace is a viable alternative to unpalatable and perhaps unsafe drinking water in many public places.

Outside the house or office, I agree that the recreational overuse of water in plastic bottles seems to be unnec­essary and wasteful. But one doesn’t have to get very far outside the city before carrying drinking water for hiking becomes essential, and glass bottles are hardly an acceptable alternative. Given the choice between the real and predictable risk of broken and damaged glass bottles and cuts from glass shards versus the theoretical risk of Bisphenol-A or other leachable molecules, it would seem that the balance of safety would strongly lean to the side of plastic containers.

Finally, we know and understand that every family needs to recognize and plan for natural and unnatural disasters that include earthquakes, being trapped in vehicles, and even the outcomes of terror. We are advised that municipal water may not always be present. Advice is to ensure an ample supply of bottled water.

While plastic water bottles may not be environmentally friendly, they are nonetheless safe, light, storable, and in some situations even lifesaving.

—Michael A. Noble, MD
Department of Pathology and Laboratory Medicine, UBC


References

1. Copes R, Evans GM, Verhille S. Bottled vs tap water. BCMJ 2009;51:112-113.
2. Ong CS, Eisler DL, Goh SH, et al. Molecular epidemiology of cryptosporidiosis outbreaks and transmission in British Columbia, Canada. Am J Trop Med Hyg 1999;61:63-69. PubMed Abstract Full Text
3. Aramini JJ, Stephen C, Dubey JP, et al. Potential contamination of drinking water with Toxoplasma gondii oocysts. Epidemiol Infect 1999;122:305-315. PubMed Abstract
4. Isaac-Renton J, Moorehead W, Ross A. Longitudinal studies of Giardia contamination in two community drinking water supplies: Cyst levels, parasite viability, and health impact. Appl Environ Microbiol 1996;62:47-54. PubMed Abstract Full Text
5. Hrudey SE, Payment P, Huck PM, et al. A fatal waterborne disease epidemic in Walkerton, Ontario: Comparison with other waterborne outbreaks in the developed world. Water Sci Technol 2003;47:7-14. PubMed Abstract

Michael A. Noble, MD,. Bottled vs tap water revisited. BCMJ, Vol. 51, No. 5, June, 2009, Page(s) 191 - Letters.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply