Public Health Water Quality and Water-Related Disease
Patricia L. Meinhardt
  • LAST REVIEWED: 24 May 2017
  • LAST MODIFIED: 24 May 2017
  • DOI: 10.1093/obo/9780199756797-0052


Contamination of water reserves by biological, chemical, and radiologic agents affects the health of millions of individuals across the globe each year. Understanding water quality and the impact of pollution on water resources is vital to worldwide public health. Historically, access to potable water and modernized sanitation has increased the lifespan and has improved the health of world citizens more than any other advancement in the field of medicine. The global public health impact of water contamination is major for many reasons: (1) safe drinking water is vital for human survival to prevent dehydration; (2) water is essential for basic hygiene and modern sanitation methods, including wastewater treatment; (3) water use is key to every sector of an industrialized, transitional, and developing economy as an essential component for the production of many goods and services; and, (4) uncontaminated water is crucial to food production and livestock health. According to the United Nations, 1.1 billion people, or 17 percent of the global population, lack access to improved water sources (an improved water source is one that is likely to provide safe water). Approximately 10 percent of the world’s total disease burden is attributable to unsafe drinking water and lack of appropriate sanitation, resulting in millions of preventable deaths each year. Contamination of water can lead to devastating medical, public health, and economic consequences for an affected community. Contaminated water is an “equal opportunity” public health crisis as water pollution is a growing problem for developing nations, transitional economies, and developed countries. The topic of water quality and water-related disease is complex and diverse in nature. The following summaries are presented as a starting point for rigorous study and are intended to act as definitive peer-reviewed and authoritative references for addressing the subject areas of water quality and water-related disease.

General Overviews

The study of water quality and water contamination is a dynamic science, constantly changing and evolving. The recognition and treatment of water-related diseases that arise from water contamination also require access to current information to accurately diagnose and to appropriately treat waterborne disease and the sequelae of acute and chronic exposure to waterborne contaminants. Up-to-date reference information is essential due to several important trends in water-related health issues including: (1) the evolving nature and increased virulence of microbial pathogens in water; (2) the addition of approximately seven hundred new chemical agents used in industry each year, many of which have the potential to contaminate water; and, (3) the need for both timely and effective responses to water emergencies and breaches in water security. Whether student, academician, or health-care practitioner, access to credible, authoritative, and current information is essential to understand the challenges of protecting water quality and to address the health effects of water contamination in exposed patients and communities. Several federal regulatory bodies, international health agencies, and educational organizations post peer-reviewed, comprehensive, and frequently updated reference material addressing both water quality issues and water-related disease information. These online resources provide excellent general overviews of all aspects of water quality and water-related disease and represent a valuable “first stop” for information gathering when approaching these complex subject areas. The most comprehensive and valuable resources addressing water quality and health-related water issues are posted at the Environmental Protection Agency (EPA) Office of Water, the Centers for Disease Control and Prevention (CDC) Healthy Water, and the World Health Organization (WHO) Water, Sanitation, and Hygiene websites. The depth and diversity of definitive reference materials offered by these federal regulatory and international health agencies is impressive. More targeted subject material is available at the Agency for Toxic Substances and Disease Registry (ATSDR) website, with an emphasis on chemical contaminants in water; the Environmental Protection Agency Science and Technology Water website, with an emphasis on wastewater and water pollution science; and, the US Geological Survey (USGS) Water Resources of the United States website, with an emphasis on water protection and water resources science. In addition, the American Water Works Association (AWWA) provides access to a broad range of information specifically related to water treatment technology, water distribution systems, and water conservation strategies. Finally, the United Nations (UN) Global Issues: Water division website targets global water issues, environmental sustainability, and water contamination as an international health burden.

  • Agency for Toxic Substances and Disease Registry.

    As an agency of the US Department of Health and Human Services, ATSDR is a federal public health agency that serves as a major resource for scientific and health information addressing harmful exposures and diseases related to toxic substances found in the environment, including water. The ATSDR website has an extensive inventory of updated web-based information dealing with hazardous chemical substances in water and their adverse impact on human health.

  • American Water Works Association.

    The AWWA is an international nonprofit educational association committed to safeguarding public health through the provision of safe water and is the world’s largest organization of water professionals representing the water industry. The AWWA website provides many useful professional and technical resources including information on water resource development and conservation, water and wastewater treatment technology, water storage and distribution, and water utility management and water science.

  • Centers for Disease Control and Prevention. Healthy Water.

    The CDC has a dedicated website that is among the most trusted sources for information on microbial and chemical contaminants of water and their impact on human and animal health. The Healthy Water website provides access to current information on drinking water, global water, sanitation, and hygiene, water-related emergencies and outbreaks, and agricultural, industrial and medical use of and potential contamination of water.

  • Environmental Protection Agency. General water-related resources.

    It is important to note that at the time of this writing, many of the EPA water-related resources have been archived. Access to these valuable resources are currently categorized at an archived website with the following targeted searches: drinking water, water quality, clean water act, surface water, urban waters, source waters, water treatment, coastal waters, and drinking water regulations.

  • Environmental Protection Agency. Office of Water.

    The EPA Office of Water has posted numerous peer-reviewed and referenced resources listed at its website addressing all aspects of drinking water safety and protection of oceans, watersheds, and aquatic ecosystems. One of the most useful tools at this website is the Drinking Water Quick Finder feature that provides easy access to important reference documents addressing waterborne chemicals contaminants, such as arsenic, lead, and perchlorate in drinking water. Note: Much of this material is currently archived.

  • Environmental Protection Agency. Science and technology: Water science.

    The EPA has developed expansive and detailed resources dedicated to water quality and the health effects of water contamination cataloged at its Science and Technology website. Technical documents address drinking water and water quality research, wastewater and water pollution science, and water quality monitoring and risk management tools and technology. Note: Much of this material is currently archived.

  • United Nations. Global issues: Water.

    The UN has a long history addressing the global crisis caused by growing demands on the world’s water resources and the subsequent impact on international health and environmental sustainability. Resources currently available at this website include many useful downloadable pdf files addressing water contamination and human health consequences on a global scale.

  • US Geological Survey. Water resources of the United States.

    The USGS website has a dedicated section addressing water issues of leading importance in the US and has collected a repository of information on surface water, groundwater, aquifers, and wells, climate change impact on water, and contamination of water with such compounds as pharmaceuticals, radionuclides, and petroleum products. The website also provides access to water data, publications, and maps specific to various US regions.

  • World Health Organization. Water, sanitation, and hygiene.

    The WHO has an impressive and expansive collection of peer-reviewed technical documents and comprehensive guidelines addressing water quality issues and the adverse health impacts of water pollution and water emergencies throughout the world. This website is the entry point to hundreds of free downloadable publications addressing a broad array of water quality and water-related disease issues.

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