Drinking water in West Virginia (USA): tap water or bottled water - what is the right choice for college students?

Do health risk perceptions motivate water - and health-related behaviour? A systematic literature review

Health-related risk perceptions are important determinants of health behaviours and components of behaviour change theories. What someone thinks or feels will motivate or hinder their intention or hesitancy to implement a certain behaviour. Thus, a perceived potential risk to our health and well-being can influence our health-promoting and/or health-seeking behaviour. We aimed to review and synthesize available peer-reviewed literature to better understand the links between water and health-related risk perceptions and behaviours. We conducted the first systematic review of peer-reviewed literature on risk perceptions and behaviours in the context of water and health, published between 2000 and 2021. A total of 187 publications met the inclusion criteria. We extracted data relating to study characteristics and categorized our results according to the major themes emerging from the literature, namely drinking water, sanitation, hygiene and wasterelated topics, health risk factors, diseases and mental health implications, and preventative measures. Our review shows that the literature has grown over the past twenty years, reporting information from different countries belonging to different income groups around the globe, conducted in various settings and contexts, among different target populations, from various disciplinary angles, using different methods, theories and approaches. Our review provides evidence of health risk perceptions determining behaviour particularly related to drinking water sources and water safety. Evidence on disease prevention, health seeking, variations and changes in perception and behaviour over space, geography, socioeconomic differences and time, and the relevance of cultural context is provided. Our review shows that risk perception studies are vital for WASH governance in terms of policy, raising awareness, education and behaviour change. In order to make risk perception and behaviour studies even more relevant to effective public health planning and health messaging, future research needs to increasingly focus on early culturally sensitive interventions and changes in perceptions and behaviours over time.

Factors Related to Water Filter Use for Drinking Tap Water at Home and Its Association with Consuming Plain Water and Sugar-Sweetened Beverages among U.S. Adults

OBJECTIVE

To examine factors associated with water filter use (WFU) for drinking tap water at home and its association with consuming plain water and sugar-sweetened beverages (SSBs).

DESIGN

Quantitative, cross-sectional study.

SETTING

The 2018 SummerStyles survey data.

SUBJECTS

U.S. adults (≥18 years; N=4,042).

MEASURES

Outcomes were intake of plain water (tap/bottled water) and SSBs. Exposure was WFU (yes, no, not drinking tap water at home). Covariates included sociodemographics, weight status, Census regions, and home ownership status.

ANALYSIS

We used multivariable logistic regressions to estimate adjusted odds ratios (AOR) and 95% confidence interval (CI) for consuming tap water, bottled water, or total plain water >3 cups/day (vs. ≤3 cups) and SSBs ≥1 time/day (vs. <1 time) by WFU.

RESULTS

Overall, 36% of adults reported using a filter for drinking tap water at home; 14% did not drink tap water at home. Hispanics had significantly higher odds of using a water filter (AOR=1.50, 95%CI=1.14-1.98) vs. non-Hispanic White. Factors significantly associated with lower odds of WFU were lower education (AOR=0.69, 95%CI=0.55-0.86 for ≤high school; AOR=0.78, 95%CI=0.64-0.95 for some college, vs. college graduate), not being married (AOR=0.81, 95%CI=0.66-0.98, vs. married/domestic partnership) and lower household income (AOR=0.68, 95%CI=0.68-0.90 for <$35,000, vs. ≥$100,000). Using a water filter was associated with higher odds of drinking >3 cups/day of tap water (AOR=1.33, 95%CI=1.13-1.56) and lower odds of SSBs ≥1 time/day (AOR=0.76, 95%CI=0.62-0.92). Not drinking tap water at home was associated with higher odds of drinking >3 cups/day bottled water (AOR=3.46, 95%CI=2.70-4.44).

CONCLUSIONS

WFU was associated with higher tap water intake and lower SSB intake among U.S. adults. WFU was higher among Hispanics, but lower among those with lower education and income and not married adults. While WFU was associated with healthful beverage habits, additional considerations for WFU may include source water quality, oral health, cost, and proper use.

Isotopic composition and major ion concentrations of national and international bottled waters in Costa Rica

Global bottled water consumption has largely increased (14.35 billion gallons in 2020) [1], [2], [3], [4], [5] during the last decade since consumers are demanding healthier and safer forms of rehydration. Bottled water sources are normally labeled as mountainous and pristine mineral springs (fed by rainfall and snow/glacier melting processes), deep groundwater wells or industrial purified water. The advent of numerous international and national-based bottled water brands has simultaneously raised a worldwide awareness related to the water source and chemical content traceability [6]. Here, we present the first database of stable isotope compositions and reported chemical concentrations from imported and national-based bottled waters in Costa Rica. In total, 45 bottled waters produced in Costa Rica and 31 imported from USA, Europe, Oceania, and other countries of Central America were analyzed for δ18O, δ2H, and d-excess. Chemical compositions were obtained from available bottle labels. National-based bottle waters ranged from -2.47‰ to -10.65‰ in δ18O and from -10.4‰ to -78.0‰ in δ2H, while d-excess varied from +4.2‰ up to +17.0‰. International bottle waters ranged between -2.21‰ and -11.03‰ in δ18O and from -11.3‰ up to -76.0‰ in δ2H, while d-excess varied from +5.0‰ up to +19.1‰. In Costa Rica, only 19% of the brands reported chemical parameters such as Na+, K+, Ca+2, Mg+2, F-, Cl-, NO3 -, SO4 -2, CO3 -2, SiO2, dry residue, and pH; whereas 27% of the international products reported similar parameters. The absence of specific geographic coordinates or water source origin limited a spatial analysis to validate bottled water isotope compositions versus available isoscapes in Costa Rica [7]. This database highlights the potential and relevance of the use of water stable isotope compositions to improve the traceability of bottled water sources and the urgent need of more robust legislation in order to provide detailed information (i.e., water source, chemical composition, purification processes) to the final consumers.

Reusable Water Bottles: Release of Inorganic Elements, Phthalates, and Bisphenol A in a “Real Use” Simulation Experiment

Reusable water bottles are growing in popularity; thus, possible chemical release from the internal surface into water should be carefully considered to control related health risks. We experimentally evaluated the release into deionized water of 40 elements, six phthalates, and bisphenol-A for 20 different reusable bottles by simulating the use in real world scenario. The 20 bottles, identified as those most purchased in Italy, were made of various materials (stainless steel, aluminum, plastic, and silicone). The experiment was carried out for four consecutive weeks in duplicate for each type of bottle. Our results showed the release, to various extents, of inorganic elements from all 20 bottles, while the release of phthalates and bisphenol-A was never found. The elements most frequently released were Al, Sr, Mo, and Cr, while the highest concentrations were for Ca, K, Mg, and Na; the release of toxic elements (such as Pb, Cd, Ni, Sb) also occurred. The comparison of our results with regulatory limits on drinking water quality revealed no exceeding values except for Al. However, these releases represent a further intake, and the related risks cannot be neglected, especially for highly susceptible populations. Thus, it is essential to correctly inform consumers both with dedicated interventions and exhaustive labelling.

Evaluation of bottled water quality by determining nitrate concentration

The presence of nitrate in sources of drinking water is a matter of concern because of its potential risk for human health. In many countries like Argentina, an increasing proportion of the population chooses to consume bottled water, among other reasons, for lack of water access. The present study was conducted (a) to evaluate the quality of bottled waters by determining nitrate concentration, (b) to relate bottled water quality with water access, (c) to analyze public awareness about bottled water quality and consumption habits of the population in the urban area of Buenos Aires. Two locations were selected, Ciudad Autónoma de Buenos Aires (C.A.B.A.) and Malvinas Argentinas in Buenos Aires Province (PBA), with percentages of water access of 99.6% and 8.8%, respectively. Random samples from both locations (n = 100) were analyzed. A survey was conducted in order to inquire about perception of population on bottled water quality and their consumption habits. In C.A.B.A., no sample exceeded the 45 mg/L limit value in force in Argentina, while in Malvinas Argentinas, 34% of the brands analyzed showed values above it. The survey revealed that 71.7% of people consume bottled water. While people in C.A.B.A. do so mainly out of habit, safety is the priority in PBA.

Drinking Water in the United States: Implications of Water Safety, Access, and Consumption

Recent water quality crises in the United States, and recognition of the health importance of drinking water in lieu of sugar-sweetened beverages, have raised interest in water safety, access, and consumption. This review uses a socioecological lens to examine these topics across the life course. We review water intakes in the United States relative to requirements, including variation by age and race/ethnicity. We describe US regulations that seek to ensure that drinking water is safe to consume for most Americans and discuss strategies to reduce drinking water exposure to lead, a high-profile regulated drinking water contaminant. We discuss programs, policies, and environmental interventions that foster effective drinking water access, a concept that encompasses key elements needed to improve water intake. We conclude with recommendations for research, policies, regulations, and practices needed to ensure optimal water intake by all in the United States and elsewhere.

Toward a comprehensive explanatory model of reliance on alternatives to the tap: evidence from California's retail water stores

Building on a recent increase in scholarly attention to the problem of tap water mistrust and resulting negative health impacts, we examine the relationship between neighborhood reliance on tap water alternatives and a range of explanatory factors. We model retail water store locations as a proxy for reliance on tap water alternatives in urbanized neighborhoods across California. Our study is unique in its inclusion of variables representing both compliance with primary and secondary water quality standards by publicly regulated drinking water systems serving particular neighborhoods, other water system attributes and the socioeconomic characteristics of neighborhoods. The location of retail water stores in urbanized neighborhoods does not appear strongly related to observed measures of water quality. Secondary contamination shows a weak relationship to tap alternative reliance, and primary contamination was not correlated with higher levels of tap alternative reliance. On the other hand, our research suggests that other socioeconomic factors, particularly country of birth, are associated with the prevalence of more water stores. Increasing reliance on tap water likely requires measuring and addressing secondary contamination found in distributional systems and premise plumbing, and more aggressive public education campaigns.