A fundamental promise we must make to our people is that the food they eat and the water they drink are safe.”

President Bill Clinton, Safe Drinking Water Act Reauthorization, August 6, 1996

The identification of disease as a result of poor water quality is conducted through the science and tool of epidemiology. Epidemiology is the study of the incidence and prevalence of disease with some indication of potential causal factors. Epidemiology seeks to identify potential causal relationships for disease onset based on time and exposure to risk factors. The effects of poor water quality adversaly impact quality of life. Dysentery from microbials and impaired cognition from elemental contaminants can affect a child’s ability to learn.

In 1855, John Snow conducted what is considered to be the first recognized epidemiologic study. His work identified cases of cholera and their association to the Broad Street Pump, where other local pumps did not comparitively reveal associated disease. In this case the risk factors were cholera and the contaminated pump at Broad Street. Subsequently the pump was locked off, eliminating the ability for the contaminated water to be used for human consumption, and the cholera was controlled.

Water, air, soil and plant biota are common pathways for exposure to water quality risk factors. Risk factors associated with drinking water quality are usually related to the microbiology and chemistry of water that is consumed, and the effect of the exposure to either. As an example, for many people the basic understanding of microbiology and water quality is the onset of diarrhea after drinking water on a camping trip, or from a contaminated well, or a trip to a foreign country. While heavy metal elements such as arsenic, cadmuim, chromium and others are necessary at certain levels for good health, large amounts and/or chronic exposures may result in toxicity, which can be associated with reduced mental and central nervous system function, and blood and vital organ damage. Dose (amount or quantity) and time are crucial in understanding potential health effects from expsoure to man-made or naturally occuring water-quality risk factors. Also, exposure requires that there is contact between the body and the harmful agent.

Surveillance for waterborne disease is the responsibility of states, territories and local public health agencies, which voluntarily report to the Centers for Disease Control and Prevention (CDC).The New Mexico Tumor Registry serves as a population-based cancer registry for the State of New Mexico and provides cancer surveillance data that is used in epidemiologic research as well as cancer control activities. Protection of drinking water quality has been a priority in NM as recently as the 2002 State of Health in New Mexicoreport, whichlists access to good quality drinking water andincludes the issues of affordability and access.

In a 1996 article, Gerba et al,substantiates that all water contains impurities that occur naturally andas a result of human activity. Gerba provides that populations at greatest risk for morbidity or mortality due to waterborne disease are children, the elderly, pregnant women and the immuno-compromised, and that they are are at the greatest risk for serious illness and mortality from waterborne disease.

Issues such as climate change, infrastructure, land use, waterborne disease and surface water management are the leading strains on drinking water quality and availability in the United States in the 21st century.In 2002, Levin et. al identified that approximately $36 billion are spent annually for public drinking water.Levin cites that the 1996 amendments to the Safe Drinking Water Act (SDWA) require the US Environmental Protection Agency to routinely examine the infrastructure needs for public drinking water systems.Infrastructure includes water treatment capabilities, distributions systems and protection of watersheds and storage reservoirs.The SDWA defines a public water system as one that regularly services 25 people or has15 service connections, which establishes the requirements for regular monitoring, specifically for maximum contamination of biologicals for total fecal coliform.

In New Mexico there is not one single factor alone that influences water quality. Sound community practices and industrial monitoring provides comprehensive safeguards to our most valuable resource for our most vulnerable populations. Protection of water quality is protection of a child’s right to learn and mature healthily to old age.

Camilla Bustamante, Ph.D., MPH, is Dean of Community Workforce and CTE at Northern New Mexico College.