Drinking Water Quality

Sex and Gender-based Analysis of this topic

Definition
Drinking water quality refers to the physical, chemical and biological characteristics of water and is generally measured by reference to a set of drinking water standards. In Canada, drinking water quality standards are set out in the Guidelines for Canadian Drinking Water Quality as well as in provincial and territorial drinking water guidelines [1]. Most Canadians enjoy a high standard of drinking water quality, although problems remain [2,3,4].  According to the report of the Walkerton Inquiry “safe drinking water” is defined as water that has a level of risk so small that reasonable and informed individuals would feel they are safe drinking the water[5]. Thus, even “safe” drinking water carries some degree of human health risk, such as microbiological or chemical contamination. It has been estimated that approximately 90,000 illnesses and 90 deaths are caused each year by contaminated drinking water [6]. Due to widespread under-reporting, the true burden of waterborne illnesses is likely significantly higher [7-9].
 
 
Sex Issues
Data on the sex and gendered health effects from chronic low-level exposure to chemical contaminants in drinking water are limited. However, research shows that the susceptibility, absorption and toxicity of chemical contaminants such as cadmium, nickel, lead, mercury and arsenic differ significantly between women and men [10]. Studies have shown associations between chronic, low-level exposures to contaminants such as lead, arsenic, nitrates and disinfection by-products and adverse reproductive health outcomes [11,12]. One estimate found that drinking two litres of water a day might expose a pregnant woman to five contaminants of particular concern during her pregnancy [13]. The effects of endocrine disrupting compounds such as pharmaceuticals in drinking water are also likely to affect women and men differently [14-16].
 
 
Gender Issues
In Canada and elsewhere around the world, women’s work in the household and child-rearing is integrally linked with water [17]. Women cook most of the food, are largely responsible for bathing and washing their children, cleaning and washing within the household, and providing care for the elderly. Around the world, a lack of access to water and sanitation directly affects women’s health, education, employment, income and empowerment [18]. Within Aboriginal communities, women have long held a special role with water and traditionally carry primary responsibility for water [19]. Women are especially impacted by increases in water costs if water is privatized as women have lower incomes compared to men [20].
 
 
Diversity
Drinking water quality varies across Canada and depends largely on where one lives [21]. In 2008, 1,766 drinking water advisories were in effect across the country [22]. Poor drinking water quality is particularly an issue in rural and remote areas, including many First Nations communities. Approximately 100 First Nations communities are under drinking water advisories and close to 50 First Nations water systems are classified as high risk, meaning they cannot produce safe water [23]. In rural Canada, it is estimated that 20-40% of all rural wells have nitrate concentrations or coliform bacteria counts in excess of drinking water guidelines and pose threats to health [24].
 
Pregnant women, infants and children, immune-suppressed individuals and the elderly are most at risk from waterborne illnesses. Studies show that these populations are more likely to become sick and experience adverse outcomes following exposure to microbial pathogens [25].
 
 
Critique

Calculations for “safe” drinking water are generally based on the consumption of 1.5L of water/day by a 70kg adult. Thus, these calculations may not be relevant to individuals who do not meet this standard [26].   In addition, only a small fraction of the many chemicals released into the environment, and possibly present in drinking water, are routinely tested or included within current drinking water guidelines.  

Sex-and gender-based data on a range of issues related to drinking water quality are needed to fully assess the connections between drinking water quality and women’s health. This includes a national surveillance system on waterborne illnesses, sex disaggregated data on water usage trends within households, and improved exposure data to chemical contaminants in drinking water of concern to women’s health.


Picture - Credit: © P Marco Veltri / The PPC

 
 
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health determinants > drinking water quality