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OCR for page R1
Drinking
Water
and
Health
Volume 4
SAFE DRINKING WATER COMMITTEE
Board on Toxicology and
Environmental Health Hazards
Assembly of Life Sciences
National Research Council
NATIONAL ACADEMY PRESS
Washington, D.C. 1982
OCR for page R2
NOTICE: The project that is the subject of this report was approved by the Governing Board
of the National Research Council, whose members are drawn from the Councils of the Na-
tional Academy of Sciences, the National Academy of Engineering, and the Institute of
Medicine. The members of the Committee responsible for the report were chosen for their
competences and with regard for appropriate balance.
This report has been reviewed by a group other than the authors according to procedures
approved by a Report Review Committee consisting of members of the National Academy of
Sciences, the National Academy of Engineering, and the Institute of Medicine.
The National Research Council was established by the National Academy of Sciences in
1916 to associate the broad community of science and technology with the Academy's pur-
poses of furthering knowledge and of advising the federal government. The Council operates
in accordance with general policies determined by the Academy under the authority of its
congressional charter of 1863, which establishes the Academy as a private, nonprofit, self-
governing membership corporation. The Council has become the principal operating agency
of both the National Academy of Sciences and the National Academy of Engineering in the
conduct of their services to the government, the public, and the scientific and engineering
communities. It is administered jointly by both Academies and the Institute of Medicine.
The National Academy of Engineering and the Institute of Medicine were established in 1964
and 1970, respectively, under the charter of the National Academy of Sciences.
At the request of and funded by the U.S. Environmental Protection Agency, Contract No.
68-01-3169
Library of Congress Catalog Card Number 77-089284
International Standard Book Number 0-309-03198-2
Available from
NATIONAL ACADEMY PRESS
2101 Constitution Ave., N. W.
Washington, D.C. 20418
Printed in the United States of America
First Printing, April 1982
Second Printing, October 1985
Third Printing, December 1988
OCR for page R3
List of
Participants
SAFE DRINKING WATER COMMITTEE
JOHN DOULL, University of Kansas Medical Center, Kansas City, Kansas,
Chairman
JULIAN B. ANDELMAN, University of Pittsburgh, Pittsburgh, Pennsylvania
DONALD R. BALER, Oregon State University, Corvallis, Oregon
WILLIAM G. C~RACKLIS, Montana State University, Bozeman, Montana
RUSSELL F. CHRISTMAN, University of North Carolina, Chapel Hill, Nodh
Carolina
STEVEN D. COHEN, University of Connecticut, Storrs, Connecticut
RICHARD S. ENGELBRECHT, University of Illinois, Urbana, Illinois
A. WALLACE HAYES, Rohm & Haas Company, Spring House, Penn
Sylvania
NAMES M. HUGHES, Centers for Disease Control, Atlanta, Georgia
VINCENT P. OLIVIERI, The Johns Hopkins University, Baltimore,
Maryland
MALCOLM C. PIKE, University of Southern California Medical School, Los
Angeles, California
R. CRAIG SCHOOL, University of Nebraska Medical Center, Omaha.
Nebraska
JOSEPH C. SWEET, Utah State University, Logan, Utah
CAROL H. TATE, James M. Montgomery Consulting Engineers, Inc.,
Pasadena, California
...
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iV LIST OF PARTICIPANTS
National Research Council Staff
RILEY D. HOUSES, Project Director
ROBERT I. GOLDEN, Staff Officer
FRANCES M. PETER, Editor
BARBARA JAFFE, Information Specialist
EPA Project Officer
KRIS~N ANNA, Office of Water Supply, U.S. Environmental Protec-
tion Agency, Washington, D.C.
BOARD ON TOXICOLOGY AND ENVIRONMENTAL HEALTH
HAZARDS
RONALD W. ESTABROOK, University of Texas Medical School (South-
western), Dallas, Texas, Chairman
THEODORE CAIRNS, DuPont Chemical Co. (retired), Greenville, Delaware
VICTOR COHN, George Washington University Medical Center, Wash-
ington, D.C.
JOHN W. DRAKE, National Institute of Environmental Health Sciences, Re-
search Triangle Park, North Carolina
ALBERT M. EN, Bowdoin College, Brunswick, Maine
RICHARD ~L, McCormick & Company, Hunt Valley, Maryland
RONALD W. HART, National Center for Toxicological Research, Jefferson,
Arkansas
PHILIP LA~RIGAN, National Institute for Occupational Safety and
Health, Cincinnati, Ohio
MICHAEL LIEBER~N, Washington University School of Medicine, St.
Louis, Missouri
BRLAN MACMAHON, Harvard School of Public Health, Boston, Massachu-
setts
RICHARD MERRILL, University of Virginia, Charlottesville, Virginia
ROBERT A. NEAL, Chemical Industry Institute of Toxicology, Re-
search Triangle Park, North Carolina
I~ MSBET, Massachusetts Audubon Society, Lincoln, Massachusetts
CHARLES R. SCHUSTER, Hi., University of Chicago, Chicago, Illinois
GERALD WON, Massachusetts Institute of Technology, Cambridge,
Massachusetts
ROBERT G. TARDI", National Research Council, Washington, D.
Executive Director
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. . . The man they called Ed said the muddy Mississippi water was whole-
somer to drink than the clear water of the Ohio; he said if you let a pint of
this yeller Mississippi water settle, you would have about half to three-
quarters of an inch of mud in the bottom, according to the stage of the
river, and then it warn's no better than Ohio water what you wanted to
do was to keep it stirred up and when the river was low, keep mud on
hand to put in and thicken the water up the way it ought to be.
The Child of Calamity said that was so; he said there was nutritiousness
in the mud, and a man that drunk Mississippi water could grow corn in
his stomach if he wanted to. He says:
'You look at the graveyards; that tells a tale. Trees won't grow worth
hil~kc in ~ Cincinnati or~v~v~rt1 hilt in a Sent Louis graveyard they grow
upwards of eight hundred foot high. It's all on account of the water the
people drunk before they laid up. A Cincinnati corpse don't richen a soil
any.'
MARK TWAIN
Life on the Mississippi
v
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Preface
The Safe Drinking Water Act of 1974 (PL 93-523) authorized the U.S.
Environmental Protection Agency (EPA) to establish federal standards to
protect humans from harmful contaminants in drinking water and to es-
tablish a joint federal-state system for assuring compliance with these
standards and for protecting underground sources of drinking water. One
section of the law [1412(e)] and its amendments (42 USC Subpart 300f et
seq., 1977) mandated that the National Academy of Sciences conduct
studies on the health effects associated with contaminants found in drink-
ing water. It stipulated that these studies evaluate the available data for
use in developing primary drinking water regulations, identify areas of in-
sufficient knowledge, and make recommendations for future research.
Amendments to the act in 1977 called for revisions of the studies "reflec-
ting new information which has become available since the most recent
previous report [and which] shall be reported to the Congress each two
years thereafter."
The first study in this series was published in 1977 under the title of
Drinking Water and Health. That volume examines the health effects
associated with microbiological, radioactive, particulate, inorganic, and
organic chemical contaminants found in drinking water. Volumes 2 and 3
of Drinking Water and Health were published in 1980. Volume 2 com-
pares the efficacy and practicability of chlorination and 11 alternative
disinfection methods for inactivating microorganisms, identifies the by-
products likely to be formed by the use of each major method, and
evaluates the use of granular activated carbon for the reduction or
..
vll
OCR for page R8
Viii PREFACE
removal of organic and other contaminants from drinking water. Volume
3 reviews 12 epidemiological studies-concerning health effects associated
with drinking water containing trihalomethanes. It also summarizes the
current state of knowledge on the relationship between cardiovascular
disease and water hardness. It adds to the 1977 publication's information
on estimation of risk to human health by extrapolating data from ex-
perimental animals to humans and also evaluates six models for the
estimation of carcinogenic risk at low doses. Furthetn~ore, it evaluates the
acute and chronic health effects associated with the products of water
disinfection and other selected contaminants. One section examines the
contribution of selected inorganic elements in drinking water to the op-
timal nutrition of humans.
The current study (Volume 4) identifies chemical and biological con-
taminants associated with drinking water distribution systems and the
health implications of deficiencies in those systems. It also contains an
evaluation of information on the toxicity of selected inorganic and organic
contaminants. Some of them are reviewed for the first time in this report;
others were reviewed in earlier volumes of this series. For the latter,
discussions include only information that has become available since the
earlier reports.
A reevaluation of the most recent information on the relationship be-
tween water hardness and cardiovascular disease was postponed pending
publication of results from several important studies that were presented
in an EPA-sponsored symposium at the University of Massachusetts at
Amherst in 1979.
On behalf of the members of the present committee and all of the
members of the previous Safe Drinking Water Committees, I would like to
express our gratitude and appreciation for the special efforts of Dr. Riley
Housewright, who has sewed as the Project Officer for the safe drinking
water studies since their inception in 1975. We wish him the very best in
his new position as Executive Director of the American Society for
Microbiologr.
We also thank Dr. Robert Golden, who completed this project after Dr.
Housewright's departure, and Ms. Frances Peter, who served as Editor of
the present book. We recognize Ms. Virginia White, Edna Paulson, and
Barbara Jaffe, who assisted in the search of the scientific literature and
reference verification.
We also acknowledge the assistance of members of the EPA staff,
especially Drs. Krishan Khanna and Joseph Cotruvo.
JOHN DOULL, Chairman
Safe Drinking Water Committee
OCR for page R9
Contents
I EXE C UTIVE S UMMARY
II ELEMENTS OF PUBLIC WATER SUPPLIES
III CHEMICAL QUALITY OF WATER IN THE
DISTRIBUTION SYSTEM
IV BIOLOGICAL QUALITY OF WATER IN THE
DI STRIBUTION SYSTEM
V HEALTH IMPLICATIONS OF DISTRIBUTION SYSTEM
DEFICIENCIE S
VI TOXICITY OF SELECTED INORGANIC
CONTAMINANTS IN DRINKING WATER
VII TOXICITY OF SELECTED ORGANIC CONTAMINANTS
IN DRINKING WATER
IX
1
9
18
108
137
152
202
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OCR for page R11
DRINKING
WATER
AND
HEALTH
OCR for page R12
