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Drinking water in the U.S. is generally considered to be safe for consumption. However, anyone with a compromised immune system, such as patients undergoing chemotherapy,  transplant recipients, or individuals diagnosed with HIV/AIDS, should consider taking precautions to prevent waterborne illnesses. Waterborne illnesses can be fatal.

Precautions include:

  • Boiling water  
  • Filtering water 
  • Drinking bottled water. 

If you purchase a filter for home use, look for one that says "reverse osmosis."

Airplane water should be avoided by people with a compromised immune system.

Reports are available on the quality of drinking water in different areas of the U.S. Commercial labs and home testing kits are available to test your water. For additional information, see: offsite link

For additional information, see:

Do I Really Need To Be Concerned About Drinking Water?

While the United States has one of the safest water supplies in the world, all sources of drinking water contain some naturally occurring contaminants. The quality of drinking water varies from place to place, depending on the condition of the source water from which it is drawn and the treatment it receives.

At low levels, many contaminants generally are not harmful in drinking water. However, for people with a weakened or compromised immune system, microbial contaminants such as Cryptosporidium, Giardia, and Microsporidium, can pose serious health risks.

While tap water that meets federal and state standards generally is safe to drink, threats to drinking water quality and quantity continue to exist. For example, a 1993 outbreak of Cryptosporidiosis occurred in Milwaukee, Wisconsin. It was attributed to high levels of Cryptosporidium in the water supply despite filtration and disinfection. More than 400,000 people were affected. More than 4,000 people were hospitalized and as many as 100 died.

If you are uncertain as to whether you should be taking any special precautions ask your health care provider, and/or consider contacting your local health department and water utility to see if there are any special considerations that you should be taking.

How Can I Find Out About The Quality Of My Water?

To find out about water in any particular area in the U.S., consider the following alternatives:

The local utility

Most local water utilities have a web site which contains information about the water quality.

Environmental Protections Agency (EPA)

The EPA requires all drinking water suppliers to provide an annual quality statement. The reports are posted on line. You can locate your local area report at: offsite link.  Click on "local Drinking Water Quality."

Don't stop reading the report just because it says in the opening that the water is safe and meets federal and state requirements. That doesn't necessarily mean it's safe for a person with a compromised immune system. It may be a hassle, but read on (or ask one of your Team members to do it for you.)

Natural Resources Defense Council

The National Resources Defense Council prepares a What's On Tap report on water quality in 19 large cities. It is available at offsite link

Commercial Testing

You can have your water tested by a private laboratory, since levels of some contaminants, such as lead, can vary from residence to residence. This is particularly applicable to people who have their own well.

You can find companies that are certified by your state to test water for a variety of contaminants. List of certified testing companies are available as follows:

In Home Testing

In home kits are available on the internet and in stores. To find out if a particular filter removes the contaminant you are concerned about, contact NSF International, a nonprofit product certification organization: offsite link or call 800.673.6275.

According to a report in The Wall Street Journal, a drawback of home testing kits is that most home kits test for one contaminant at a time, which leave you to determine what to test for. Other traces may be missed.

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How To Make Drinking Water Safe

If you wish to take precautions to reduce the risk of a waterborne illness, including eliminating bacteria and viruses, consider boiling water, filtering water, and drinking bottled water.

The following guidelines apply to the most common problem in U.S. drinking water: cryptosporidium. For further information regarding Drinking Water Standards and Health Advisories, call the Environmental Protection Agency's Safe Drinking Water Hotline at 800.426.4791 or 703.285.1093.

Boil Water

The most effective way to ensure that drinking water is free of Cryptosporidium is to boil it. According to the Centers for Disease Control ("CDC") and the Environmental Protection Agency, heating water at a rolling boil for one minute kills Crypto. (At an altitude of 6,000 feet or above, it is necessary to boil water for longer than one minute.)

  • After the boiled water cools, put it in a clean bottle or pitcher with a lid and store it in the refrigerator.
  • Use the water for drinking, cooking, or making ice, as well as for brushing your teeth.
  • Be sure to wash any water bottles and ice trays with soap and water before use, and do not touch the inside of them after cleaning.

Filter Water

While not as effective as boiling water, a point-of -use (personal use, end-of-tap, or under-sink) filter is an alternative to consider if proper guidelines are followed.

Look for filters with reverse osmosis. Such filters remove bacteria, viruses and cryptosporidium. (If you have young children, keep in mind that reverse osmosis also removes flouride from water which can increase the risk for dental cavities in children.)

Following is a list of other types of filters with information from the Centers for Disease Control And Prevention (CDC): :

  • "Absolute 1 micron": On other filters look for the words "absolute 1 micron." The CDC indicates that some filters labeled "1 micron" and most "nominal 1 micron" filters will not work against Cryptosporidium.
  • "Standard 53" and "Cyst Removal": Filters labeled as certified by NSF International (National Sanitation Foundation) under "standard 53" for "Cyst Removal" are also considered effective against Cryptosporidium. Note that NSF tests filters for a number of things. A label with just an NSF trademark without saying it is certified under "standard 53" for "cyst removal" may not mean that the filter is effective against Cryptosporidium.
    • If you are uncertain about the effectiveness of a filter you are considering purchasing, contact NSF International at 800.673.8010 to receive a list of "Standard 53 Cyst Filters." Check the model number on the filter you are considering purchasing to make sure it is exactly the same as the number on the NSF list.
  • EPA approved: Some filters may be labeled "EPA approved", but the EPA does not approve or test filters.
  • EPA registered: Some filters may be labeled "EPA registered", but the EPA does not register filters for removal of Cryptosporidium.

Filters labeled with only the following words, may not  protect against Cryptosporidium:

  • Effective against giardia
  • Effective against parasites
  • Carbon filter
  • Water purifier
  • Activated carbon
  • Removes chlorine
  • Ultraviolet light
  • Pentiodide resins
  • Water softener

Keep in mind that poor filter maintenance can cause your filter to work improperly or in some cases may even worsen contamination. Follow the manufacturer's directions, including directions for replacing filter cartridges.

NOTE: In 2013, Consumer Reports listed ZeroWater ZP-010 as top rated. Cost is approximately $40. A years filter supply costs about $50. It's Best Buy water filter was Applica Clear 20 CSW100A at $21.


Tablets are available to purify water, and are useful for camping or emergencies. We have not seen reports on whether they eliminate crypto.

Bottled Water

The origin of the water, the types of microorganisms in the water, and the treatment of the water before it is bottled may vary considerably among bottled water companies and even among brands produced by the same company.

There have been no nationwide tests comparing bottled to tap water.

It is estimated that 25% - 40% of bottled water is actually bottled tap water. In one extreme case found in a study conducted by the National Resource Defense Council, "spring water" was actually water taken from an industrial parking lot next to a hazardous waste site.

Bottled water is regulated as a food by the U.S. Food and Drug Administration. It is also regulated by many states. However, according to the Campaign for Safe and Affordable Drinking Water, the FDA subjects water to less rigorous testing and purity standards than the EPA requires for your tap water. The FDA does not regulate bottled water that is packaged and sold only within a state.

To make sure that you know what you are buying, read the label:

  • Distilled water: The Centers for Disease Control and Prevention (CDC) indicates that any bottled water treated by distillation or reverse osmosis before bottling assures removal of Cryptosporidium.
  • Filtered water: Additionally, the CDC indicates that water passed through a commercial filter meeting the same criteria as that for a point-of-use filter (see above) before bottling will provide nearly the same level of removal as distillation or reverse osmosis.
  • Protected well and spring water: The CDC also indicates that bottled waters from protected well and protected spring sources are less likely to be contaminated by Cryptosporidium than bottled waters containing municipal drinking water derived from less protected sources such as rivers and lakes.

The International Bottled Water Association (IBWA) is a trade association representing all segments of the bottled water industry. As a condition of membership, all IBWA bottler members are required to submit to an unannounced annual plant inspection. For more information, go to offsite link or call 800.water.11

Safety Of Drinking Water On Airplanes and Ships

Airplanes: In tests reported in January 2005, one in six airliners had drinking water that failed to meet federal safety standards set by the U.S. Environmental Protection agency.

Although the agency’s guidelines suggest that testing be done quarterly, or at least that the water systems be flushed and disinfected quarterly. A published report in 2004 indicated that it wasn’t clear how often either has been happening.

Ships: The Vessel Sanitation Program of the CDC includes detailed guidelines about how water takes can be constructed, where ships can make freshwater from seater and how often the water has to be tested. The program conducts unannounced inspection of cruise ships twice a year. The results are available at offsite link

A Few Tips To Help Avoid Unsafe Water

  • Don't add ice cubes from tap water that was not boiled or filtered to safe water.
  • Don't swallow water while brushing your teeth or showering.
  • Take your own water on airplanes or drink bottled water or beverages.
  • Try not to swallow water from lakes, rivers and swimming pools.

To learn more, see: The Drinking Water Book: A Complete Guide To Safe Drinking Water, by  Colin Ingram, Ten Speed Press, Berkeley, CA