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THE FINANCIAL COSTS OF TOXICS IN THE
DRINKING WATER SUPPLY
In January of 2002 the American people found out that there was too much
arsenic in their drinking water. How were they informed? Was a scientific
report released? No. They were informed in what some claim was a
politically motivated action. In its final days and hours the Clinton
administration finalized a long-awaited regulation reducing the amount of
arsenic allowed in drinking water from 50 micrograms per liter the U.S.
standard since 1942 to 10 micrograms per liter that is the standard used
by the European Union and the World Health Organization.
In March 2002 Washington policy makers subjected the American people to
more politically motivated activity. The EPA, under the new leadership of
Bush's appointee, Christie Whitman, withdrew the pending new regulation.
Now the public was really confused. Was there too much arsenic in the
water or not? Why had EPA taken this new action? When asked about the
action Ms. Whitman explained, in what surely must have been an
embarrassing moment for her, that EPA didn’t have enough evidence to back
up the decision and the new regulation would cost too much to implement.
Well how much would it cost to comply?
In its original 2001 proposal the EPA said reducing the arsenic level to
10 ppb would affect about 4,100 water systems serving some 13 million
people. These systems would have to spend $180 million annually to
implement the standard.
And what would be the benefit? EPA claimed that the rule would prevent
from 20 to 30 deaths from lung and bladder cancer each year. But some
epidemiologists say the standard could save 10 times as many lives. So we
have a range of 20 to 300 deaths prevented.
So that is about 6 million dollars to save a life. Is that too much?
Let’s examine the compliance costs in more detail. For systems serving
fewer than 500 households EPA estimates that 3,000 of them (5.5%) of the
54,000 community water systems, and 1,100 (5.5%) of the 20,000
non-transients, non-community water systems would need to take measures to
meet the new standard. These households would see there water bill
increase between 200-300 dollars annually.
For community water systems serving fewer than 10,000 households the
increase in cost is expected to range between 38 and 300 dollars per
household. EPA estimates about 97% of these systems would be affected.
For community water systems that serve more than 10,000 households, annual
household costs for water are expected to increase from about 1 dollar to
32 dollars
When all these numbers are summed up what is the final figure? EPA
estimated the total national, annualized cost for the new regulation to
cost about $181 million per year.
But not so fast! The American Water Works Association has something to say
about these estimates. And what do you think they had to say?
Interestingly, they did support the reduced standard. But they estimated
that the new rule would cost $600 million annually. The AWWA also
estimated that an additional $5 billion in capital outlays would be
required.
In fairness to the EPA, the AWWA estimate includes costs of handling
arsenic-contaminated residuals and the AWWA estimates that more systems
would be affected by the new ruling than did the EPA.
The AWWA estimates that compliance with the rule could cost individual
households in New England as much as $2,000 per year.
So we have a cost to water companies of between 181 million to 600 million
dollars per year and a cost to consumer between 200 to 2000 dollars per
year. When one considers the assumptions used by both sides, these numbers
are not so different.
Because some might argue this is a great deal of money especially in
today’s economy it is fair to ask about the magnitude of the threat posed
by arsenic to the health of the American population.
Is arsenic toxic? If so, why? At what level and who might be at risk? And
how might arsenic get into the drinking water?
First, to make sure we all are talking about the same language, some
background information about waterborne diseases.
All substances, microbial or chemical, have the potential, and the key
word here is potential, to cause disease. Whether they do so depends on
several variables. How much you ingest, the dose, how often you ingest it,
the duration, how old and how healthy you are. Your age and your health
and your genetic background will determine the effectiveness of your
immune system and your detoxification system, two systems important for
you to remain healthy in the presence of a toxic substance.
One other definition: The EPA classifies waterborne diseases as either
acute or chronic meaning that some diseases happen quickly and some
slowly. This distinction is important because toxics produce different
types of disease. For example, microbes usually work quickly, in hours or
days producing fevers, gastrointestinal upset and diarrhea. But chemicals
act slowly; sometimes years of exposure are required to produce a disease.
So for arsenic we would expect correlations between arsenic levels and
diseases that are chronic – diseases like cancers, birth defects, and
neurological degeneration.
Why are these distinctions necessary? Because of the costs associated with
the disease. Acute diseases are usually self limiting or treated
inexpensively with antibiotics, and the patient may only be sick for a day
or two – so the cost to the economy would be limited.
But chronic diseases might keep a person sick for protracted periods of
time, sometimes a lifetime and the costs to our economy can be
considerable if we take into account lost wages and costs of expensive and
prolonged treatments. Of course it is almost impossible to calculate the
costs of birth defects both to the family and the society. Clearly, when
calculating the financial cost to a society of a toxic substance the type
of disease is important.
Therefore, arsenic, a chemical, must be ingested over a period of time and
in sufficient amounts to cause disease and when it does produce a disease,
arsenic produces chronic diseases.
But isn’t arsenic a naturally occurring chemical? Indeed it is. Arsenic is
found in foods as well as air and water. It is estimated that a typical
daily diet will contain about 10 to 15 micrograms of arsenic.
At toxic levels what will arsenic do? A recent study indicates that
arsenic disrupts the activity of glucocorticoids, compounds that have a
variety of functions including regulation blood sugar.
Interestingly, this same study suggested that arsenic at high levels
inhibits those mechanisms that normally suppress tumor production. This
finding led to the suggestion that instead of causing cancer arsenic
promotes the growth of tumors triggered by other carcinogens. And by the
way, arsenic-induced effects appeared at concentrations as low as 2
micrograms per liter. Keep in mind, the new EPA regulation calls for 10
micrograms per liter and the average person ingests 10-15 micrograms per
day. These numbers suggest we getting our minimal daily requirement.
Other epidemiological studies suggest an association between drinking
arsenic-tainted water and skin, lung, liver and bladder cancers. A 1999
report by the National Academy of Sciences estimated that daily ingestion
of water containing 50 micrograms of arsenic per liter would add about 1
percent to a person's lifetime risk of dying from cancer
Some studies also found that arsenic harms the central and peripheral
nervous systems… as well as heart and blood vessels. As I mentioned,
arsenic has been associated with birth defects and reproductive problems.
Conservative estimates based on all these data suggest that more than 34
million Americans drink tap water, supplied by systems containing average
levels of arsenic that pose unacceptable cancer risks.
Parts of the Northeast have arsenic concentrations that exceed 10 µg per
Liter and as I mentioned this is the World Health Organization's
provisional guideline for arsenic in drinking water.
However, a look at a USGS map of arsenic distribution in US shows only
moderate levels in Connecticut.
Turning now to how arsenic might get into our drinking water supply. In
addition to watershed run off, where else might arsenic come from:
manufacturing; mining; farming; faulty septic systems; solid waste
disposal; and precipitation from the air; as a by-product of trash
burning; and more recently, leeching from preserved wood. The pressure
treated wood used in building decks and children’s playground equipment,
this wood is preserved with salts of arsenic.
Each of these sources represents a separate industry, and because there
are several industries involved, any new regulations on arsenic in the
drinking water could have a negative and costly impact on these
industries, and the US economy. Clearly, these industries will have a
stake in these new regulations and because these regulations are likely to
have a negative impact on their bottom line. It is reasonable to expect
that these stakeholders would lobby against any new regulations.
So estimating the costs associated with reducing arsenic in the drinking
water supply are complex and include many more variables then just the
cost of removal of the arsenic from the drinking water. In addition,
because of the absence of adequate health data, medical costs may be
underestimated as well.
But, and this is a question, should the decision about what levels of
arsenic levels are acceptable in the drinking water be decided on the
basis of cost?
Or, the more general question what role should cost have, when making
public health policy?
Just think for a moment about the costs associated with removal of lead.
Yes, the costs are significant but what would be the cost to the health of
the public from failure to remove it. In making decisions about lead we
had the benefit of overwhelming amount of scientific evidence to support
the conclusion that lead was harmful. And it was this evidence that was
used to convince policy makers to spend the money to remove lead.
By comparison, we are just beginning to find out about arsenic and so at
this stage, while the scientific evidence is under review, we have to
decide if we should act now, or wait. This is a public health policy
decision for all of us and therefore important for us to consider.
Each year Connecticut’s Institute of Water Resources has a theme for its
seminar series. This year the theme is “Public Health and Connecticut’s
Water Resources”. So let me conclude with a few comments – observations
really – about public health in general and, specifically the impact of
the events of 9/11 on public health policy in the US.
For most of the 20th century and even until 9/11, the focus of public
health in the US and indeed, world wide, was on infectious diseases.
Recall what have been called the four great public health achievements of
the 20th century…Vaccination… Pasteurization… Chlorination…. and
Fluoridation…. The effects… of these measures on the health…. of the
American people…. and people worldwide…. goes beyond mortality and
morbidity numbers… These public health triumphs have improved our very
quality of life….. But these achievements have become so woven…. into the
fabric of our daily life….that the public doesn’t even notice….In fact
they have become so invisible…. that policy makers had taken public
health…. and the public health system in the US…. for granted.
All that changed on 9/11….. The tragic events of 9/11…. brought the
condition of our public health system…. to the attention of state and
federal policy makers. The word bioterriorism…. was in the headlines and…
daily news stories…. presented a number of possible scenarios…. When
anthrax was found in the mail system, one of these possible scenarios….
became a reality.
When it finally became clear to federal and state officials that toxic
agents could be distributed to the public… thru the air… it became obvious
to consider the potential vulnerability of our water supply.
Arsenic is not an agent of the bio-terrorist. But nevertheless…without
enlightened public health policy…. people die from it.
While the 181- to 600 million dollars it would cost to reduce arsenic in
the drinking water may appear significant…… and the improvement to public
health minimal – the 30 human lives that we are told would be save ….the
magnitudes of these numbers….. should not result in automatic dismissal….
of the proposal…. to reduce arsenic in the drinking water.
We as scientists and public health officials and yes, as citizens… have a
responsibility to pressure policy makers….. to continue to support a
program to improve the public health of the American people. And not just
on projects…. related to bioterriorism.
We have a responsibility to let every policy maker at the federal and
state level know that…here….in America….government has a responsibility to
advocate policies to improve the health of the American public…..
In America… the public health triumphs of the 20th century have played a
major role in enhancing the quality of life of all its citizens…..In
America – where the right to life, liberty the pursuit of happiness is
guaranteed to all… and not restricted to those who can pay for them ….In
America …an America that now wages war…. this America must not abandon
public health….
In 1953 President Eisenhower, a person familiar with war and its long-term
effects…. And… the President who warned us…. against the increasing power
of the military industrial complex…. had this to say:
Quote “Every gun that is made…. every warship launched….. every rocket
fired…. signifies, in that final sense, a theft from those who hunger….
and are not fed…. those who are cold and are not clothed….. The world in
arms is not spending its money alone…. It is spending the sweat of its
laborers…. the genius of its scientists… and the hopes of its children”
end quote.
We…scientists…. public health officials…water utility operators… have our
own battles and our own war. Every day we fight in a battle …. to protect
the health of the American people and…. While… from time to time…we may
loose some of the battles…. if we persevere …we will win this war.
Thank you.
As always, reader’s
comments are encouraged. Dr.
Rossomando’s email address is DrRossomando@WaterborneDiseases.org |
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