December 2005
                                  Water Works
                                  Information for  Older Adults  and
                                  Family Caregivers
Older adults

are considered


vulnerable to



Persons living

with HIV and

those with


immune systems

are also at

greater risk.
           Water is essential to our lives.
           We use it for drinking, cook-
           ing, bathing, cleaning, and
           growing crops. Because
water is so integral to our daily activities, it
is important for consumers to know when
it is safe.
Water, if contaminated, can harm our
health especially that of older persons and
those with chronic conditions.  Persons liv-
ing with HIV and those with compromised
immune systems are also at greater risk.
Environmental contaminants can be
encountered in drinking water and during
recreational activities such as swimming.
Contact with water pollutants can also
occur when sewers overflow. You can  pro-
tect your health by learning how you can
reduce or eliminate exposure to contami-
nants in water.

Tap Water in the Home:

Although most drinking water is safe, inci-
dents of contamination can and do occur.
Pollutants that may be present in the water
include chemicals such as radon, and  lead,
bacteria and viruses. This section describes
some of the potential problems you can
find in your household tap water.

Bacteria and viruses are known as
microbes. They are present in  drink-
ing water but most are not harmful.
Occasionally drinking water may contain
disease-causing microbes in particular
those microbes that cause gastrointestinal
illness. Usually our bodies' protective  bar-
riers and immune systems prevent them
from causing disease. However, due to
the decline of the human immune system
with age and changes in the protective
barriers in the gastrointestinal functions,
older adults are particularly susceptible to
microbial illnesses. Gastrointestinal (Gl)
pathogens found in drinking water include
parasites, such as Cryptosporidium
and Giardia, bacteria such as E. coli,
Salmonella and Shigella, and viruses such
as Norwalk. About 211 million episodes of
Gl illnesses occur each year in the US1.

Long-term exposure to lead can cause
health problems in the nervous sys-
tem. Lead can  contribute to high blood
pressure, nerve disorders, memory and
concentration problems, and  muscle
and joint pain. Lead accumulates and is
stored in our bones. During menopause,
as bones start to break down, lead  may
be released  from the bone, resulting
in high blood lead levels. Even if your
household water is provided by a public
utility, lead may be present due to corro-
sion of household  plumbing systems or
the presence of lead service lines.

There is evidence that long-term exposure
to high levels of arsenic can cause cancer,
increase cardiovascular problems and
elevate diabetes rates. Arsenic contamina-
tion is either naturally occurring (part of
the local geology) or occurs as the result
of industrial or agricultural practices that
involve land  application of arsenic con-
taining chemicals. EPA has a standard for
public drinking water systems to ensure
that people are not exposed to high  levels
of arsenic. However, the standard does
not cover private wells, systems with fewer
than 15 "hook-ups" or serving 25 people. If
1 Mead PS, Slutsker L, Dietz V, McCaig LF, Bresee JS, Shapiro C, Griffin PM, Tauxe RV.
 Food-Related Illness and Death in the United States. Emerging Infectious Diseases, 1999; 5(5):607-625
                         EPA Drinking Water Hotline (800) 426-4791


Older adults can be at risk
for dehydration because as
people age the thirst sensa-
tion decreases and they do
not feel the urge to drink
as often as when they were
younger. They may also take
medications that increase the
risk of dehydration or have
physical conditions that make
it difficult to drink. Exposure to
microorganisms in water can
make people sick, and may
cause diarrhea increasing the
risk of dehydration.
Signs of dehydration include:

    Dry or sticky mouth

    Low or no urine out-
    put; concentrated urine
    appears dark yellow

    Lack of tear drops

    Sunken eyes

    Lethargic or comatose
    (with severe dehydration)

Because dehydration can be
life threatening, drink plenty

of water each day. If you have
decreased your tap water
intake because you do not
like the taste or are concerned
for its quality, you should treat
it or find an alternative source
of water until the problem is

your drinking water comes from a well
or a small system, you may want to test
it for arsenic.

Radon gas is the second leading cause
of lung cancer in the US. Nearly 1 in 15
homes is estimated to have high levels
of radon. Radon is especially danger-
ous because it is odorless and invisible.
Radon naturally occurs in rock, soil and
water. If your household water comes
from a well, radon can be released into
the air while showering. If your home
has high levels of radon, well water
may be  one of its sources.

How  Can I Avoid

Water-Related  Hazards?

The most important step is to be aware
of advisories issued by your local health
department or department of environ-
ment and abide by their advice. Learn
about your water and whether you
should test for certain contaminants.
    Learn About Your Drinking Water:
    If your water comes from a public
    water system, it must meet EPA
    standards. Counties are required to
    provide users with records of test-
    ing.  Check your water provider's
    annual water quality report, also
    called a consumer confidence
    report or call your water provider
    to find out whether you need to
    be concerned about certain types
    of pollution. If you live in an apart-
    ment building, ask the manager
    to post the consumer confidence
    report in a public location. If your
    water comes from a well, it is not
    subject to EPA standards. Your
    household should take special pre-
    cautions, such as annual testing, to
    ensure that your water is safe.

    Follow Public Notices on Drinking
    Water: Your water supplier is
    required to issue a notice by news-
    paper, radio, TV, mail or hand-deliv-
    ery if there is a waterborne disease
    emergency. The notice will describe
    any precautions you need to take,
    such as boiling your water or using
    bottled water. Follow the advice of
    your water supplier. Boiling water
    for one minute will normally kill
    micro-organisms but will not help
    with chemical contamination.
    Contact Your Water Supplier to
    See if You Should Test for Lead:
    You cannot see, smell, or taste lead.
    Call your local health department
    or water supplier to find out if you
    should test your water for lead.
    Do not boil your water. Boiling
    your water will not rid lead from
    your water and will actually make
    the  problem worse because the
    concentration  of lead will increase
    as the water evaporates. If you
    think your plumbing system might
    contain lead, use only cold water
    for drinking and cooking. Run cold
    water until it becomes as cold as it
    can get, especially if you have not
    used your water for a few hours.
    To find out more, call the National
    Lead Information Center at (800)
    Test for Radon in the Air of Your
    Home: There are many kinds of
    low-cost, "do-it-yourself radon test
    kits that you can purchase through
    the mail or at hardware stores. You
    can also have a qualified profes-
    sional conduct a test. If you have
    high levels of radon, it may be
    entering your home through the
    water or the soil. If your water
    comes from a public water sup-
    ply, contact your water supplier. If
    you have radon in your water from
    a private well, call EPA's Drinking
    Water Hotline at (800) 426-4791.

Water-Related Hazards

from Swimming

Older adults are encouraged to remain
physically active. Most beaches are safe
for swimming; however, beach water
may contain invisible disease-causing
microorganisms. Swimming in con-
taminated water may result in minor ill-
nesses, such as sore throats or diarrhea.
Older adults with weakened  immune
systems have a greater chance of get-
ting sick from contaminated water.
    Beach Closures: States, tribes,
    and local government health and
    environmental agencies mea-
    sure and identify microorganism
    levels at beaches to see if water
    meets EPA's standards for health.
    When microorganism levels are
    unsafe, agencies post warnings or
    close the beach. Levels are most
    likely to be high after storms.  It

    is important for older adults with
    health conditions to check and
    follow beach advisories, because
    they may be more susceptible to
    microbes than healthy adults.

Water Infiltration

Hazards in the Home,

Especially after Floods

Inadequate home maintenance is a
potential source of exposure to contam-
inants for older adults. If home repairs
are not carried out as needed, exces-
sive moisture or water may accumulate
indoors. This can result in mold growth,
particularly if the moisture problem
remains undiscovered. Mold can cause
allergic reactions in sensitive individu-
als, such as sneezing, runny nose, red
eyes, and skin rash (dermatitis) and, in
some extreme cases, breathing prob-
lems. Contact with water pollutants can
occur when there is sewage back-flow
into your home. Contact can occur
if your waste water drainage pipe is
blocked connecting you to the public
sewage system or a septic system due
to infiltration from tree roots. Sewage
backflow is  particularly common after
catastrophic rain events that lead to
    Inspect Your Home for Leaks:
    Establish a  regular program to
    inspect your home for water leak-
    age problems in bathrooms, the
    laundry and around windows and
    doors. Do not neglect the roof gut-
    ters and eves. Look for signs of

    Eliminate Water to Eliminate
    Mold: Mold needs water to grow.
    To prevent  mold, fix plumbing leaks
    and other water problems as soon
    as possible. Scrub mold off hard
    surfaces with detergent and water
    and dry completely. To  eliminate
    mold in your home, clean up the
    mold and eliminate the water
    source.  Some cleaning products are
    formulated to treat mold growth.
    After the Flood, Clean Damaged
    Area: Floods create health risks.
    Sewage and other materials can
    enter your home through flood
    water. Even when the flood water is
What Should  I Do If I
Can't Drink My Water?
During spills or temporary
treatment problems, you may
not be able to drink your water
for a short time. People with
special health needs or people
living in areas of known water
contamination may need to
consider alternative water
sources for the long term.
    Follow Public Notices on Drinking Water: Your water
    supplier is required to issue a notice by newspaper, radio,
    TV, mail or hand-delivery if there is a waterborne disease
    emergency. The notice will describe any precautions you
    need to take, such as boiling your water or using bottled
    water. Follow the advice of your water supplier. Boiling
    your water for one minute will normally kill microorgan-
    isms but will not help with chemical contamination.

    Drink Bottled Water: Some companies lease or sell
    water dispensers or bubblers and regularly deliver large
    bottles of water to homes and businesses. Bottled water
    can be expensive compared to water from a  public
    water system. Bottled water quality varies among brands,
    because of the variations in the source water used, costs,
    and company practices. Persons with compromised
    immune systems may want to read bottled water labels
    to make sure more stringent treatments have been used,
    such as reverse osmosis, distillation, UV radiation, or filtra-
    tion by an absolute 1  micron filter. For more information
    on whether your bottled water meets FDA standards,
    check with NSF International (
    sumer/bottled_water/ or call 877-8-NSF-HELP).

    Install a Home Treatment System: If you have a long-
    term water problem, home treatment may be necessary.
    Home treatment can include filters used at the tap or at
    the connection between the water main and the connec-
    tion to the house. If radon is a problem, home treatment
    may be a solution.

    clean, standing water and wet materials are a breed-
    ing ground for microorganisms. Remove standing
    water, dry out your home, and remove wet materi-
    als. Clean and disinfect the damaged area to reduce
    your risk of disease. Rugs, curtains, and furniture
    may need to  be replaced if sewage entered your
    After the Flood, Inspect Your Wells: If you have a
    private well, do not turn on the pump or use well
    water for drinking or washing. Talk to your state or
    local  health department to find out what precau-
    tions to take.

How Can I Protect My

Private Well Water?

Private drinking water supplies are not subject to EPA
standards. If your water comes from a well, it is not
automatically tested by experts to identify problems. You
must take special precautions to ensure the protection
and maintenance of your drinking water:

Identify Potential Problems
Identifying potential problems is the first step to safe-
guarding your drinking water. Start by consulting a local
expert such as your local health department, agricultural
extension agent, a  nearby public water system, or a
geologist at a local  university. Ask them about problems
that may affect the water quality of your well.

Test  Your Well Water Every Year
Test your well water every year for bacteria, nitrates, total
dissolved solids, and pH levels. If you suspect other con-
taminants, test for those as well. Many contaminants are
colorless and odorless, so you will not be able to tell if
you have a problem without a test.
More frequent water tests may be needed when:
    there are unexplained illnesses in the family
    your neighbors find a dangerous contaminant
    in their water
    you note a change in water taste, odor,
    color or clarity
    there is a spill of chemicals or fuels into
    or near your well
    you replace or repair any part of your well system

Prevent Problems
Keep fertilizers, pesticides, herbicides, fuels, and other
pollutants away from the well. Take care when working
or mowing grass around your well. Contact your local
public health department to find out how often you
should pump and inspect your septic system. Do not dis-
pose of hazardous materials in septic systems.

How Can I Learn  More?

EPA's Aging Initiative is working to protect older adults
from environmental health  risks through the coordina-
tion of research, prevention strategies, and public educa-
tion. For more information, visit

Additional Resources:

Water on Tap: What You Need to Know
Arsenic in Drinking Water
Consumer's Guide to Radon Protection
Emergency Disinfection of Drinking Water erg.htm I
Guidance for people with Severely Weakened Immune
Information for Private Well Owners
Mold Resources
Safe Drinking Water
                of Older Americans
                                                     Publication Number EPA-100-F-05-042