Clean water is one of the most fundamental requirements of human health. Whether it is used for drinking, cooking, washing or recreation, we all expect our water to be safe. If it is not, micro-organisms can cause health problems ranging from a mild stomach upset to a serious illness such as cryptosporidiosis, and chemicals can cause poisoning.

Local authority environmental health practitioners are involved in protecting water quality in their areas. As well as sampling the public water supply from time to time, they are responsible for identifying and checking private water supplies. Where quality standards fall below those required, EHPs work with the water providers to minimise risks to health.

However, having a safe water supply is no good if people cannot afford to pay for it. The CIEH was instrumental in ending the disconnection of domestic consumers in debt. As the real price of water has risen in recent years, the CIEH has lobbied government to recognise water poverty as a growing problem, and to develop policies to reduce the number of households affected. We have resisted the spread of metering due to its effects on affordability and access, calling instead for equity in charging methods. The CIEH has promoted action to reduce water need through such mechanisms as a new Water Saving Trust.

EHPs have some responsibilities for waste water too, both ‘grey’ water and sewage, with powers to deal with defective and insufficient drains, cesspits and small treatment plants.

▼ Regulation of water quality 

In England and Wales the main responsibility for ensuring our drinking water is clean and “wholesome” lies with the water companies which supply it. The standards they must meet are set out in the Water Supply (Water Quality) Regulations 2016

Part III of the Regulations prescribes standards of wholesomeness in respect of water that is supplied for cooking, drinking, food preparation, washing and other domestic purposes, and for commercial food production purposes. Permitted levels are set within the Regulations for chemicals such as lead, mercury and fluorine, as well as for microbiological contaminants such as E.coli and other coliform bacteria.

At a national level, the Environment Agency is the government body responsible for making sure that the quality of water resources does not deteriorate and that it is improved when necessary. The Drinking Water Inspectorate, part of the Department for Environment, Food and Rural Affairs, oversees the quality of public drinking water supplies. 

At a local level, local authorities are responsible under the Water Industry Act 1991 for keeping themselves informed about the wholesomeness and sufficiency of water supplies in their area. Where a local authority considers that the public water supply may become unwholesome or insufficient, it must inform the water supplier, which must then take appropriate action. 

Environmental health professionals play a key role in protecting local water quality. As well as sampling the public water supply from time to time, they are responsible for identifying and checking thousands of private water supplies, big and small, under The Private Water Supplies (England) Regulations 2016 in England and their equivalents in the other parts of the UK. Where problems with such supplies are discovered, EHPs work with those who provide them to ensure that the water is improved. If necessary, they can take legal action to achieve this.

Bathing waters

Local authorities are responsible for providing information on the quality of over 400 mainly coastal ‘designated bathing waters’ during the annual bathing season (15 May - 30 September). Based on the results of laboratory tests carried out by the Environment Agency, signs maintained by councils must provide a summary of the quality of the bathing waters, including factors that can affect the water like nearby sewage overflows or rivers, together with additional information about any 'abnormal situations' that affect bathing waters, for example a breakdown at a sewage pumping station or a slurry spill and, if the pollution could affect people swimming or paddling, how long it’s expected to persist. 

Based on sampling data taken over 4 years bathing waters are classified as either excellent, good, sufficient or poor. If a bathing water is classified as ‘poor’, a council has to display an 'advice against bathing' symbol. Councils must also display information on the causes of pollution and measures to clean it up. 

The quality of water in swimming pools is regulated under the Health & Safety at Work etc Act 1974. 

▼ Water poverty 

Because an adequate supply of water is so vital to human life and public health, the CIEH believes that every household should be enabled to receive all the wholesome water it reasonably needs.

While the concept of fuel poverty – defined as a household needing to spend more than 10% of its net income on fuel to achieve a satisfactory heating regime – is recognised by the UK government, there is no similar standard for water supplies.

Applying the same methodology, research conducted by the CIEH and the Centre for Utility Consumer Law in 2002 concluded that up to four million households in England and Wales – about one in six – could be spending an equivalent proportion or more, that is at least three times that of the population as a whole. Some – the poorest households in the region with the highest prices – were paying more than 10 times as much as a consequence of successive governments’ policies.

So far blocked by Ofwat, no ‘social tariffs’ have yet been introduced to assist consumers who may face difficulty in affording water. There is a firm view in the industry that help for poorer consumers should come from government, not from better-off consumers. The Water Industry (Charges) (Vulnerable Groups) Regulations 1999, intended to assist a small group of consumers, were revealed by the research to have been ineffective as a means of redressing the balance, with take-up being less than 1% of the numbers eligible.

The CIEH report, Water Poverty in England and Wales made the following recommendations:

  • The government should give consideration to setting 3% of net income as the level above which it is unreasonable to expect a household to meet water charges, acknowledge a higher expenditure to imply water poverty, and develop policies to reduce the numbers of households affected.
  • The water regulator Ofwat should investigate the extent to which water poverty is a factor contributing to water debt, require the companies to publish equivalent data to that provided in the energy industry and ensure that water bills do, in fact, reflect the principle of affordability.

Spurred in addition by the outcome of PR04 – the last quinquennial review of water charges by Ofwat which will see real water prices rise further in the period to 2010 – the government has since set up a review of water affordability, led by Defra. Though its work continues, its interim recommendations – involving better benefit and meter take-up by poorer consumers – were criticised as inadequate by commentators.

▼ European Union legislation 

The EU takes a keen interest in water quality. Achieving a high level of protection for Europe’s water is one of the key objectives of the European Commission’s Blueprint to Safeguard Europe’s Water Resources, published in November 2012.

There are four principal pieces of EU legislation on water:

  • The 1998 Drinking Water Directive which sets out water quality standards for a number of substances and upon which the UK’s Water Supply (Water Quality) Regulations 2000 are based
  • The 1991 Urban Waste Water Treatment Directive which deals with the treatment and discharge of sewage.
  • The 2006 Bathing Water Directive which sets out quality standards for areas of natural water used for bathing.
  • The 2001 Water Framework Directive which regulates the way Europe’s river basins are managed and sets out environmental objectives for water sources across the continent.

The Water Framework Directive requires member states to both prevent any deterioration in the quality of their water and to protect, enhance and restore water bodies, where necessary, so that they can be classified as being “of good status” by 2015. To help them do this, the Directive contains a set of indicators defining what constitutes high, good and moderate status for a range of elements.

It requires member states to prevent or limit the input of pollutants into groundwater and to prevent the deterioration of the status of all bodies of groundwater within their territories. Information on what the UK is doing to implement the Directive can be found at here.

In addition, the 2004 Environmental Liability Directive aims to prevent and remediate all serious damage to natural resources including any waters to which the Water Framework Directive applies.

▼ International water issues 

Lack of access to clean water in developing countries is one of the most pressing problems facing humanity as we enter the 21st century. It is estimated that each year more than one billion people have little choice but to resort to using potentially harmful sources of water. According to the World Health Organisation, four out of 10 people in the world do not have access to even a simple pit latrine and nearly two out of 10 have no source of safe drinking water. An estimated 3,900 children die every day as a result.

The United Nations has Millennium Development Goals to reduce by half the proportion of people without access to safe drinking water and basic sanitation by 2015 and designated 2008 the UN Year of Sanitation.

A number of environmental health practitioners from the UK have dedicated themselves to helping people in developing countries develop decent standards of public and environmental health. One organisation working to bring clean water to communities across the globe is Water for Kids.

It has set up successful projects in countries including Peru, the Gambia and Tanzania. The CIEH is an active sponsor of the charity. Another charity with similar aims is Water Aid.

International protocol on water and health

In 1999 the Third Ministerial Conference on Environment and Health in London adopted a Protocol on Water and Health.

The Protocol was added to the 1992 Convention on the Protection and Use of Transboundary Watercourses and International Lakes and came into force in August 2005, becoming legally binding for the ratifying countries.

As the first major international legal approach for the prevention, control and reduction of water-related diseases in Europe, the Protocol requires signatories to establish and maintain comprehensive national and / or local surveillance and early warning systems to prevent, and respond to, water-related diseases.

The signatories also agreed to promote international co-operation to establish joint or co-ordinated systems for: surveillance and early warning systems; contingency plans; and responses to outbreaks and incidents of water-related diseases and significant threats of such outbreaks.

By adopting the Protocol, the signatory countries agreed to take all appropriate measures to achieve:

  • Adequate supplies of wholesome drinking-water
  • Adequate sanitation of a standard that sufficiently protects human health and the environment
  • Effective protection of water resources used as sources of drinking-water, and their related water ecosystems, from pollution from other causes
  • Adequate safeguards for human health against water-related diseases
  • Effective systems for monitoring and responding to outbreaks or incidents of water-related diseases
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