By Kelly A. Reynolds, MSPH, PhD

Bottled water sales have been on a mostly steady increase for over a decade. It is now the number-one beverage in the United States and has been for several years running. While there are several benefits to bottled water, there are also some risks. This month’s On Tap will look more closely at the pros and cons of one of America’s favorite drinks.

Bottled water background
Municipal drinking, or tap, water supplies are regulated by the US EPA, while bottled drinking water is regulated by the Food and Drug Administration (FDA). In addition to requiring producers to ensure the bottled water is from a protected water source, the FDA also monitors processing and packaging plants for quality-control practices and the sanitary conditions of facilities. There are many different types of bottled water products. FDA-approved labels include bottled water, drinking water, artesian water, mineral water, sparkling bottled water, spring water and purified water (including distilled, demineralized, deionized and reverse osmosis-treated). Waters may also have flavors or nutrients added.

According to the Beverage Marketing Corporation, Americans (on average) consume over 39 gallons (147 liters) of bottled water annually per capita.1 With sales surpassing soft drinks, bottled water has been a collective benefit for consumers seeking healthier, portable drinking options. Convenience is also a big plus among consumers. Single-serving sized bottled water has driven the measured growth in the beverage category, accounting for over 67 percent of the overall shares of bottled water sold.

Environmentalists have voiced concerns over the amount of waste produced from all those single-use plastic bottles of water. While pollution is an ongoing concern, bottled water manufacturers have made a concerted effort to reduce the amount of plastic in their packaging. According to data from the International Bottled Water Association (IBWA), the weight of half-liter plastic water bottles has been reduced by nearly 50 percent over time and consumers are increasingly contributing to frequent recycling.2

Historical bottled water outbreaks
What about the safety and quality of bottled water? Outbreaks of disease from bottled water exposures are not common, however, they do still occur. Based on surveillance summary data from the Centers for Disease Control and Prevention (CDC), from 1971-2014, at least 17 bottled water outbreaks were documented (Table 1).3 Not all waterborne hazards cause acute effects but rather may be more prone to long-term health outcomes, such as cancer, that would not be documented in outbreak surveillance measures.

It is important to read the bottled water label and understand the different types of source waters and associated treatments. One of my mentors and an icon in environmental microbiology, Dr. Charles Gerba, had an infamous line: “Every stream is a beaver’s latrine,” warning of the potential for microbial contamination in untreated drinking water sources. Although water that comes from protected wells and springs is less likely to be contaminated compared to surface or tap water sources, they are not typically subjected to additional treatments.
Bottled water that is labeled purified indicates additional treatment relative to spring water sources. Treatments designed to effectively remove parasitic organisms (such as Cryptosporidium) include reverse osmosis, distillation or one-micron absolute filtration methods that can remove waterborne parasites. Ozone and ultraviolet light also kill microorganisms in water when applied properly. These interventions are essential for the prevention of serious infections, especially in immunocompromised individuals.

Emergency response
Bottled water companies have provided lifelines to communities where municipal supplies (and even POU devices) have been compromised, especially in regions impacted by natural disasters and flooding. Following devastating impacts from hurricane Katrina in New Orleans, forest fires in California and lead contamination in Flint, MI, bottled water suppliers mobilized quickly to deliver water to areas where public supplies were impaired. In Flint, bottled water was provided to residents who could not reach the city’s free-water distribution centers. For many Flint residents, free bottled water was provided for nearly a year and a half, due to ongoing lead exposure potentials.In addition, standard preparedness protocols recommend that everyone have a two-week supply of water on hand in the event of an emergency. Bottled water can be stored for long periods of time to support basic needs should public supplies be compromised. The CDC recommends planning for a gallon of water per person per day.

Media mentions
Popular media has targeted the bottled water industry in recent years, along with the FDA, for alleged failure to enforce quality standards. In 1999, the Natural Resources Defense Council (NRDC) published a 133-page report on the wide range of bottled water product types and quality and the perception among consumers that bottled water is safer than tap water.4 A main focus of the NRDC report was the lack of FDA quality oversight on the rapidly growing product.

More recently, a Consumer Reports (CR) investigation found that the FDA cited bottled water companies at least 14 times over the last 10 years for violation of regulatory standards. In addition, FDA failed to issue product recalls or inform consumers of contamination events ranging from E. coli to arsenic.5 According to a CR survey, 40 percent of Americans believe bottled water is safer than tap water. Depending on the water source, treatments applied and the quality of the storage container, this may be true.

Regulatory compliance concerns have long plagued municipal water supplies, and on a much larger scale. Of the approximately 50,000 US EPA-regulated community water systems (CSWs), 40 percent violated at least one drinking water standard in 2018. That’s 20,000 facilities not meeting regulatory requirements. Seven percent (n=3,500) were non-compliant relative to health-based violations. In response, the agency formed the National Compliance Initiative (NCI) to reduce CSW noncompliance. NCI’s goal is to increase US EPA’s response capacity and reduce health-based standard violations by 25 percent by the end of the 2022 fiscal year.

Caveat emptor
Caveat emptor (Latin for “Let the buyer beware”) is a common disclaimer in the sale of consumer products where the seller may not transparently disclose all the information a buyer might need to make an informed purchase decision. In the case of drinking water, the sellers, whether they be from the bottled water industry or public municipalities, are primarily self-monitoring and self-reporting entities and discerning product quality is not an easy task.

Household POU water treatment is an equalizer to these uncertainties, regardless of the tap water source. POU devices let the buyer know exactly how their water is being treated, how those treatment works are being maintained and the performance efficacy of the methods. But what about the convenience and transportability of bottled water? Reusable, refillable, portable containers offer the same convenience as bottled water at a much lower cost and waste production. Just make sure to properly sanitize the bottles every day after using. Bottles may be sanitized in the dishwasher on the high heat and dry cycle or with a dilute bleach solution (one teaspoon of bleach per gallon of water).


  1. Beverage Marketing Corporation. Latest News | Consulting, Financial Services and Data for the Global Beverage Industry. Published 2017. Accessed August 13, 2020.
  2. IBWA. U.S. Consumption of Bottled Water Shows Continued Growth, Increasing 6.2 Percent in 2012; Sales up 6.7 Percent. Published 2013. Accessed August 13, 2020.
  3. CDC. Commercially Bottled Water. Published 2014. Accessed August 13, 2020.
  4. Olson ED, with the assistance JD, Poling D, Solomon JDG. BOTTLED WATER: PURE DRINK OR PURE HYPE? 1999. Accessed August 14, 2020.
  5. Felton R. The FDA Knew the Bottled Water Was Contaminated. Consumer Reports. Published 2019. Accessed August 14, 2020.

About the author
Dr. Kelly A. Reynolds is a University of Arizona Professor at the College of Public Health; Chair of Community, Environment and Policy; Program Director of Environmental Health Sciences and Director of Environment, Exposure Science and Risk Assessment Center (ESRAC). She holds a Master of Science Degree in public health (MSPH) from the University of South Florida and a doctorate in microbiology from the University of Arizona. Reynolds is WC&P’s Public Health Editor and a former member of the Technical Review Committee. She can be reached via email at [email protected]


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