Environmental Factors and Health 7 Drinking WaterIn Denmark approximately 99% of the drinking water supply is based on groundwater. A protected groundwater resource free of contaminants and attractive to drink is therefore essential to the general health of the entire population. The utilisation of groundwater is subject to a number of limitations, quantitative as well as qualitative. Quantitative limitations are those considerations that must be given to other water supplies, watercourses, wetlands etc. Qualitative limitations are induced in part by natural conditions such as salt water in coastal areas and mineralised water from certain geological strata. They are, however, also to a significant degree induced by the impact of pollution from the surface and extraction induced deterioration of water quality, e.g. from excessive extraction. Thus environmental factors of the water media cover naturally occurring elements, pathogenic agents and anthropogenic substances. The concentration levels in tapped water will determine the degree of exposure to humans. This chapter will focus on the protection of human health reflected in the regulations and administrative practices connected with drinking water. 7.1 Human exposure to environmental factors7.1.1 Environmental factorsThe primary factors of concern are summarised in table 7.1. Table 7.1
In addition, the Legionella bacteria, which are common in hot water systems, may grow in heated water and cause infection by inhalation of aerosols during showering. This may lead to Legionellosis or Pontiac fever. Especially complex and branched hot water systems may give high residence times and temperatures between 30 and 40 oC, which favours the growth of the bacteria. 7.1.2 Sources of pollutantsThe sources of environmental factors in groundwater in Denmark posing a potential exposure risk represent three sources:
The sources of environmental factors in drinking water (treated groundwater) posing a temporary exposure risk in addition to the above mentioned are:
Point source pollution
Of these point sources, old industrial sites and non-secure chemical waste dumps are generally considered to pose the greatest threat to groundwater quality. Contamination is often difficult to handle, not least because of the varying composition of the initial chemical products which, depending on the geochemical environment, follow a variety of paths of decomposition before entering the aquifers. Examples of major contaminants from the most widespread former industries are:
Within the group of organic micro-pollutants, chlorinated hydrocarbons, aromatic hydrocarbons and phenols have been found in 21, 14 and 8% respectively of 3,565 sampled water supply borings around the country (GEUS, 2000). As far as heavy metals are concerned, only nickel is found in any significant percentage: 4.3% of 7,940 water supply borings. The origin of nickel is naturally occurring. Nickel in sediments is not a result of industrial point source impact (see below). Diffuse source pollution Diffuse source pollution relates to the application in agriculture of fertilisers and pesticides to soil and crops and risk of contamination of the groundwater resource. Increased nitrate levels in groundwater in Denmark were recognised as a threat to water quality around 1980. As a result resources were invested in research to improve our understanding of the cause-effect relationships concerning nitrate contamination. This combined with an increasing media and political awareness of the problem as well as the incentive the EU nitrate directive provided, were some of the main instruments in paving the way for present day regulations. These notably include the county authorities' prioritisation of drinking water areas and associated legislative restrictions regarding land use. Drinking water areas are those areas where main infiltration to the drinking water reservoir takes place or are assessed as future infiltration areas (see section 7.4.1). Nitrate has been found above the guide level of 25 mg nitrate/l in 9% of water supply borings in Denmark and 3% above the maximum admissible concentration of 50 mg nitrate/l. Pesticide contamination of groundwater has become a major water quality issue during the 90s. The conjunctive development of better analytical instrumentation improving detection limits and increased sampling and analyses substantiated the threat pesticides posed and still pose to water quality. Partly as a result of this, the Danish EPA instigated the out-phasing and imposing of strong limitations on many of the pesticides detected in drinking water, a second updated pesticide action plan has been published (Pesticide Action Plan II, 2000) and the Danish Agricultural Advisor Centre has recently promoted "best practices for handling pesticides". Overall, the quantities of active compounds have been lowered as has the total spraying frequency. Intensive research in this field is on going with the aim of quantifying the threat of pesticides to water quality. Pesticides and degradation products have been found in 23% of 5,643 sampled water supply borings. The maximum admissible concentration of 0.1 m g/l was exceeded in 9% of the borings. In Denmark, the health impact of occupational exposure to pesticides has been documented. However, the impact on public health from pesticides and nitrate or other chemical pollutants in drinking water has not been investigated. Extraction induced contamination Extraction of groundwater may due to proximity of mineralised groundwater near to a freshwater resource cause influx of salts and contamination of the water resource. Lowering of the groundwater table around a well has in some cases caused contamination of the freshwater by Ni contaminated infiltration due to geochemical processes and leaching in near surface sediments. Bacterial and chemical contamination in the water supply network The dimension of pipes in the supply network combined with the speed of flow of water, are the primary controlling factors on the treated waters residence time in the pipes. Despite proper treatment at the waterworks even a very small bacterial content in the water might induce a water quality problem due to excessive residence time in the network, especially if cold and hot water pipes are placed close together. Long residence time may also imply release of chemical contaminants from the water pipes. Problems with contaminants originating from long residence times in water pipes in the individual houses may be minimised by letting the water run until cool before tapping for drinking purposes. Flow of wastewater into the water supply network Accidental spillage or flow of wastewater has in a few cases temporarily contaminated small town water supplies. The most serious example in Denmark concerned a major outbreak of gastroenteritis affecting about 1,600 people in a small Danish town in the winter of 1991. The outbreak was caused by a congested municipal sewer and by technical defects in a privately owned waterworks. In another case, in 1997, a small river flooded the area around the local water works and the river water containing some sewage had entered the clean water tank. Up to 900 persons may have been affected by gastroenteritis due to contamination. In water resource planning there is accordingly high awareness of the of risk of contamination of drinking water, and wastewater contamination of drinking water is very seldom in Danish water supply. In the period 1992-97 16 episodes with microbiological contamination of drinking water were been reported in Denmark. 23,000 persons have been exposed and approximately 6,400 cases of decease have been reported. Only in few episodes, the actual cause of contamination was identified. Probably even more cases have occurred without being reported. 7.1.3 Human exposureThe way of influence from substances injurious to health in drinking water is by direct exposure from contaminated drinking water contaminated with substances present in concentrations that pose a health risk. The various sources of contamination are outlined above. Apart from microbiological impact from wastewater contamination the only documented cases of impacts on human health directly related to drinking water concern a few cases of Ni-allergy, where the source could be traced back to anomalous Ni concentrations in drinking water (extraction induced contamination, see above). The regular monitoring of raw water and drinking water quality as an integrated and high priority issue in Danish water supply should be emphasised in this context as it enables rapid and focused response to deterioration in water quality. Thus, although there are finds of pesticides, organic micro pollutants etc. in water supply borings the persistent focus on water quality by local and regional authorities ensures that contaminated borings and well fields are temporarily or even completely shut down if there is suspicion of human health impacts. There a number of examples of aborted borings especially in and around urban areas. In some cases extraction of groundwater from borings and well fields is maintained for remediation purposes to stop spreading of polluted groundwater to other well fields. Figure 7.1 7.2 Level of protection7.2.1 Quality criteria/normsFor the guidance of public authorities, the Minister for the Environment and Energy has laid down provisions as to the quality of drinking water. These include both quality standards claimed by the EU directive on drinking water (98/83/EEC) as well as nationally derived quality criteria for other frequently identified substances. (See Appendix 4 containing a national draft list of drinking water standards according to dir. 98/83/EC and a national assessment of relevant drinking water quality criteria (not yet adopted). Methods and principles for conduct of health assessment and derivation of drinking water quality criteria are presented in appendix 1). Generally, the drinking water quality criteria and drinking water standards are set at a level, which is considered to reflect a high standard as consumption of the drinking water should be healthy for the population. Furthermore, the water should visually appear clean and be without any unwanted taste or odour. This applies for instance for pesticides (including biocides) following EU standards, which determine the limit value for the content of pesticides in drinking water to 0,1 mg per substance and 0,5 mg for the total of pesticides. With respect to soil contamination in relation to groundwater, the objective is to protect groundwater as a resource, irrespective of whether abstraction borings are located in the area or not. Risk assessment procedures are described in section 6.2.1. The assessment of groundwater quality criteria is based on quality standards and criteria for drinking water, as groundwater, after ordinary water treatment processes, must fulfil the requirements for drinking water quality. 7.3 Regulation and strategy7.3.1 Objectives and principlesGroundwater constitutes approximately 99% of the drinking water resource in Denmark and has always been regarded as a high quality water resource - also when measured on an international scale. However, from 1980 and onwards awareness grew among the authorities that the main drinking water resource in Denmark - groundwater - was under increasing threat of contamination from human activities related primarily to industry and agriculture. The objective of the regulation for groundwater protection is thus, to ensure that the drinking water resource is protected and remains protected from activities and impacts posing a threat to the quality of our main water resource. Cleaning of groundwater for drinking water purposes is very seldom used in Denmark. The present day regulation for the protection of the drinking water resource in Denmark is given by the Water Supply Act, The Soil Protection Act and the Environmental Protection Act and associated Statutory Orders from the Ministry of the Environment and Energy. In this context, the international protocol on water and health adopted in London in 1999 should be mentioned. According to the Protocol the water resources shall be protected by establishing targets and by development of national or local action plans in order to avoid negative effects from pollution and different forms of land-use. 7.3.2 Legislation on drinking water protectionThe Water Supply Act The original Water Supply Act from 1978 focused primarily on regulations related to licences to abstract ground water, duties of the license holder, agreements on real property etc. The revision to the Water Supply Act, passed by the Danish Parliament 26 June 1998, contains a major addition concerning mapping of the groundwater resource, vulnerability assessments and planning of groundwater protection. Section 3 of the revised The Water Supply Act (No. 479 of 1st July 1998) specifically focuses on the protection of groundwater resources and regulates water resource planning with the objective of ensuring:
A key element in the Act is the designation of drinking water areas in which main infiltration to the groundwater reservoir takes place, as mentioned previously and elaborated in section 7.4.1. Within such areas detailed mapping and investigation shall identify areas vulnerable to specific contaminants, e.g. nitrate. Areas identified shall be subject to an assessment comprising a detailed mapping of land use, pollution threats and the natural protection of the groundwater resource. The resulting action plan shall describe the need for action concerning possible restrictions in land use and other human activities. It is within the jurisdiction of the regional and municipal authorities to seek agreements with landowners based on the action plan for regulating agricultural practices, purchase of property etc. The act includes regulations for the compensation of landowners by the negotiating party for loss of income, sale of land or property. The negotiating party may be the county, municipality, local water supply or combination of these. Statutory order on Water Quality The need for establishing formal water quality criteria was reflected in a statutory order on water quality in 1980 in which maximum permissible concentrations for a number of constituents in water were stated. The order was revised and replaced by the statutory order no.515 of 29 August 1988 on "Water quality and supervision of waterworks". The values and limits in this order are in accordance with the EU-directive 80/778/EEC on water quality. Guidelines for Water quality and supervision of water supplies The Danish EPA has issued guidelines (no.3, 1990) for the municipal authorities monitoring of drinking water quality and supervision of water supplies as an amendment to Statutory order no.515 mentioned above. The background for the guidelines is that water supply from especially private borings supplying a single household and to a lesser degree private water works often produce water of poor quality. Reasons for this are in part deficient technical installations and the borings location relative to pollution sources. The objective of the guidelines is to strengthen the procedures for water quality by increasing the local authorities' options for detecting deterioration in water quality and addressing the problem at an early stage. It is also the objective to improve the supervision of the effectiveness of water treatment. Guidelines for water quality monitoring The Danish EPA has in 1997 issued supplementary guidelines (no. 2 1997) for the monitoring of drinking water quality with special emphasis on detailed analytical programmes for larger municipal water supplies producing more than 700,000 m3/year. The Planning Act The Planning Act no. 388 of 6 June 1991 includes the regulation on the environmental impact assessment of activities that may pose a pollution threat to various media including groundwater. The Planning Act has as one of its overall objectives to ensure a balanced development of the Danish society through concurrent planning on the national and regional level. Planning activities shall be undertaken with due consideration to valuable historic, cultural and natural values of the country and shall prevent pollution of air, soil and groundwater. The latest revision of the act passed in 1999 (no.551 of 28 June 1999) includes legislation in accordance with the revision of the EU directive 85/337/EEC from 3 March 1997 (97/11/EEC) concerning the environmental impact assessment of various activities on the environment. Planned new activities in drinking water areas covered by this legislation shall therefore be subject to an impact assessment of the activity pollution threat to the drinking water resource. The Soil Contamination Act The increasing awareness by authorities that landfills with various wastes presented a threat to groundwater quality led to a revision of the Chemical waste deposit Act of 1983 resulting in The Waste deposit Act of 1990, which in 2000 was replaced by the Soil Contamination Act, which has a much broader perspective. The primary objective of this legislation is to prevent, eliminate or reduce soil contamination to hinder harmful impact of soil contamination to groundwater, human health and the general environment. Reference is given to chapter 6 on the soil media. The Environmental Protection Act The Environmental Protection Act focuses in terms of groundwater protection on the responsibility of owners of industrial, agricultural activities as well as land- and property owners in general to ensure that their activities do not give rise to a pollution threat to groundwater. Owners shall comply with the regulations given in the law administered by the local, regional or national authorities.
Owners of such activities as included above shall comply with recommendations by authorities (local, regional or national) either in the planning of an activity or as a result of inspection from an on-going activity. The activity shall consequently meet the requirements of the Environmental Protection Act, Chapter 3 concerning protection of soil and groundwater. The section states that compounds, products and materials that may pollute the groundwater, soil and subsoil shall - unless permitted otherwise:
Statutory order on manure Statutory Order no. 877 from 10 December 1998 from the Ministry of the Environment provides specific limits for production and use of manure for fertilising crops on a farming unit. The limits relate directly to the type and number of livestock. The statutory order is in accordance with the Nitrate directive (91/676/EEC). 7.4 InstrumentsThis section describes the legal, administrative and economic instruments that exist within the Danish Environmental legislation for groundwater protection. 7.4.1 Regulatory instrumentsNorms For the guidance of public authorities the Minister for the Environment and Energy may lay down provisions as to the quality of drinking water. Quality standards for drinking water are in accordance with the EU-directive on drinking water quality. The directive provides the minimum requirements to drinking water quality (see Appendix 4) and national legislation may set more stringent standards for drinking water quality. Health based drinking water quality criteria for additional substances are derived on a national basis (Appendix 1). Only few specific groundwater quality criteria have been derived. Normally drinking water quality criteria are used in the assessment of groundwater, which must fulfil drinking water standards after ordinary water treatment. In Denmark, this comprises aeration and filtration. Guidelines have been issued by the Danish EPA for risk assessment of chemical substances in drinking water (DEPA, 1992). Furthermore, the Danish EPA has published health based drinking water quality criteria for several compounds and groups of compounds e.g. heavy metals, cyanides and phenols (DEPA, 1995). Appendix 1 provides a description of the methods and principles behind health assessment and derivation of drinking water quality criteria together with an overview of the present drinking water quality criteria. Monitoring Monitoring of the groundwater resource on a national scale was implemented following the approval by parliament of the Action Plan Aquatic Environment in 1987. The monitoring programme is based on wells located in 67 local areas evenly distributed across the country typically with 10 - 15 wells within each area. Furthermore, water analyses from agricultural water sheds and water supply wells are integrated in the monitoring programme. The wells are sampled on a yearly basis for analyses of standard water quality parameters (naturally occurring components and physical-chemical indicators such as pH, taste), bacteriological analyses, inorganic traces, organic micro pollutants and pesticides). The monitoring programme enables the Geological Survey of Denmark and Greenland to provide the authorities and public with an annual overview of the state of the drinking water resource and thus also the scientific base for political initiative if so required. Enforcement notices to the polluter Danish environmental legislation is based on the polluter pays principle. The liability for soil contamination can be considered as both a regulatory and an economic instrument. The Soil Contamination Act defines a set of rules on administrative orders to the polluter. An order on cleaning up pollution can be given by the municipal or county authority. The concrete order concerning the cleaning up of such pollution is given to the polluter, and this order can be given irrespective of how the pollution has happened. It is furthermore without importance whether the addressee of the order owns the polluted premises. If more than one polluter is involved in pollution, a compliance order must be given to all of them. The authority, which has conducted a cleaning up, may sue the responsible persons and businesses for the costs of remedying environmental contamination. For further detail, please refer to chapter 6. Restrictions on land use Within drinking water areas are designated as vulnerable to nitrate, the Minister for the Environment may impose restrictions on requests for increasing livestock that can increase the risk for contamination of groundwater and surface water. The Minister may also impose restrictions on the amount of manure that may be applied for agricultural use. Planning instruments The primary objective of the regulation is to prevent deterioration of the groundwater quality, and for this purpose planning instruments are of primary importance. Designation of drinking water areas The Danish counties have designated areas with special drinking water interests, which cover 35% of the country. Remaining areas have been designated as valuable water abstraction areas and areas with restricted water abstraction interests. The latter constitute a minor percentage of the designated areas and are largely located along some coastal areas and urban industrial centres. The designated areas play a key role in the prioritisation of contaminated sites for investigation and remediation. Figure 7.2 Point sources According to the Soil Contamination Act, the county council shall carry out mapping, possible through technical investigations, of contaminated areas in co-operation with the municipal council (see chapter 6). Diffuse sources Following the passing of the revised Water Supply Act in 1998 the counties initiated vulnerability mapping of the drinking water resource. This comprises both basic hydrogeological mapping and compound specific mapping initially with respect to nitrate but also pesticides in the near future. The objective of the hydrogeological mapping is to provide a technically solid framework in terms of understanding of infiltration, geology, groundwater flow etc. for the vulnerability mapping. Environmental agreements With the increasing focus on groundwater protection and reduction of diffuse source impact from nitrate especially at present, the counties and municipalities have the option to negotiate environmental agreements regarding land use and agricultural practices and offer economic compensation for loss of income. This is the recommended approach and clearly preferable to non-negotiable law enforcement and expropriation. 7.4.2 Economic instrumentsTaxes are used in two cases: Water Charges The revised Water Supply Act from 1998 enables counties - who are responsible for the assessment, protection and management of the drinking water resource - to finance these activities by putting a fee on water abstraction. Any water abstraction within a county is based on a permit by that county in which the maximum limit of groundwater extracted per year is stated. The charge is calculated per m3, based on the maximum permitted water extraction irrespective of weather the owner of the well or borings actually extracts groundwater up to this limit. For permits for water extraction for industry and agriculture, e.g. water for cooling or irrigation of crops, the fee is based on 1/3 of the maximum permitted water extraction / year. This charge is, in addition to the standard fee, paid by households and others in Denmark for water consumption, also paid per m3 water consumed. Pesticide taxes With the aim of reducing pesticide use in agriculture and public and private cleaning of roads and gardens, taxes have been put on pesticides. The revenue of these taxes is funding a research programme for the environmental and health effects of pesticides. The Water Fund For private water works with a yearly abstraction below 80.000 m3/year the National Water Fund enables these water works to apply for funding of vulnerability assessments within the catchment area of the water works as well as for other purposes. Some clean-ups can also be financed through the Water Fund with the double aim of protecting the scarce water resources by reducing the drinking water consumption and funding of remedial actions on contaminated borings and water abstraction zones. Programme for Development of Technology Soil and Groundwater Contamination In 1996, a programme for the development of clean-up and remediation technologies relating to soil and groundwater contamination was set up primarily to stimulate the public authorities to advocate innovative methods and replace standard excavation and replacement of contaminated soil (see further information in section 6.4.2. 7.5 ActorsWater supply in Denmark is decentralised and based on both public and private water supply. All water supply is covered by the Water Supply Act passed by the Parliament and administered by the state authorities. Management of the water resource and water supply is the responsibility of the counties and municipalities. The primary actors concerning regulation of groundwater contamination are listed in table 7.2. For general descriptions of the mentioned actors please refer to chapter 3. Table 7.2
7.6 EvaluationThe objective of the drinking water regulation in Denmark is that the drinking water supply shall be based on unpolluted groundwater - tasteful, clear and free of smell. The consumer shall be able to drink it without worries of contamination. Therefore the protection of the groundwater resource has a very high priority, and the quality criteria set for groundwater are generally the same (or even lower) as for drinking water, which is basically following the EU directive on drinking water. There are very good reasons for setting strict objectives for drinking water, as drinking water cannot easily be replaced by other choices of drink. We all need plenty of drinking water every day, for drinking and for cooking. Health impacts caused by consumption of drinking water in Denmark are rare and generally the objectives of the regulation are obtained. However, health impacts do occur and most often as a disease caused by microbial contamination in the water supply network. Health impacts from chemical components in drinking water are only observed in a very few cases as nickel allergy (nickel from pyrite rich sediments) or methemoglobinemia caused by nitrate. Furthermore, all contaminants in groundwater and drinking water are not known because the monitoring programmes only find those selected substances they are designed for. So other substances, that haven't yet been recognised as potential health factors, stay unattended. To our knowledge, no studies in Denmark have been made with respect to the evaluation of health effects from long-term exposure to low levels of contaminants in drinking water. Another important characteristic is the delay between the origin of pollution and the occurrence of contaminants in the groundwater, not to say in the drinking water. The delay can be tens of years. Many contaminants are most likely on their way towards the groundwater and cannot be stopped by new regulation. A large number of drinking water abstraction borings have been aborted because of groundwater contamination from either point sources or diffuse sources, and this picture must be expected to continue. Today's regulation will in most cases first show results in many years. One trend to observe in the regulation of drinking water is the increase in use of chemicals in society, chemicals of which we in many cases have limited knowledge. Some of these may end up in groundwater. Other trends are connected to the supply network in which new materials may be the source of chemical contaminants or microbial growth in drinking water. Water savings may give lower flow and hence longer residence time in water pipes, which increase concentrations of contaminants released from the materials of the supply network and may also increase the risk of microbial contamination. One of the great challenges of regulation is therefore to foresee future contamination problems. In the light of the limited knowledge of many chemicals including their health effects and future occurrence in groundwater, the use of the precautionary principle in the regulation is obvious. Prevention of new contamination from both point sources and diffuse sources is very important. Especially the use of fertilisers (nitrate) and pesticides are in focus to day and should be also in the future. Another challenge is to design the monitoring programmes to give the best possible protection of public health. Prevention of microbial contamination in the supply network by maintaining and developing strict standards for water supply networks must also be given priority as well as regulation of the materials used for the supply network. The need for new knowledge is obvious concerning several items:
7.7 ReferencesEU Legislation Directive 80/778/EEC (1980): "On the quality of water intended for human consumption". Directive 85/337/EEC (1985): "Effects of certain public and private projects on the environment - EIA". Directive 91/676/EEC (1991): "Concerning the protection of waters against pollution caused by nitrates from agricultural sources." Council Directive 97/11/EEC (1997): "Effects of certain public and private projects on environment (revision of Council Directive 85/337/EEC)". Council Directive 98/83/EEC (1998): "On the quality of water intended for human consumption (revision of Council Directive 80/778/EEC)". Danish Legislation The Water Supply Act : Act no. 299 of 8 June 1978. The Planning Act: Act no. 388 of 6 June 1991. The Soil Contamination Act: Act no. 370 of 2 June 1999 (replaces Act no. 420 of 13 June 1990). The Environmental Protection Act: Act no. 358 of 6tJune 1991. Statutory Order no. 515 of 29 August 1988 on Water Quality and Supervision of Waterworks. Statutory Order no. 877 of 10 December 1998 on Production and Use of Manure. DEPA (1990): "Guidelines for Monitoring of Drinking Water Quality and Supervision of Minor Water Supplies: Guideline from the DEPA no 3". DEPA (1992): "Guidelines for Risk Assessment of Chemical Compounds in Drinking Water" Guideline from the DEPA no 1. GEUS, 2000: "Groundwater monitoring. Geological Survey of Denmark and Greenland". Pesticide action plan II. The Ministry of the Environment and Energy, The Ministry of Foods, Agriculture and Fisheries, March 2000. DEPA (1997): "Monitoring of water quality at waterworks: Guidelines from the DEPA no.3". DEPA (1995): "Toxicological quality criteria for soil and drinking water. Project no. 12 on soil and groundwater".
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