Insecurities about water quality have led to a boom in sales of bottled water. But the health benefits of the phenomenon are probably minimal.

We were surprised to hear recently that sales of drinking water are now the fifth largest earner of overseas currency for Fiji. A little investigation suggested that that figure may well be correct, but threw up further surprises.

Much of Fiji has high rainfall, but water is in short supply in some areas. Villagers can easily dig shallow wells, and Aid agencies have dug deep wells for some villages. But deep water is often mineralised. We have stayed on islands were rain is the only supply of drinking water. As populations have grown, water extraction has allowed intrusion of salt water, and the well water is brackish. After weeks of washing in brackish water, a fresh shower is a great luxury. Tourist resorts build de-salination plants but that is not an option for villagers.

According to the Australian Financial Review, Aid money was used to develop a mountain spring as a source of export water. The main market is the USA where Fiji water is now the 6th highest-selling bottled water after advertising endorsements from Tiger Woods and Elle Macpherson. Good luck to the entrepreneurs, but I wonder if the contributors realised the destination of their charitable dollars.

Something is odd about a third world country exporting drinking water to the USA. Fifty years ago American travellers had one main grumble about Europe; the tap water was unsafe to drink. This implied that the tap water was drinkable back home where the only people refusing US tap water were right-wing conspiracy theorists who claimed that somebody (either the government or the commies) were adding chemicals to damage the mental health of citizens.

Bottled water was then almost entirely ‘mineral water’, either naturally carbonated water from a few famous springs or the much cheaper alternative invented by Schweppes. Scandals about contamination of some famous springs damaged the market, but some genius discovered that bottled drinking water did not need to be carbonated and any source of clean water would do.

Until that time the manufacturers of soft drinks were regarded as the epitome of value improvers; the addition of carbon dioxide and a few drops of syrup converted water at low cost to a marketable product. But the drinking water industry changed this perception. All the costs are in bottling and transport, the cost of the water in the bottle is as near zero as makes no difference.

The industry started in the USA but then took Europe by storm, 15 years ago British sales of bottled water had reached £216 million and London restaurants were charging £1 per glass. It took longer to reach Australia and NZ but the sight of all those tourists clutching their bottles had an effect.

Have a look in your local supermarket, there are a variety of brands and unless you buy it in very large containers it is more expensive than petrol. Marketing has been closely targeted, using magazines and radio stations rather than TV. The sales people know their main clientele, young, affluent travellers.

By a strange bit of timing the tap water in Europe had become safe to drink just before bottled water became popular. In fact one of the priorities of government has been the provision of safe tap water (it is even safe to drink on the main Fiji island), but as it became safe, tourists stopped drinking it.

So what is the motive? At least partly it is fashion, backpackers have been seen furtively refilling their bottles at the tap so later they can be seen with the right brand. But most clearly believe it is healthier to drink ‘natural spring water’. Some brands will tell you they are ‘fat free’! Ironically the quality standards on most tap water is probably higher than those on much bottled water. But backpackers are all aware of the high incidence of ‘traveller’s diarrhoea’, one estimate is 20 million cases per year world-wide, though it could be much higher.

Herbert DuPont is Chief of Internal Medicine at St Luke’s Episcopal Hospital Houston Texas and an expert in diseases of the alimentary tract. His opinion is that although “Most people think it (diarrhoea) is caused by the water”, it is not. “Bad food is responsible for 90% of traveller’s diarrhoea.”

Even in the USA, eating out is twice as dangerous as eating at home. Scientific American July 2000 contained some amazing statistics. A large percentage of outbreaks of food poisoning could not be traced to a particular source, however of those that could be so traced, the most dangerous foods were not those I would have suspected:

Food that caused a problem % of outbreaks
Salads 12.4
Fruit and vegetables 6.0
Beef 2.3
Chicken 2.1
Fish (including shellfish) 1.3
Milk and eggs 1.0
Pork 0.4

Vegetarians beware; the most dangerous items are those generally considered the most healthy! However going back to Professor DuPont, he warned that the really dangerous items were sauces and condiments, particularly if they were not properly refrigerated. I suspect (without any evidence) that this may be the case here.

It seems obvious that these percentages would be quite different in other countries, but if you cannot trust the salads in the USA, those bought from street vendors in Asia must be pretty dodgy.

In the past, epidemics of the great water-born diseases, typhoid and cholera, killed millions- and they were a threat to the traveller. But in countries were most of the bottled water is being drunk, this is no longer the case. The last major outbreak of cholera from a public water supply was in a South American country where activists had opposed chlorination. Chlorine of course is a chemical, and a poison, and they should not be putting it in our drinking water! I suspect that if travellers were questioned, many would give ‘chlorination’ as a reason for not drinking tap water. I just wonder, how safe is bottled water?

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