The quality of drinking water is paramount for public health. Despite important improvements in the last decades, access to safe drinking water is not universal. The World Health Organization estimates that almost 10% of the population in the world do not have access to improved drinking water sources. Among other diseases, waterborne infections cause diarrhea, which kills nearly one million people every year, mostly children under 5 years of age. On the other hand, chemical pollution is a concern in high-income countries and an increasing problem in low- and middle-income countries. Exposure to chemicals in drinking water may lead to a range of chronic non-communicable diseases (e.g., cancer, cardiovascular disease), adverse reproductive outcomes, and effects on children’s health (e.g., neurodevelopment), among other health effects. Although drinking water quality is regulated and monitored in many countries, increasing knowledge leads to the need for reviewing standards and guidelines on a nearly permanent basis, both for regulated and newly identified contaminants. Drinking water standards are mostly based on animal toxicity data, and more robust epidemiologic studies with accurate exposure assessment are needed. The current risk assessment paradigm dealing mostly with one-by-one chemicals dismisses the potential synergisms or interactions from exposures to mixtures of contaminants, particularly at the low-exposure range. Thus, evidence is needed on exposure and health effects of mixtures of contaminants in drinking water. Finally, water stress and water quality problems are expected to increase in the coming years due to climate change and increasing water demand by population growth, and new evidence is needed to design appropriate adaptation policies. This Special Issue of International Journal of Environmental Research and Public Health (IJERPH) focuses on the current state of knowledge on the links between drinking water quality and human health.

This comprehensive handbook provides an authoritative source of information on global water and health, suitable for interdisciplinary teaching for advanced undergraduate and postgraduate students. It covers both developing and developed country concerns. It is organized into sections covering: hazards (including disease, chemicals and other contaminants); exposure; interventions; intervention implementation; distal influences; policies and their implementation; investigative tools; and historic cases. It offers 71 analytical and engaging chapters, each representing a session of teaching or graduate seminar. Written by a team of expert authors from around the world, many of whom are actively teaching the subject, the book provides a thorough and balanced overview of current knowledge, issues and relevant debates, integrating information from the environmental, health and social sciences.

The purpose of this Special Issue, “Water Intake, Body Water Regulation, and Health”, is to present novel reviews and experimental data regarding hydration physiology and its implication in overall health. Water has previously been dubbed the forgotten nutrient due to humans’ and animals’ ability to subsist seemingly unchanged across a wide range of daily water intakes. However, with the introduction of stressors such as exercise, diseased states, and/or chronic high or low water intake, the homeostatic signals related to body water regulation can influence organ and whole-body health. This Special Issue will discuss water intake, the scientific rationale surrounding the U.S. and European water intake guidelines, homeostatic mechanisms, diseases related to dysfunction of water regulation, and differences in the volume and the vehicle in which the water is contained (i.e., plain water versus mixed beverages) on water intake during and following exercise. The aim is to continue discussion surrounding water, the previously forgotten nutrient, and highlight the importance of water in daily life.

As the human population grows-tripling in the past century while, simultaneously, quadrupling its demand for water-Earth's finite freshwater supplies are increasingly strained, and also increasingly contaminated by domestic, agricultural, and industrial wastes. Today, approximately one-third of the world's population lives in areas with scarce water resources. Nearly one billion people currently lack access to an adequate water supply, and more than twice as many lack access to basic sanitation services. It is projected that by 2025 water scarcity will affect nearly two-thirds of all people on the planet. Recognizing that water availability, water quality, and sanitation are fundamental issues underlying infectious disease emergence and spread, the Institute of Medicine held a two-day public workshop, summarized in this volume. Through invited presentations and discussions, participants explored global and local connections between water, sanitation, and health; the spectrum of water-related disease transmission processes as they inform intervention design; lessons learned from water-related disease outbreaks; vulnerabilities in water and sanitation infrastructure in both industrialized and developing countries; and opportunities to improve water and sanitation infrastructure so as to reduce the risk of water-related infectious disease.

This volume describes the methods used in the surveillance of drinking water quality in the light of the special problems of small-community supplies, particularly in developing countries, and outlines the strategies necessary to ensure that surveillance is effective.

Cyanobacterial toxins are among the hazardous substances most widely found in water. They occur naturally, but concentrations hazardous to human health are usually due to human activity. Therefore, to protect human health, managing lakes, reservoirs and rivers to prevent cyanobacterial blooms is critical. This second edition of Toxic Cyanobacteria in Water presents the current state of knowledge on the occurrence of cyanobacteria and cyanotoxins as well as their impacts on health through water-related exposure pathways, chiefly drinking-water and recreational activity. It provides scientific and technical background information to support hazard identification, assessment and prioritisation of the risks posed by cyanotoxins, and it outlines approaches for their management at each step of the water-use system. It sets out key practical considerations for developing management strategies, implementing efficient measures and designing monitoring programmes. This enables stakeholders to evaluate whether there is a health risk from toxic cyanobacteria and to mitigate it with appropriate measures. This book is intended for those working on toxic cyanobacteria with a specific focus on public health protection. It intends to empower professionals from different disciplines to communicate and cooperate for sustainable management of toxic cyanobacteria, including public health workers, ecologists, academics, and catchment and waterbody managers. Ingrid Chorus headed the department for Drinking-Water and Swimming-Pool Hygiene at the German Environment Agency. Martin Welker is a limnologist and microbiologist, currently with bioMérieux in Lyon, France.

Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate The Dietary Reference Intakes (DRIs) are quantitative estimates of nutrient intakes to be used for planning and assessing diets for healthy people. This new report, the sixth in a series of reports presenting dietary reference values for the intakes of nutrients by Americans and Canadians, establishes nutrient recommendations on water, potassium, and salt for health maintenance and the reduction of chronic disease risk. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate discusses in detail the role of water, potassium, salt, chloride, and sulfate in human physiology and health. The major findings in this book include the establishment of Adequate Intakes for total water (drinking water, beverages, and food), potassium, sodium, and chloride and the establishment of Tolerable Upper Intake levels for sodium and chloride. The book makes research recommendations for information needed to advance the understanding of human requirements for water and electrolytes, as well as adverse effects associated with the intake of excessive amounts of water, sodium, chloride, potassium, and sulfate. This book will be an invaluable reference for nutritionists, nutrition researchers, and food manufacturers.