Egyptians often joke about the quality of their tap water, foreigners are strongly advised not to try their luck by drinking it, and the media often speculates on the amount of bacteria lurking in it for the unaware consumers. But how grounded are these assumptions? And who is to be held responsible for the quality that many do not trust?
In an interview with Al-Masry Al-Youm a top-ranking official from the Cairo Water Authority reassuringly stated that any concerns over water quality do not concern them. “When water leaves our treatment plants, it is 100 percent clean.” This is because of meticulous laboratory analyses conducted every two hours alongside intense purification processes, reported to both the Ministry of Water and Irrigation and the Ministry of Health. Thus it would seem that the problem lies elsewhere. The official further stressed that “the problem is not in the treatment plants but rather in old and low-quality pipes that don’t comply with Egyptian and international standards, alongside poorly-maintained water tanks that emit dangerous elements into the water.”
Research conducted by Hanaa M. Salem served to show that residents of Heliopolis, Zaitoon, Matariya, Salam and Marg districts might end up experiencing severe health complications such as renal failure, liver cirrhosis, chronic anemia and gastrointestinal disorders due to high concentrations of lead, copper, nickel and molybdenum detected in the water.
Nevertheless, not everyone is alarmed. “Even if heavy metals do occur in Cairo’s water, they are all below the detection level and thus do not present any threat,” said Edward Smith, Professor of Environmental Engineering at the American University in Cairo, who carried out two long-term studies of Nasr City and Maadi’s tap water between 2005 and 2008. “The problem is more with high levels of chlorine and trihalomethanes (THMs, byproducts of chlorine) which occasionally exceed local and international standards, but when you have to choose between dangerous diseases resulting from inadequate water treatment and high levels of those chemicals that might lead to future health issues, you opt for the latter without the slightest of doubts,” he continued.
However, scientists have a great arsenal of studies proving that the hypothetical could in fact become real if levels of chlorine and THMs are not regulated. One hospital-based study in Italy, for example, linked elevated levels of THMs with lower mean birth weights among mothers over 30; research conducted by Kallen and Robert connected high levels of THMs with preterm delivery, and an ecological study in Finland claimed that the consumption of chlorinated water increased the risk of kidney and stomach cancers by 1.2-1.4 percent and 1.1-1.2 percent respectively. THMs were also associated with colon, rectal and brain cancers but the data were not sufficient enough to firmly confirm these links. Additionally, there have been many studies of THMs concerning bladder cancer in men.
Hussein Khaled, professor of medical oncology and former dean of Egypt's National Cancer Institute disagreed. “Bladder cancer in Egypt is mainly caused by either smoking or bilharziasis, not water. Of course, any chemical in the water may trigger the disease, but there should be a number of factors for the person to actually fall ill.”
Even more curious was the assumption that drinking chlorinated water is not as dangerous as showering, bathing or swimming in the same water. Studies suggest that showering for ten minutes in warm water treated with chlorine is equivalent to drinking 2.7 liters of such water per day. Swimming presents a bigger threat, as the amount of THMs absorbed during a one-hour swim will be 141 times higher than a ten minute shower and 93 times higher than water ingestion. Water temperature is also crucial. Showering at low temperatures (28-32 Celsius), the person will inhale approximately 0.5-0.6µ chloroform (a type of THM), while showering at high temperatures (38-41 Celsius) the amount of chloroform inhaled will reach about 7.0µ±2.0µ.
Based on this information, it can be concluded that the risk of bladder cancer is more likely through dermal or inhalation exposure rather than orally, as through the former mode of exposure THMs will be systematically distributed via the blood, whereas in the latter they will be most probably inactivated in the liver. However, since experiments showing the impacts of chlorinated water via the skin are yet to be conducted, there are still plenty of uncertainties connected with these conclusions.
Nevertheless, the World Health Organization seems to be optimistic about chlorinated water, stating that even though it might trigger asthma, dermatitis and bladder cancer, more thorough research is needed to draw a definite connections. So while these studies are carried out, we as consumers will need to remain cautious.