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Feb. 9, 2024

Water & Health

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Health Chatter

Stan and Clarence chat with Dave Hokanson, Sandeep Burman, Alycia Overbo, and Chad Kolstad from the Minnesota Department of Health about water in relation to public health.

Listen along as the the MDH team shares their wealth of knowledge on water.

Join the conversation at healthchatterpodcast.com

Brought to you in support of Hue-MAN, who is Creating Healthy Communities through Innovative Partnerships.

More about their work can be found at http://huemanpartnership.org/

 

Research

  • Clean Water 101 
  • Quick facts 
        1. Clean water is vital to health, communities, and ecosystems 
        2. Clean Water Act (1972)  → establishes basic structure for regulating pollutants in waters within the United States and regulating quality standards for surface waters 
          1. Reorganized and expanded version of the 1948 Federal Water Pollution Control Act 
        3. More research is needed to continue understanding the relationship between human health and water/clean water/bottled water 
        4. Climate change will continue to impact water quality and quantity by increasing/decreasing precipitation and increasing the temperatures of lakes and other waterways 
          1. Public health issues related to water and climate change include mold, damage to crops/agriculture, surface water contamination, sewage overflows, waterborne disease outbreaks, runoff/sediment, mold, etc. 
  • Bottled water 
        1. Safety/standards of bottled water are regulated the FDA
        2. There is currently no standardized label required for bottled water
        3. Contaminated bottled water can be harmful to health 
          1. Outbreaks associated with bottled water are rare, but they do happen 
        4. Concerns about microplastics in plastic water bottles 
          1. A recent study found that bottled water sold in stores contain 10-100x more pieces of plastics than previously thought/estimated 
          2. Minuscule plastic particles can invade individual human cells and tissues in major organs potentially interrupting cellular processes 
          3. Chemicals from plastics can end up in the liver, kidney, or brain and even make their way to the placental boundary/end up in an unborn child 
  • Water in Minnesota 
        1. MN has over 6,600 public water systems 
          1. Combination of community (i.e. groundwater that provides water to people in their homes) and non-community systems (water systems that provide water to “transient” populations)
        2. St. Cloud and Pipestone received special recognition for their water infrastructure projects 
          1. EPA said the projects demonstrate the highest levels of innovation and excellence in capturing nutrients, generating renewable energy, and reducing nutrients and chloride in lakes, rivers, and streams 
        3. MDH’s role 
          1. MDH publishes annual reports on the status of drinking water in Minnesota 
          2. MDH also publishes Drinking Water by the Numbers, the 2019 Nitrate Report, and the 2016 Environmental Health Public Drinking Water Resampling Analysis
          3. MDH also provides water-related guidelines for schools, businesses, restaurants, consumers/general public, health care professionals, beaches/pools, etc. 
  • Drinking Water Protection
        1. Prevention 
        2. Treatment 
          1. Home water treatment (MDH)
        3. Monitoring 
  • Lead & Water 
  • Why is it a concern?
        1. Flint water crisis (2014) → drinking water source switched from Detroit’s system to the Flint river to save the city money; inadequate testing and treatment led to discolored, bad-smelling, low quality drinking water which led to rashes, itchy skin, hair loss, and lead poisoning in children 
        2. Led can get into tap water through service lines, pipes, and/or corrosion 
        3. Led is especially dangerous and harmful for children and pregnant women
          1. Damage to nervous system, learning disabilities, impaired hearing, etc. 
  • Reduce exposure/prevention 
        1. EPA determines what levels of contaminants (such as led) are safe to consume 
        2. CDC recommends that public health action be taken when led levels in a child’s blood exceed 3.5 micrograms per deciliter 
  • Solutions 
        1. Water treatment 
        2. Removal/replacement of lead service lines 
        3. Efforts in education 
        4. Health communication
  • Water & War 
      1. War over water as a resources
      2. Access to clean drinking water after conflict 
      3. Example → water being used as a weapon during the war in Israel 
  • Water and Health Equity 
    1. BIPOC communities have disproportionately lower access to clean/safe water
      1. Structural disparities related to quality issues, affordability, flooding, etc. 
    2. Certain rural and urban communities also face challenges related to clean and safe water 
    3. EPA’s Advancing Water Equity and Access for all Commitment to invest $500 million to assist communities in closing the water gap (Biden/Harris administration, 2023)
    4. Importance of communities being involved in the decision-making processes regarding their water sources, etc. 

Sources

Transcript

Hello everybody, welcome to Health Chatter. In today's show, it's actually kind of a special show when you really get down to it, it's about water and health. And if you really think about it, water one way or another affects all of us. So we'll get to all of our illustrious guests that we have quite a few of them for our show today in just a minute. We have a great crew that makes all Health Chatter broadcasts. successful, including Maddy Levine-Wolfe, Erin Collins, and Deondra Howard, who do our background research. All our research is available on our website. And for this show, you'll see all that as well. Our production manager is Matthew Campbell, and our marketing person and researcher is Sheridan Nygard. So thank you to all of you. Without your assistance, none of these shows would be successful. You're a great crew. And then, of course, there's my cohost for all the shows on Health Chatter, and that's Clarence Jones. It's been a pleasure working with you. Whoa, these shows. I think we're closing in on our 80th show here, 80, 81st show, something like that. And it's been really quite interesting. We've learned a lot, a lot. Then we also have Human Partnership, who's our sponsor for all of our shows. It's a great community health organization. Recommend that all of you check out their website at HUMAN partnership. That's H-U-E-M-A-N, partnership.org. Thanks so much. And you can also check out our website at heal With that, I'm gonna turn our great show coming up here over to my cohost. Clarence Jones, Clarence take it away. Hey, thanks Dan. And I want to thank everyone for listening to our show today. Great show. And I wanna start off with Dave Hocklinson because this is how we got connected to this whole process. I had seen Dave in a couple of community events and I just happened to see him in a bowling alley one day and we had a chance to sit down and talk. And it was there that I found out that he was involved with water. And we had this fascinating conversation about water and what's happening here in Minnesota. And so it's been over probably close to 10 years that we've been talking about having another conversation about water. And so today we are honored that Dave and his colleagues are here. I just wanna tell you Dave is the assistant manager of the drinking water protection section at MDH. We also have Anna Sleep. She is the lead in drinking water coordinator for the drinking water protection program at MDH. We have Sandy Berman. He is a current drinking water administrator for the state of Minnesota. We have Alicia Overbow. She's a supervisor of the communication and strategic initiative unit at MDH. We got some really special people here and we're gonna be talking about something that when I first started talking to Stan about this, I started talking about this issue around liquid gold because there's so many articles in the paper that is talking about water. And we're here in the land of 10,000 lakes, right? And it should be that we don't have any water problems, but I think it was a time for us to have a great conversation about this issue. So with that, Stan, I'm gonna turn it back over to you because I know that you have a lot of questions to answer or to ask to our colleagues here. who have public health backgrounds, you know, inevitably, one way or the other, there's always conversations around water. Everybody, doesn't matter where you are, around the world is linked with water one way or another. And when water is compromised, it really is a problem. So let's talk about water being compromised first. And one of the things that can compromise are drinking water. So either Anna or Sandeep, you wanna take that one? Thanks, we'll try that again. Now that I've unmuted myself successfully. But yes, drinking water is a fascinating utility because at the end of the day, it is a utility. Public water supplies are a utility. That is provided to us. It is really an intersection of two dimensions. You have the natural environment, which is the sources of our water. Ultimately, that's our lakes and rivers and streams and our underground waters. And you have all of the infrastructure that takes that raw water and it makes it portable and fit for human consumption. So how much effort you have to spend in making that raw water portable depends on the quality of that raw water, sometimes very little and sometimes a lot. But in terms of water getting compromised, you can see how these two dimensions come together. We have the natural environment and we have the built environment and these two have to function hand in hand. And if either of those is not the way this should be, so if the quality of the natural water isn't fit for human consumption, then there you have a problem there. And then sometimes you can have perfectly good raw water available, but your infrastructure isn't working the way it should be. And then you get compromised there too. So you can have the quality of the water be the problem. And sometimes it's just the quantity. And the quantity again is a It could be you have constraints in the quantity of the natural raw water available to you. You know, that's droughts and we see some very profound effects of climate change happening that is causing different concerns there. And then sometimes the infrastructure, the mechanical things that get the water to you, those may break down. So you can have both quantity and quality aspects introduced from the infrastructure as well. So it's kind of, if you look at it that way, it's like a two by two matrix and then you have quantity and quality and then you have the raw water and the finished water, which is the natural environment and the infrastructure. So you could have issues kind of on this grid, if you imagine this matrix kind of four quadrants and each of those could be compromised and constrained or you could have more than one of these areas. And then it... the effect starts to magnify itself. So, yeah, I'm not, and most public water systems are quite robust and there's lots of measures in place to prevent this from happening. But these are kind of these areas, you know, four areas, quantity, quality, and then natural and built. You know, the intersections of these is where you can have the compromise take place. So one quick thing, and then I'll let Clarence chime in here. You said it was interesting, you said for human consumption. Well, we also have animals too. Okay, so like, you know, from listening on, it's right behind me is my dog. So is water the safety of water for humans and for animals as well? Or is it, how is it distinguished, I guess? I think it's the same, you know, living creatures kind of biologically, we're really all the same. So, things that would impair the human body, probably not very good for animals, pets, livestock, really the same quality concerns I think exist. Yeah. Okay, Clarence. Yeah, I am excited about having you both on this program. And the reason for that is that You know, I know Stan started off talking about the toxicity of water and what's going on in the world. Can you give us kind of an overview of what's happening here in Minnesota as it relates to water, because I think that part of it is that, again, we are in a place where there is a lot of water. We see a lot of water around us. But every time we turn on the news, we hear about places like Flint, Michigan, and other kinds of places where there's some real issues. about other places in the world where they're having problems with water. I think that many people are interested in learning about what is good water and sometimes when the water comes out it's brown, those kinds of things. So let's talk about water. Let's talk about its vitalness and why is it important. I like what Stan said. Stan talked about the dogs. That's also part of public health as well. So just so you know that. Let's talk about water. What's the state of water in Minnesota? Well, I'm happy to, yeah, no. Yeah, I'm happy to report that people in Minnesota can generally feel really good about their state of water, especially their public water, right? We are lucky in this state that we have a lot of water, as you were saying, we're pretty water rich. And then generally speaking, the quality of those source waters is pretty good, right? We're predominantly, we predominantly are consumers of groundwater. So most of the public water supplies in the state, 80% of the, population of the state that drinks public water is getting their water from groundwater. And then the remaining 20% is coming from surface water. And our surface water sources are some pretty well-known sources, primarily the Mississippi River, Lake Superior, and then some kind of smaller lakes in the southern part of the state. Again, blessed with really good water quality inherently in those surface water bodies. And then our groundwaters are pretty high quality too. So in that regard, we are fairly well off both in terms of quantity and quality. Do have to be careful because the pressures continue to grow in terms of population growth and use of water for not just drinking, but for irrigation, agriculture in other ways, industry. So the demand on water keeps on growing because water is not just a public health. essential requirement for humans to live, but it's also critical for industry and commerce and recreation. And the same water that's used for all of those purposes. So we have to be careful about using the sheer demands on water. And then we have to keep watching out for threats, you know, both natural and man-made because again, you can have geologically we have minerals that are not good for us in large quantities. Things like arsenic and radium and even iron manganese at high levels could be a problem. And then there's all of the artifacts of our economy of today. Lots of agriculture, lots of industry. And again, environmental protection, pretty in a different place today than it probably was 50 years ago. So a lot of practices that were commonplace and... acceptable and even permitted, you know, 50 years ago, led to contamination of the waters. And so there's some of that legacy contamination that impacts water supply sometimes, and that has to be dealt with. Going forward, I think we, generally speaking, our environmental laws, our conservation laws are much more rigorous now, much more sophisticated. So we're probably not causing additional problems in terms of chemical pollution. but we do have a legacy of chemical pollution that has to be diligently monitored. But in spite of all of that, those things are all fairly well understood, fairly well documented. There aren't any kind of hidden dangers that we're gonna stumble into with one of our water supplies. So given this multi-pronged approach that exists of testing the waters, monitoring it, keeping an eye on things, I think public water supplies in Minnesota are some of the safest and most reliable in the country. And I think we have the numbers reflect that, you know, we save drinking water act as the underpinning of nationally. That's how public water supplies are monitored and you have to comply with that. We have one of the highest compliance rates in the country. You know, we're probably up there in that top five, 10% nationally off. how well we comply with the Safe Drinking Water Act. So a pretty great record to be proud of. I mean, we are a large state. We're sort of in the middle, as far as population and size goes. So in spite of that, we have a very good track record for how well our public water supplies rank nationally. So lots to be grateful for, but also lots to just be careful and continue to meet as well. Thank you, Anna. I want to ask you a question though. Even though Sandy's talked about how great the water supply is here, a lot of folks are drinking bottled water. A lot of people are not, you know, so I know in your position, drinking water, what's going on with the bottled water? Because I think that's also a concern for a lot of people, even though, you know, you say that we have safe water. A lot of people are drinking bottled water. I've got three brands in my office right now. What's up with that? What's, why are we so concerned about water? Um, you know, everyone's concerned about not just water, their health. It's more than just, um, the water quality that comes from the tap. Some people like bottled water for taste. Some people like that crystal clear color. And if their water has certain minerals in it, it might not have that crystal clear color, um, but the standards for bottled water and, uh, public drinking water are are very similar. And in general, the qualities are comparable between bottled water and water provided by public systems. Public water systems test the water for over 100 contaminants to make sure it's safe. So it's really up to a customer's choice on what they prefer to drink. A lot of people have a favorite taste of water. They have their favorite brand of bottled water. And even if you talk to... someone who's used to well water. Some people like that kind of hard water mineral taste. Some people are, you know, they love the city water that's been softened and has some of that extra treatment that takes out some of those minerals. So there's also a customer choice there too, that may impact why people choose bottled water or tap water or a mix of both. So let me, I'm gonna go back a little historically here. For those of us in public health, where we remember John Snow, okay? And a cholera epidemic that happened in London, England. And they found that it was a contaminated basically water that was coming out of a pump, the Broad Street pump in England. So let's talk about disease. and water. And also, I'll add one thing on this. You know, when we've all gone through COVID, and actually we're still dealing with it. But, you know, lately, the last, what, year, maybe two years, we've been seeing reports of COVID showing up in water sampling in order for us to determine Can either one of you talk about disease and water? Yeah, thanks, Dan. So when it comes to waterborne disease, you know, infectious disease that can spread through your public water supply, the biggest concern really is bacteria and coliform bacteria that's associated with, you know, fecal matter. And what's the source of that? That's your sanitary system, right? Your wastewater system. And oftentimes, these are just the way our infrastructure is built. You know, there's only so much room to put all of your underground utilities. our sanitary sewer lines and our drinking water lines sometimes are in close proximity. But the big safety measure there is the fact that drinking water is pressurized and that keeps anything from getting into it. Now, occasionally you have incidents where you lose pressure, you have waterman breaks or mechanical failures. So that's where you worry about the wastewater side of things or even just... shallow groundwater that may have maybe tainted with microorganisms getting into your water supply. And so there exists lots of procedures to detect those issues and that's when you get those boil water advisories and the non-drink advisories still the problem can be solved and system can be flushed and repaired and lots of sampling takes place to ensure that there are no bacteria showing up and then people can go back to using their water. So that's the big source of concern is just the bacteria from the outside environment getting into what's essentially closed and sanitized system, which is your public water supplies, the conveyance for that. There are pathogens that can live in drinking water systems. And again, there's a number of measures to counteract that. Properly maintained public water system where the water is moving is not stagnant, is flush properly. is not a conducive environment for opportunistic pathogens like Legionella, for instance, very specific conditions have to come together. And usually that's because of a poorly maintained system. So again, there's multiple ways through which you monitor that to make sure that those conditions never come to exist where you can have an opportunistic pathogen like Legionella take hold. So in a public water system and kind of. closed system that it is, you know, those are kind of the primary things you worry about. It's just bacteria, which is, you know, all pervasive and present everywhere and the opportunistic pathogens and there's just a host of safety mechanisms in place where those conditions that could be favorable are detected early and fixed. So again, the public water system is very adept at ensuring that. waterborne disease doesn't take hold and doesn't propagate through a polychloric system. So Anna, let me ask you this question. What do we really, really need to know about water and the supply? What do we really, really need to know? I mean, because everybody assumes water is just a, just like, oh, it was just water. But what do we really, really need to know about water and the supply? I would say a couple of things that we really, really need to know about water. and the water supply is how much work the people who run the water system do to make sure that it's safe for everyone. We've got those water operators out there keeping it safe and they work, you know, usually, especially in the small towns, those water operators are also keeping our wastewater safe and they're wearing multiple hats working for the city. So keeping that in mind, depending on the source of that water. They may have different types of treatment that they're monitoring and keeping track of, responding to those water main breaks or those incidents that Sandeep mentioned. And then they follow up with the Department of Health to make sure they're doing all the testing needed to make sure things are safe when they bring the system back online. And then I'd say the other really important thing is to think about what you can do in your own home to keep the water safe once it gets into your house. So that's making sure that you let the water run, especially if you have an older home where lead might be present, making sure it's not sitting stagnant in the pipes for a long period of time, and then reducing your risk by always drinking cold water. If you need hot water, heating it up on the stove or in the microwave, but using that cold water, and then keeping your building plumbing, the maintenance on that up to date. So usually there's little screens on the end of faucets. You can clean those. A lot of people don't know that they can clean those. Most of them just screw off and you can soak them in vinegar for five minutes, brush them off, rinse and put back on. And that can help reduce lead in your water, but it can also keep biofilm from building up and clouding up your water. So there's lots of things that you can do at home as well to keep your water safe. So I think those are the two big things for me, just how much work goes into it to make it clean for you and then things you can do at home to reduce your risk. Nothing's risk-free. So are there seasonal differences in the safety of water? For instance, do we, if it's really hot outside or if it's like the middle of summer and there are a lot of fertilizers that are being used, you know, on lawns. and in crops and everything. Are there seasonal variations in overall safety of water? So that's a great question. And some of that may depend on if you're a private well owner or if you get your water from a water system. So water system, so like municipal water is usually fairly constant throughout the year. The water system may have seasonal trends that they have to adapt for, but the water quality that you get as a consumer is pretty constant. If you're... A private well owner, depending on the state of your well, there may be seasonal variations in quantity and quality. And that's why we do recommend that private well owners test their water periodically to make sure it's safety is being maintained. Private well owners may also have softeners. Some private well owners may have iron filters or arsenic treatment. So just making sure if they do have some treatment maintaining it regularly. I wanna ask a question in this, and I want you to be totally honest with me, okay? This is health chatter, and so we don't do politically correct stuff, we just talk, all right? So what is the real future of water in Minnesota and the world? Because I think that there are some real challenges that we're going to be facing. So what is the real future of water in Minnesota and the world? I think the future in Minnesota is good. You know, we can be hopeful that it's going to be a stable future where both quantity and quality can be sustained. And that again goes back to what we're blessed with for natural resources and then the regulatory and, you know, administrative environment that exists, investments that have been made and will continue to be made on the infrastructure side. And the fact that in Minnesota, we recognize the value of water, by and large, it's something that cuts across party lines and any other kinds of differences. We may have other things. There's no one questions the value and importance of water to not just everyday life, but to industry and commerce. So it cuts across all of those things. So I think this is a state that does recognize the value of water, does recognize the importance to keep making those investments. And we have the national factors working in our favor so far in terms of our resources. And so that of course is something that'll have to be watched. As we know that things are changing in the environment and what does the long-term future hold that we have to adapt to climate then make sure we are conserving and protecting the natural resources so we always have abundant sources. Globally, like you said, it is probably a lot more challenging. Again, we have... the impacts of climate change are going to be widely felt and they're going to vary. And I think if you look at some of the global statistics, big chunk of this planet, a lot of countries are in a water-stressed environment and that's not likely to improve on its own. So they are going to have to be very careful about managing and conserving water. And again, I think water is... as you said, it's liquid gold. It is probably the constraining resource. And I think that is getting recognized more and more that water, the availability of water is going to be a driving factor in how nations and economies fare over time. So it is a very, very critical issue, something that everyone needs to pay a very close attention to. Minnesota, I think we can be optimistic. Globally, I think... A lot of attention will need to be paid to make sure that everybody on planet Earth has a safe and sustainable water future. It's not a guarantee, I think a lot of hard work. Yeah, and that gets into that whole issue around health equity because we know that, and we want to make sure that that's one of the things that we talk about was that it costs a lot of money to maintain these water systems. And you have people in places where they don't have the, the tax structure or they don't have the infrastructure to make that happen. So what's gonna happen? I mean, again, I mentioned Flint, Michigan, I mentioned some other, there was a lot of different places that we talked about. How are we going to be able to, again, I know we're talking about Minnesota here, but there are other people in other parts of the world, how are we gonna be able to, and what should be our focus in terms of making sure that we maintain good, healthy water? What are your thoughts? It's a, I think that's a really, really important issue and that is getting the attention it deserves in Minnesota. Is that happening everywhere else? That's really hard to know without knowing kind of in details of how those states or those cities may be managing some of the health equity issues. But this is an issue that in Minnesota has been front and center for a long time. And it really comes down to does everybody have access to the same quality of water at kind of the same rates, right? So that's a big focus here for us in Minnesota, Department of Health, working with our other sister agencies, working with the legislature to really try and level that playing field to assure that at least public water supply consumers across the state are really experiencing. level playing field in terms of what they're getting and how much they're having to pay for it. So we build in a lot of those factors into how systems are funded, how public funds are used, trying to maintain that balance. So that will remain a focus on the public water supply side of things. That's definitely sort of a fundamental part of the process now. It gets a lot more complicated when you look at what's happening on people that have private wells, you know, 20% of the state's population still gets their water from private water supplies. And there's probably big differences there because people are responsible for upkeep of their private water system entirely on their own. And I think that's the part where the state probably needs to pay some attention to and you need to cross those barriers off. You know, those are... private properties and its private infrastructure, what is the government's role in that? So I think those are discussions that are taking place. There are some fundamental things there that have to be figured out. But if you look at the fact that drinking water, the fundamental right to everyone's entitled to, whether they're drinking from private supplies or public supplies, then I think the private side of the matter probably needs a lot more discussion, a lot more attention to be paid for it to. to give those people the same kind of protection and facilities that public water supplies enjoy today. Well, you know, interesting enough, the question that I have, and I'm a community member, so the question that I have is really about the land and the water. I think, Anna, you were alluding to that. You were talking about the pipes and flushing out the things and like that. Can you talk, Anna, could you talk about the way in which the state is taking a look at lead. I mean, I know you can't do everything, but it is an issue and it's causing problems with pregnancies, with brain development, those kinds of things. So what do we do? Yeah, so there's no safe level of lead and that includes drinking water too. Lead in paint and lead dust is still the biggest exposure route Minnesotans have to lead. So that comes from those older homes that may still have lead paint in them. But lead from drinking water is still a concern in Minnesota. We've just been working to put $240 million that's being invested into getting lead out of drinking water, trying to get those lead service lines out and to make sure that that's done in an equitable way so that people who are exposed to lead from those service lines. it gets out as quickly as possible. We're kind of having a goal to get that out within 10 years, which we're seeing also reflected in the lead and copper rule improvements, which is a nationwide effort that's also been proposed to try and get lead out nationwide in 10 years from those service lines. Here in Minnesota, we also work with schools and childcare so that they can test for lead. We run a lead testing program for them using the water infrastructure improvements for the nation's funding. But there's grants going out to schools and child cares to get lead out when they found it, to make sure that when it's found, they're able to actually address it and not just go, we found it, what do we do? So we wanna make sure that they can do something about it as well. So we're working pretty hard on lead in drinking water in Minnesota. So let me ask you, so there are certain things that are not good in water like lead, but then again, there are certain things that are good in water and sometimes what we add to the water, like fluoride in water, fluoridation. And we see some political ramifications behind that. There are some communities that are against fluoridation of water, et cetera, et cetera. So can you guys comment a little bit fluoride in water. Yes, Dan, again, that's one of the prevailing issues of our time is the debate about adding fluoride to water. So there's unquestionably data that has shown that the addition of those small quantities of fluoride has had a huge impact on dental health. But nonetheless, we also know that fluoride in higher quantities can go the other way, that it can cause you harm. So this aspect gets studied very... and scientists the world over in the US work very hard to make sure that the amount of fluoride that is the that's set in Minnesota, it's set in it's set in state statute and nationally CDC has guidance for how much fluoride needs to be added. And those numbers have been revised down downwards as you know now we get fluoride from other sources to this fluoride in toothpaste and fluoride in mouthwash. So with all of that, the amount of fluoride that gets added in municipal waters has been revised downwards to keep that total exposure to fluoride at a safe level. And certainly all the, this is a very, very highly researched topic. Lots of experts looking at this very closely the world over. So I think people can be confident that the small amount of fluoride being added into municipal water supplies is not going to push us over that area where we're getting too much fluoride. But nonetheless, this is a topic of great debate and people are certainly justified in having concerns are we getting too much fluoride because that is not healthy either. But again, all we can do is assure people that this is an issue that everyone's aware of. And again, our medical community, our scientific community, keep a very close eye on how much is being added to municipal supplies to make things, just keep things in balance. Yeah, you know, what also strikes me is what I would consider to be like border issues. Like how is it that we maintain the same kind of safety in our water that they do like in Wisconsin or in Iowa? I mean, you know, the difference between a border is a line. So how is it that we work with states across the border for safety of water. Yeah, the underpinnings again on public water supplies, you know, we everybody follows the Save Drinking Water Act. That's the federal requirement. All the states in the United States, barring perhaps one, have been delegated the authority by the federal government to administer the Save Drinking Water Act in the state. So we're all really, you know, using the same playbook. So that's so we can be assured that you travel across the border, you're the water in a public water supply really, you know, is following the same rules and regulations and the same kind of testing, the same, everybody has to meet the same quality criteria. So that's a pretty constant thing as you travel across the United States. So there's definitely some reassurance in that. And besides that, there is a lot of coordination and communication and sharing of information and cross-training and learning from each other. We do a lot of things collaboratively with our neighboring states. And we share some of our source waters. You know, we have the same aquifers, the same surface water bodies, the same rivers that flow across. So there's a lot of coordination on making sure that we are helping each other out and keeping those source waters safe. There's definitely coordination there. And again, I think state to state, you know, share the same values, share the same signs, share the same regulations. So it is not a, you know, patchwork. It is a pretty consistent body of regulation and practices across this country. So that's a very good thing that gives us that assurance that we're not going to be running into different sort of frameworks as we travel across the country. It is a very consistent situation. And I think that's reassuring. Let me ask a question there. This is kind of more of a personal question. What's that with you, Anna? How did you get involved in water? And then Sandy, how did you get involved in water? I mean, it seemed like... I'm always interested in that. What was that epiphany that says, hey, I like water? I mean, you know what I mean. So let's talk about that. Yep. So let's see. How did I get involved in water? So I would say I got involved in water kind of professionally. When I was in graduate school, I went to graduate school at the University of Maine in Orono. radiation in water. So I studied lots of different types of environmental radiation, but I actually studied radon in drinking water and radium, which is pretty common out in Maine. And so when I moved to Minnesota, I was teaching for a while, but my first job at the state of Minnesota was working on the radionuclides rule for drinking water, because Minnesota also has some aquifers where there's naturally occurring radioactive materials. So working with water systems who have to take that mineral out before it gets to consumers. So that's how I got interested in water and I've stayed in that field. Then now I work mostly with getting lead out of drinking water. Sandeep, how about you? You and water, your relationship with water. So it goes back to, I grew up in India, country that has lots of water and also very little water depending on where you are in the country. And I trained to be an engineer and a geologist there. And I was fascinated with working on big projects, mining and tunneling and building book dams. That's how I started and realized that water was central to all of those things. You're either trying to control water, harness water, or do something with water. And got me thinking about the value of water itself fundamentally. So I got interested in water and I came to the United States for graduate studies and I wanted to really study water. And then I went from just studying how to find water, use water, to really protecting and conserving it. I went to work in the pollution control industry, cleaning up big contamination. And again, contamination in water, especially drinking water with the most highest profile, highest importance projects. My graduate thesis had to do with water. I was part of the team that developed the Wellhead Protection Plan for the state in the early days of the plan. Then I kind of went away from drinking water per se but worked in areas that were related to drinking water. So then came to MDH four years earlier in this position. It was sort of coming back to my roots and coming back to drinking water. So I think a long association with water, different aspects of it, sort of over time really began to understand that water is liquid gold and especially drinking water is the defining issue of our time and it's gonna define where we go as a species in the future. So... I think there can be no, as you said yourself, you cannot possibly understate the value of drinking water, what it means to humankind. You know, it's interesting that you say that. Yeah, let me say this real quick, Sam. You know what's interesting for me, this is health chatter, okay? I never, ever, I'm a seasoned person, okay? I never, never realized that water had different taste. You know, it was just water. And I think maybe about, my wife would always tell me stuff like, well, I like this water better than I like that water. So what difference does it make? It's just water. Okay. But it's only been very, very recently that I found out there is a difference in the taste of water. And you know, I think Anna, you talked about the fact that you got minerals, you got chemicals and those kinds of things. And so now I've become a water connoisseur or snob. So anyway, I just want to tell my story. That's my story and I'm sticking to it. Okay, Stan, your turn. So, you know, it's really interesting when you start reading about space exploration. And one of the first things that, when you're exploring space is whether or not there's water available, no matter what. And there's scientific, investigations for water. So obviously it's not just the liquid gold per se here, but it's also in the universe as a whole. So let me bring up another issue that's kind of hitting all of us, and that's war. So you know there are two major wars are going on in the world right now, one in in Gaza and there's a lot of destruction. And almost the first thing that comes out of that is the need for water. One way or the other, there's a need for water. And when these wars stop or they're done and hopefully sooner than later, How is it that a war torn area can develop, frankly, relatively quickly, safe water for its population? Or is that something that's got to be brought in until a new infrastructure is developed? So I think Stan, I think there's, unfortunately there's, you know, the water infrastructure, however robust and resilient you make it, you can't really design something that's sustained, can sustain human conflict and deliberate targeting, because I think that is a strategic thing, is to take out some of those infrastructure things to force the other side to capitulate. So it takes a long time to rebuild your water systems. So again, you have to, make sure that the source waters have come through relatively intact and ground water, surface water, they'll be affected differently. Surface water is a lot more vulnerable. And the infrastructure, if it's been physically destroyed, you're looking at a very time consuming, very expensive effort to bring that back into use. So for a long time, you're probably looking at bringing water in and supplying it to people that way. And I think that's typically what you see as, that's why water is such a... huge component of aid packages that go in and relief supplies. Water is running center. Humans can probably can survive a long time with food shortages, but a lot less without water. So I think water, just bringing water in, supplying water to these areas, it just becomes a fundamental part of the relief efforts and the rebuilding. Yeah, yeah. So... For our listening audience, this is interesting. Perhaps either one of you can reflect on this. This is from our research crew. Four and a half million Minnesotans, and we're just talking Minnesota now, so you can kind of guess what it might be in your particular state, whoever is listening. 4.5 million Minnesotans consume water from 6,649 public water. systems, this is just Minnesota now, which include municipalities, resorts, daycares, restaurants, and other establishments that provide drinking water. So I mean, when you think about that, for most of us, this is kind of invisible to us, which by the way, success of public health is often invisible. It's when all of a sudden there's like a problem that becomes more visible to all of us. Like all of a sudden the water doesn't taste good or it looks funny, or what have you, or there's contaminants in it. But in Minnesota, we're in pretty good shape. Minnesota has an exceptionally high rate of compliance with the Safe Drinking Water Act. And I think Sandeep, you mentioned that. Nearly 98% of public water systems and over 99% of the population they serve have drinking water that meets all federal-based standards. That's pretty good, pretty, pretty good. And it really goes to you, the professionals that monitor this and connect with one another statewide to make sure that our drinking water is safe. So tell me, if, you know, so this is, you know, a health chatter, what do you want the public to know? I mean, if you, if you know, a couple one-liners from each one of you to end our show with you, what would it be for our listening audience? I guess mine would be to just... I guess I would still go with, you're a part of the water too. So everyone's responsible for keeping water safe, whether that's keeping garbage out of the waste, whether it's picking up pollution, whether it's doing things in your home to make sure your water quality stays safe. I mentioned letting it run. and doing those things to protect specifically from lead. But those things also can help just maintain good water quality. So I think it's really important that people feel like they're part of making sure water in Minnesota is safe so that they have some investment themselves in being proud of how great our water quality is here because it takes everyone. Yeah. Sandeep. I would just really tell Minnesotans to trust their public water supply, to be very proud of their public water supply, to feel very safe about drinking their public water supply. It's a great resource provided to them at very, very low cost. To balance that, they should be appreciative of that and as Anna said, do their part because... Water is a great aggregator. It picks up everything on the land surface, anywhere else, and things ultimately end up in the groundwater or the surface water, that's our drinking water. So little things that people can do around their homes and their neighborhoods, simple things like picking up trash, picking up after their dog when they're walking their pets. Those little things may not seem like it, but they all ultimately end up in the water one way or the other, and that's what we drink. So the less we, you know, we can reduce the burden on our source water, water will continue to stay abundant and cheap. So everyone has a role in this, but at the end of the day, people should appreciate that the water they get to drink from a public water supply is a finished product. A lot of work goes into it, a lot of regulations govern it. There is a tremendous amount of transparency about it. So... they can help themselves to all that information about their water very easily from their city website or by calling Department of Health. So it's an open book, people should trust it and they should enjoy it and they should do their part to protect it. Well put, well put. Clarence. Thank you both, thank you all. We have those that spoke and those that didn't speak. We thank you for the work that you're doing. I really, you know, David, when Dave and I were talking about this, I really appreciated his explanation of so many different things about how the water supply is being protected. You know, and you talked about the work that's being done in order to make it safer. And so I just wanna say from community health, for community health process, thank you. And, you know, thank you. That's what I say, I love that water. Stan. Thank you. The expertise that's, like I had mentioned, almost invisible to most of the population comes from people like you, the professional aspects of helping to keep all of us safe. And it's really greatly appreciated. We also greatly appreciate the insights that you've given to all of us in our drinking water. Something that we take for granted, but perhaps a takeaway from this show is, You shouldn't take it for granted. There are things that you can do to help make it continue to be safe going forward. So thank you both Sandeep and Anna for being with us today. We have great shows coming up on HealthChatter. One down the pipe pretty quick is on organ donation, which should be an interesting topic. And we'll see, maybe we can get more and more people to be organ. donors when they listen to our show. So stay tuned for that. In the meantime, to all of you out there listening to audience, keep health chatting away.