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Statement Of Brenda M. Afzal
Environmental Protection Agency
Aging Initiative Public Listening Session
Baltimore, Maryland
May 7, 2003
Brenda M. Afzal, RN, MS
Environmental Health Education Center
University of Maryland School of Nursing
Environmental Health Education Center
University of Maryland School of Nursing
Good Afternoon, My name is Brenda Afzal, I am community health nurse. I work here at the University of Maryland School of Nursing, Environmental Health Education Center. For the last few years I have worked to educate nurses and other health care professionals about issues related to the environmental health of communities. I have a particular interest in drinking water issues. Every day 240 million of us turn on our faucets in order to drink, bathe, and cook with water supplied by public water systems. In general, most Americans assume the water they are provided is pure and free of contaminants. Should the elderly make that assumption? As vigilant as our municipal water suppliers try to be, the sewage and drinking water infrastructure in our nation is aging. Systems can and have failed in cities across the nation causing occasional microbial contamination resulting in mild to health effects in the general population. The elderly, who may be more vulnerable to this contamination due to a decreased immune response and the presence of other chronic diseases, are more likely to experience serious complications from microbial contamination. In addition, the elderly may experience health effects due to acute and chronic exposure to chemical contaminants that may be in their drinking water. For example, there are regional issues related to the presence of arsenic in drinking water. According to the National Academy of Sciences, arsenic is a known carcinogen and may contribute to bladder, lung, liver, and skin cancers. It is suspected that arsenic has a negative affect on heart and blood vessels and may harm central and peripheral nervous systems. Chlorine, used by many water utilities to disinfect drinking water, is an effective disinfectant however, as it oxidizes it produces trihalomethanes (byproduct of chlorinating water that contains natural organics) some of which have been linked to bladder and rectal cancers. These are just two of the chemicals that may cause chronic health effects in the elderly; there are many, many more.
The Environmental Protection Agency encourages those Americans with special vulnerabilities to ask their health care providers about their drinking water concerns. Health care providers receive very little environmental health education while in school and may not know where to go to access information to guide their vulnerable patients in issues related to drinking water.
Three minutes does not begin to allow for even a partial discussion of the special vulnerabilities of the elderly that are related to drinking water. However, critical issues that need to be addressed include:
- Consumer education on drinking water vulnerabilities and sources of information about local drinking water issues. We need to Guarantee our right to know what's in our water.
- Health care provider education on drinking water contaminants, health effects, tap water alternatives, and the special vulnerabilities of the elderly.
- Improve drinking water research and disease monitoring. Improved recognition and reporting of diarrheal diseases related to water contamination.
- Strengthen, don't weaken, health standards for drinking water.
- We need to include senior interests in ongoing discussions about affordability secondary to needed Improvements in our drinking water and sewage infrastructure.