Calcium

1
Calcium Magnesium in Drinking Water

• Industry Positions Options
• WQA Aquatech USA
• 30 March 2005
• Regu P. Regunathan
• ReguNathan Associates, Inc.

2
Expert Committee Conclusions

• Community and bottled water suppliers should
  provide information to the general public and
  health professionals on the composition of water
  for constituents including possibly beneficial
  substances.
• Water bottlers should also consider providing
  waters with mineral compositions that are
  beneficial for population segments.
• Information should be provided on methods of
  application of home water softening devices so
  that consumers will also have access to
  mineralized water for drinking and cooking.
• A detailed state-of-the-art review should be
  prepared prior to consideration in the next
  revision of the WHO Guidelines for Drinking-water
  Quality.

3
POU/POE Products Affected

• POE Water Softeners
• POU Membrane Systems
• Reverse Osmosis Nano Filtration
• POU Distillers
• POU POE Deionizers

4
Industrys Immediate Reaction

• Is it good or bad for the industry?
• This is from well-known Experts. Are we qualified
  to oppose if bad for us?
• Potential Response by Regulators around the world
  to regulate even though it is not a WHOs own
  position (at least not yet)
• Guilt by Inference without complete Discussions
  or Deliberations
• Being pushed to a premature Response by the
  Industry

5
Submission of Comments to WHO by the Industry
Groups

• Aqua Europa (Task Force)
• December 2004
• January 2005
• (Including a review by Dr. Morris of UK)
• Water Quality Association (Task Force)
• January 2005
• IBWA
• January 2005

6
Comments by Aqua Europa in Dec 04

• Lack of Quantitative Evaluations of higher CVD
• Inclusion of Ca despite lack of good correlation
• Naturally Soft Vs Softened
• Possible Beneficial Effect of Trace Elements in
  Hard Water
• Lack of Recommendation about other substances of
  concern (Fe, I)

7
Evaluation Comments by Dr.Morris of UK
(Requested by Aqua Europa)

• Quality of Evidence poor, but recommendations
  definitive strong
• Non-Systematic Review of Articles in the
  Literature
• Language, Publication Reporting Biases in
  Review
• Soft Water harmful, not hard water beneficial?
• Low Effect of Water on CVD as opposed to other
  well-known factors
• Adding Magnesium may not be w/o risks

8
Comments by Aqua Europa in Jan 05

• Submitted Supported Dr. Morris Comments
• Pointed out the Weak Association of Water to CVD
  per Dr.Morris review
• Suggested water be considered only for hydration
  , not a vehicle for nutrients
• Supported the idea of Formal Systematic
  Evaluation, Technical Conference and Expert
  Committee Meeting

9
Comments by WQA

• May lead to negative perceptions by Consumers
  Regulators
• High RDA Vs Very Low Recommended Values for the
  addition of Ca Mg
• Are Large Cities with Soft Water at Risk?
• Soft Water Vs Softened Water (provided
  Comparisons an old Study of Kansas Cities)
• Softeners RO take out harmful elements How
  about Benefits Vs Harm?
• Effect of RO Softener etc. use in Hard Water
  Areas?
• Wondered about review of Russian Literature by
  all Experts

10
Comments by IBWA

• Remove References to Bottled Water (BW)
• BW a Beverage of Choice by Consumers unlike
  Water supply
• Water not the only source for mineral intake
• NRC in 1997 NIH in 2002 concluded more studies
  needed in this area

11
Comments by IBWA (Contd)

• All Conclusions about the benefits of minerals
  from water are premature
• High RDA Vs Low Recommended Additions
• Charge was to examine Demineralized water.
  Committee extended beyond their charge
• All types of BW satisfy the hydration needs of
  consumers
• Guide Values, if later set by WHO, should be done
  carefully and deliberately

12
General Theme of Comments

• Acknowledgement of Experts Intentions
• Lack of Quantitative Estimates
• Methodology Concerns
• Low Recommended Mineral Addition in comparison to
  RDA for Ca Mg
• Many Cities of World with Soft waters
• Naturally Soft Waters Vs Softened Water
• Other Studies Reviews not in agreement

13
What Happens Now?
14
Probable Immediate Future Activities

• Formal Systematic Evaluations
• Technical Conference
• Expert Committee Meeting
• Possible Change to WHO Guidance on this Issue

15
Possible Outcomes

• Evaluation Discussion shows no Relationship
• There may be a Relationship, but Inconclusive
  Need more Studies
• An inverse Relationship is found to exist and
  Actions recommended including establishment of
  Guide Values by WHO
• May lead to some Regulatory Actions

16
Industry Options
17
Potential Response by Industries

• Cities Around the World with Naturally Soft Water
  supplies will face a dilemma of needed addition
  of Ca Mg as opposed to the economy of such
  action
• Only a small portion of their treated water is
  actually consumed even though they would have
  to treat all 100.
• POU/POE Industry will need to reevaluate how to
  realign its activities.
• Bottled Water Industry will have to realign its
  product line.
• Develop a product line just for Improving Mineral
  Intake

18
POU Industrys Potential Response

• Develop Products capable of adding target amounts
  of Ca Mg to drinking water
• Add or make available such a product to all
  appropriate applications
• Naturally Soft Waters just to treat drinking
  water
• After the POU RO/Distillers/DI Units
• After the Whole House Softeners at the kitchen
  sink and elsewhere

19
POU as a Final Barrier

• Aesthetic Concerns
• MCL Vs MCLG
• Treatment Effects
• DBP Levels
• Process Changes
• Distribution Related Effects
• Corrosion Products
• Microbial Intrusions
• Endemic Diseases
• Security Issues

20
POU as a Final Barrier/Treatment

• Aesthetic Concerns
• MCL Vs MCLG
• Treatment Effects
• DBP Levels
• Process Changes
• Distribution Related Effects
• Corrosion Products
• Microbial Intrusions
• Endemic Diseases
• Security Issues
• Beneficial Mineral Addition Unit ?

21
Water Softeners

• We need to keep in mind Softeners are for
  providing good water for Cleaning Washing. We
  can still do that for the user
• We can provide one of several options to the
  consumer for Drinking Water
• Separate Hard Water line to the kitchen sink
• Small bypass to have target hardness levels in
  the cold water
• POU Mineralization unit under the kitchen sink
  with Separate Tap
• Soften Hot Water Only in lower hardness areas

22
Why then such Reaction from us?

• Doubt about Scientific Accuracy
• Unsure of lack of bias in all experts approach
• Stigma on the industry of removing elements
  beneficial to the Consumers
• Potential uninformed Regulatory Response in
  different countries and regions
• Suspicion of uneven treatment of our industry
  compared to others

23
Actions on our part

• Continue to resist unsupported regulatory actions
• We need to decide if and how we are to support
  the formal Evaluations and Technical Conference
• Some support from WQRF/WQA
• Support from the industry members in the form of
  financial contribution?
• Attend the conference in good numbers especially
  if held in USA

24
Questions?