According to new research from the Centers for Disease Control and Prevention (CDC), hospitalizations from three common and preventable waterborne diseases – Legionnaire's disease, cryptosporidiosis and giardiasis – could cost the U.S an estimated $539 million dollars each year. These figures represent only a fraction of all waterborne disease costs. They underscore the large and hidden burden of waterborne disease including direct federal and state expenditures associated with contaminated drinking water and recreational water. Modest investment in waterborne disease prevention programs in the U.S. could lead to significant healthcare cost savings.

According to the study, “These cost data highlight that water-related diseases pose not only a physical burden to the thousands of people sickened by them each year, but also a substantial burden in health care costs, including direct government payments through Medicare and Medicaid,” says Michael Beach of the Centers for Disease Control and Prevention.

Using data from a large insurance claims database between 2004 and 2007, Beach and his team estimated the total range of hospitalization costs for giardiasis to be $16-63 million; cryptosporidiosis to be $37-145 million; and Legionnaires' disease to be $101-321 million.

There are several modest changes that can be made to prevent these diseases and reduce health care costs associated with treating waterborne diseases. Examples of these changes include public education campaigns, appropriate maintenance and improvement of building water systems and regular inspection of pools and other recreational water facilities. This research illustrates the importance of properly maintaining water storage and distribution equipment and adjusting swimming pool water chemistry and addressing indoor cooling water systems.

Investment in wastewater and drinking water upgrades will be an important piece of ensuring safe water in the future. Monitoring for pathogens and indicators of safe water are necessary. Most U.S. water systems employ chlorine-based disinfectants to achieve residual protection throughout the distribution system mandated by the Safe Drinking Water Act, and new sensors and real-time assessment will make it possible to monitor and maintain water quality.

For more information about the public health benefits of chlorinated water, please visit our website.

(Joan Rose, PhD, is the Homer Nowlin Chair in Water Research at Michigan State University and a member of the Water Quality & Health Council.)

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