Drinking water and public health: the importance and handling of drinking water-related exposures in Sweden

Access to safe drinking water is a human right, indispensable for health. Drinking water of adequate quality is relatively easy to produce in Sweden.

Yet, the system is vulnerable as illustrated by aging water works, emerging freshwater scarcity and several recent large outbreaks of viruses or parasites and contamination of PFAS.

Such problems are expected to escalate due to climate change, making alterations and adaptations of drinking water production necessary. Clearly, any deterioration in drinking water quality has the potential to largely impact the population health.

Drinking water producers rarely face only one potential hazard, thus any risk reducing activities need to be based on a comprehensive risk-benefit assessment.

Such evidence-based assessment is under development but impeded by large data gaps on the population health consequences of the overall drinking water quality.The aim is to improve knowledge on drinking water-related health effects among adults and newborns and to integrate them into a risk-benefit assessment to support drinking water producers.

The project comprises a population-based large studies assessing the relationship of i) drinking water-chlorination with cancer of the bladder and colon, ii) magnesium and calcium in drinking water with risk of cardiovascular diseases, and iii-iv) fluoride in drinking water and urine with bone health, v) gestational PFAS exposure and adverse reproductive outcomes and maternal morbidity.