Commercially Bottled Water

Basics

Americans spend billions of dollars every year on bottled water. People choose bottled water for a variety of reasons including aesthetics (for example, taste), health concerns, or as a substitute for other beverages.

If you have questions about bottled water, make sure you are informed about where your bottled water comes from and how it has been treated. The standards for bottled water are set by the United States Food and Drug Administration (FDA). The FDA bases its standards on the EPA standards for tap water.

• For basic information on bottled water, see EPA’s brochure on Bottled Water Basics [PDF - 7 pages].
• Read the label on your bottled water. While there is currently no standardized label for bottled water, this label may tell you about the way the bottled water is treated.

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• Check the label for a toll-free number or Web page address of the company that bottled the water. This may be a source of further information.

Bottled Water & Immunocompromised Individuals

People with compromised immune systems may want to take special precautions with the water they drink. In healthy individuals, the parasite Cryptosporidium can cause illness; however, for those with weakened immune systems, it can cause severe illness and possibly death. Look for bottled water treatments that protect against Cryptosporidium, which include:

• Reverse Osmosis
• Distillation
• Filtration with an absolute 1 micron filter

For further information on Cryptosporidium, visit CDC’s Cryptosporidiosis: A Guide to Commercially-Bottled Water and Other Beverages.

Fluoride and Bottled Water

Some bottled waters contain fluoride, and some do not. Fluoride can occur naturally in source waters used for bottling or be added. Most bottled waters contain fluoride at levels that are less than optimal for good oral health. 

To learn more, check out the CDC's Frequently Asked Questions About Bottled Water and Fluoride.

Safety and Regulation

The FDA regulates bottled water under the Federal Food, Drug, and Cosmetic Act and sets standards for bottled water that are based on ones developed by EPA. If these standards are met, water is considered safe for most healthy individuals. The bottled water industry must also follow FDA’s Current Good Manufacturing Practices (CGMPs) for processing and bottling drinking water.

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Bottled Water Outbreaks

Although bottled water outbreaks are not often reported, they do occur. It is important for bottled water manufacturers, distributors, and consumers to:

• Protect and properly treat water before bottling
• Maintain good manufacturing processes
• Protect bottled water during shipping and storage
• Prevent contamination at the point of use (after purchase by the consumer)

The presence of contaminants in water can lead to adverse health effects, including gastrointestinal illness, reproductive problems, and neurological disorders. Infants, young children, pregnant women, the elderly, and people whose immune systems are compromised because of AIDS, chemotherapy, or transplant medications, may be especially susceptible to illness from some contaminants.

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For more information on water-related diseases, see the Index of Water-related Topics.

* Based on tracking of waterborne outbreaks from 1971-2010. For a complete listing of water-related surveillance data, see CDC's Surveillance Reports for Drinking Water-associated Disease & Outbreaks. Outbreak reporting is dependent on detection, investigation, and reporting of the outbreak. This requires health effects to be measured and these health effects to be linked to water exposure. However, many contaminants (i.e., many chemicals) in drinking water may not cause easily recognizable outbreaks because they require a long chronic exposure period. As a result, they would not be part of waterborne disease outbreak reporting or part of this list.

** Etiology unidentified: contamination of water with sodium hydroxide suspected based upon incubation period, symptoms, outbreak investigation and laboratory findings.

† The other symptoms reported were chemical esophagitis and burns in mouth.

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