When we met Michelle Anderson, she was teaching her home-schooled son about the scientific method, the process by which problems can be solved through doing research, developing a hypothesis, conducting experiments and drawing conclusions.
It’s a subject she’s qualified to teach. After she and her family moved to Greer in 2003, she found herself trying to solve a discomforting problem.
“I started getting severe stomach cramps, and then my son was also getting them at the same time,” says Anderson, 40. “We were both nauseated, and I just thought we had some kind of stomach bug."
At first, the “bug” would go away for a couple of weeks, then come back stronger than before. Eventually, Michelle’s cramps never went away and she says her stomach bloated to twice its size.
"I went to the doctor, had him check me out thoroughly, but he couldn't find anything wrong.”
She says later, she developed a harsh rash on her forehead that would burn every time she took a shower. Her husband also noticed skin problems. It was then that she developed her own hypothesis: could her water be the source of her family’s ailments? Internet research yielded a website that only strengthened her hypothesis.
"On chloramine.org, I saw that other people were having symptoms,” says Michelle. “I started reading through the list and I thought, 'that's me, that's me, that's me'."
Chloramine.org was created by a concerned citizens’ group in California that formed after their water utility began using chloramine to disinfect the water. Michelle called her water provider, Greer Commission of Public Works.
“Do you use chloramine?”
“Yes, we do.”
"I was shocked when I found out that's what's in my water,” says Michelle. “I was absolutely shocked."
WHAT IS CHLORAMINE?
The disinfection of drinking water is no doubt one of the greatest public health achievements of the 20th century. Until then, people were at the mercy of bacterial illnesses like cholera, typhoid and dysentery. Today, most public water providers in the United States (80%) use chlorine to kill those bacteria. But almost 20% use a combination of chlorine and ammonia known as monochloramine or chloramine.
According to the Environmental Protection Agency’s website, which contains a whole 29-page section on chloramine, there are some advantages to using the mixture. Two of the major ones being: (1) it doesn’t dissipate as quickly as chlorine, providing long-lasting disinfection as water moves through the system of pipes that carry it to homes, and (2) chloramine produces fewer regulated disinfection byproducts than chlorine. Disinfection byproducts are chemicals that are created when disinfectants react with natural organic matter in water; the EPA regulates, or puts limits on, 11 disinfection byproducts. In recent years, those limits have become more strict, which is why chloramine has grown in popularity among water providers. (Keep this in mind for later.)
Three public utilities in the Upstate use chloramine: Greer CPW, which serves 17,000 customers, Greenwood CPW, serving 42,000 customers, and Greenville Water System, serving 450,000 people, not only in Greenville County but also in parts of Pickens, Anderson and Laurens Counties.
Dan Tuck, Superintendent of Greenwood’s water treatment plant, says they switched to chloramine in the 1980s to meet EPA regulations for disinfection byproducts.
Nick Stegall, General Manager of Greer CPW, says they switched to chloramine about 20 years ago to keep the water disinfected “at the correct level” throughout the distribution system.
Greenville Water System has the longest history with chloramine. It has used it to disinfect water since 1933.
“Chlorine is a powerful disinfectant, but the levels of chlorine can drop very quickly after it's done some of its disinfecting work,” says Frank Eskridge of GWS. “We like the long-lasting protection that chloramines afford us in the distribution system."
HEALTH PROBLEMS?
Chloramine.org claims that the chemical mixture can cause various health problems and aggravate existing ones, primarily skin, digestive and respiratory ailments.
Michelle Anderson is not alone in the Upstate when it comes to people who believe they are sensitive to the substance. Diane Saltzman lives in Simpsonville, which is served by the Greenville Water System. She says after moving there three years ago, she immediately developed digestive problems.
“I had had acid reflux before, but never anything as bad as this,” says Saltzman. “This was far worse. I had no idea what was causing it until I read about the chloramine.”
She says she stopped drinking her water, and the symptoms immediately went away. But she hasn’t found a way to completely avoid chloramine: she says she and her husband both suffer from red, irritated eyes after they get out of the shower.
Chris Klein moved from Greer to Duncan just to get away from the water. He says his skin would often look red and inflamed after he took a shower.
“I had this rash on my back and on my hands that just wouldn’t go away,” says Klein. “It was like an extreme sunburn.”
But he says after moving to Duncan, his skin cleared up almost immediately. He says his digestive problems also went away. Michelle says her stomach problems also ended when she stopped drinking her water.
"It was amazing,” says Anderson. “It was a total difference. I felt like I was human again."
LACK OF RESEARCH
Greenwood and Greenville water officials say they’ve never heard customers complain of health problems related to chloramine.
“We’ve been using it for almost 80 years. I think we would have heard something by now if people were having a problem with it,” says Eskridge.
Anderson says the lack of complaints to water providers is because most people blame their symptoms on something else.
“Very few people know that it’s in their water and that it can cause these kinds of problems,” says Anderson. “Doctors don’t even know.”
We checked with some of the leading allergists and dermatologists in the Greenville area. None seemed familiar with chloramine and said they do not consider it a possible factor when patients come in with certain symptoms. However, Dr. Gordon Johnson, an optometrist at Blue Ridge Vision in Greer, says over the years he has seen a few patients who were sensitive to chloramine.
“They come in with extremely red eyes, like they’ve spent all day in the swimming pool,” says Johnson. “I keep chloramine on my list of possible factors that I consider when I see someone like that.”
On its website, EPA says health authorities have recognized that some people may have a “chemical sensitivity” to chloramine. It says it has set a regulatory limit “to levels where no adverse health effects are anticipated”. It advises people who are concerned about sensitivity to consult their physicians. But it also says, “a doctor would have difficulty making a direct link between a health problem and chloramine or any other disinfectant in water”.
EPA’s website says there are few studies on how chloramine affects human health and states “gaps in research…should be filled”. It says the Centers for Disease Control investigated reports of health effects on citizens in Vermont but was unable to draw any conclusions.
“TOXIC CONSEQUENCES”
Dr. Michael Plewa says chloramine may pose a far greater health risk than stomach aches and rashes.
Plewa is a geneticist at the University of Illinois, Urbana-Champaign. He is considered one of the nation’s foremost experts on the toxicity of disinfection byproducts in drinking water, having conducted numerous studies and published several papers on the subject. He is currently studying a group of byproducts called nitrosamines.
"Nitrosamines are highly toxic carcinogens that you would like not to have in drinking water," says Plewa.
Nitrosamines usually occur in water that contains chloramine. The most toxic nitrosamine is nitrosodimethylamine, or NDMA. NDMA has caused liver cancer in lab animals and is listed as a “probable human carcinogen” by EPA.
"It can be metabolized by enzymes into a form that then can cause damage to DNA, which ultimately can lead to cancer," says Plewa.
Greenville Water System's 2011 water quality report, which contains testing results from 2010, shows the system does have NDMA in it. It measured .0034 parts per billion. But customers have no way of knowing if that is high or low. That's because EPA has not set a regulatory standard for NDMA, meaning it has not set a limit for how much of it water providers can have in their water. Plewa believes they should.
"With all that we now know about NDMA, I believe EPA should regulate it," says Plewa. "More research needs to be done to protect the public health."
EPA declined our repeated requests for interviews on camera and over the phone. The agency would only answer questions in writing. We asked why NDMA and other nitrosamines are unregulated.
EPA answered this way: "EPA believes sufficient health information is available on nitrosamines to evaluate the potential risks from exposure to drinking water.... Five nitrosamines (including NDMA) are listed on the Agency's third Contaminant Candidate List and EPA is currently evaluating the available health and occurrence information to determine whether a drinking water standard is appropriate."
VOLUNTEER STATE POLICY
Adding to questions about the safety of chloramine is the state of Tennessee's stance on it. The law there requires water providers to have free chlorine throughout their systems. Sherwin Smith, the program manager for Tennessee's Division of Water Supply, says his state believes chlorine is "much better" at killing bacteria than chloramine.
"Chloramine will disinfect the water, but it takes many many times longer to do the same job that chlorine does in a very short period of time," says Smith.
EPA, on its website, acknowledges that chloramine takes much longer to kill bacteria, viruses and other potentially harmful organisms.
Eskridge says chloramine has always been effective at killing bacteria in Greenville Water System. However, he also says in the early 1990s, the system had "slightly higher" levels of coliform bacteria, so managers initiated a one-month "disinfection switch" policy. For one month out of the year, GWS turns off the ammonia and feeds free chlorine.
"That way, anything that might be in the distribution system is being hit with two different kinds of disinfectant, and we have found our water quality numbers are excellent because of that," says Eskridge.
Smith says another reason Tennessee doesn't allow chloramine is there's just too much unknown about its disinfection byproducts like NDMA.
"Some of those unregulated byproducts, the results of those on human health is not really well understood at this point," says Smith.
GREER CONSIDERS A SWITCH
Greenville and Greenwood say they will continue to use chloramine. But Greer is considering switching to another disinfection method. Not because of NDMA, but because of concerns raised by Michelle Anderson and a few other customers.
"We take their concerns seriously," says Greer CPW General Manager Nick Stegall. "We want to ensure quality water. We want to do the best we can to help them with their health issues."
He says his staff members have visited plants in Tennessee and Anderson to see how they do it without chloramine and have talked with several other water providers. Greer is also using an engineering firm to help evaluate other disinfection methods. He says he hopes his staff can make a recommendation to commissioners "within a few months".
Anderson says she is glad Greer is at least considering dumping chloramine. But until it does, she will continue to go out of her way to avoid her own water.
"We don't drink it, we don't cook with it, we don't give it to our pets," says Anderson.
She even washes her hair with water her husband brings in from Spartanburg, warming it up in the microwave and then taking it to the shower.
Yes, it's inconvenient, she says. But not nearly inconvenient as life before she learned about chloramine.
"The best thing of all would be that people wouldn't have to go through this, they wouldn't have to have their lives turned upside down because of water."
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