3. DRINKING WATER INTAKE BACKGROUND KEY GENERAL POPULATION STUDIES ON DRINKING WATER INTAKE RELEVANT GENERAL POPULATION

Transcription

1 3. DRINKING WATER INTAKE BACKGROUND KEY GENERAL POPULATION STUDIES ON DRINKING WATER INTAKE RELEVANT GENERAL POPULATION STUDIES ON DRINKING WATER INTAKE PREGNANT AND LACTATING WOMEN HIGH ACTIVITY LEVELS/HOT CLIMATES RECOMMENDATIONS REFERENCES FOR CHAPTER 3...3

2 Volume I - Generl Fctors Chpter 3 - Drinking Wter Intke 3. DRINKING WATER INTAKE 3.1. BACKGROUND Drinking wter is potentil source of humn exposure to toxic sustnces. Contmintion of drinking wter my occur y, for exmple, percoltion of toxics through the soil to ground wter tht is used s source of drinking wter; runoff or dischrge to surfce wter tht is used s source of drinking wter; intentionl or unintentionl ddition of sustnces to tret wter (e.g., chlorintion); nd leching of mterils from pluming systems (e.g., led). Estimting the mgnitude of the potentil dose of toxics from drinking wter requires informtion on the quntity of wter consumed. The purpose of this section is to descrie key pulished studies tht provide informtion on drinking wter consumption (Section 3.2) nd to provide recommendtions of consumption rte vlues tht should e used in exposure ssessments (Section 3.6). Currently, the U.S. EPA uses the quntity of 2 L per dy for dults nd 1 L per dy for infnts (individuls of 1 kg ody mss or less) s defult drinking wter intke rtes (U.S. EPA, 198; 1991). These rtes include drinking wter consumed in the form of juices nd other everges contining tpwter (e.g., coffee). The Ntionl Acdemy of Sciences (NAS, 1977) estimted tht dily consumption of wter my vry with levels of physicl ctivity nd fluctutions in temperture nd humidity. It is resonle to ssume tht some individuls in physiclly-demnding occuptions or living in wrmer regions my hve high levels of wter intke. Numerous studies cited in this chpter hve generted dt on drinking wter intke rtes. In generl, these sources support EPA's use of 2 L/dy for dults nd 1 L/dy for children s upper-percentile tpwter intke rtes. Mny of the studies hve reported fluid intke rtes for oth totl fluids nd tpwter. Totl fluid intke is defined s consumption of ll types of fluids including tpwter, milk, soft drinks, lcoholic everges, nd wter intrinsic to purchsed foods. Totl tpwter is defined s wter consumed directly from the tp s everge or used in the preprtion of foods nd everges (i.e., coffee, te, frozen juices, soups, etc.). Dt for oth consumption ctegories re presented in the sections tht follow. However, for the rtes my overestimte the potentil exposure to toxic sustnces present only in locl wter supplies; therefore tpwter intke, rther thn totl fluid intke, is emphsized in this section. All studies on drinking wter intke tht re currently ville re sed on short-term survey dt. Although short-term dt my e suitle for otining men intke vlues tht re representtive of oth short- nd long-term consumption ptterns, upper-percentile vlues my e different for short-term nd long-term dt ecuse more vriility generlly occurs in short-term surveys. It should lso e noted tht most drinking wter surveys currently ville re sed on recll. This my e source of uncertinty in the estimted intke rtes ecuse of the sujective nture of this type of survey technique. The distriution of wter intkes is usully, ut not lwys, lognorml. Insted of presenting only the lognorml prmeters, the ctul percentile distriutions re presented in this hndook, usully with comment on whether or not it is lognorml. To fcilitte comprisons etween studies, the men nd the 9th percentiles re given for ll studies where the distriution dt re ville. With these two prmeters, long with informtion out which distriution is eing followed, one cn clculte, using stndrd formuls, the geometric men nd geometric stndrd devition nd hence ny desired percentile of the distriution. Before doing such clcultion one must e sure tht one of these distriutions dequtely fits the dt. The ville studies on drinking wter consumption re summrized in the following sections. They hve een clssified s either key studies or relevnt studies sed on the pplicility of their survey designs to exposure ssessment of the entire United Sttes popultion. Recommended intke rtes re sed on the results of key studies, ut relevnt studies re lso presented to provide the reder with dded perspective on the current stte-ofknowledge pertining to drinking wter intke KEY GENERAL POPULATION STUDIES ON DRINKING WATER INTAKE Cnd Deprtment of Helth nd Welfre (1981) - Tpwter Consumption in Cnd - In study conducted purposes of exposure ssessments involving source-specific y the Cndin Deprtment of Helth nd Welfre, 97 contminted drinking wter, intke rtes sed on totl individuls from 295 households were surveyed to tpwter re more representtive of source-specific tpwter intke. Given the ssumption tht purchsed foods nd everges re widely distriuted nd less likely to contin source-specific wter, the use of totl fluid intke Exposure Fctors Hndook Pge August

3 Volume I - Generl Fctors Chpter 3 - Drinking Wter Intke determine the per cpit totl tpwter intke rtes for t home nd tpwter consumed wy from home. The vrious ge/sex groups during winter nd summer sesons survey lso did not ttempt to estimte intke rtes for fluids (Cndin Ministry of Ntionl Helth nd Welfre, 1981). other thn tpwter. Consequently, no intke rtes for totl Intke rte ws lso evluted s function of physicl fluids were reported. ctivity. The popultion tht ws surveyed mtched the Dily consumption distriution ptterns for vrious Cndin 1976 census with respect to the proportion in ge groups re presented in Tle 3-1. For dults (over 18 different ge, regionl, community size nd dwelling type yers of ge) only, the verge totl tpwter intke rte ws Tle 3-1. Dily Totl Tpwter Intke Distriution for Cndins, y Age Group (pprox..2 L increments, oth sexes, comined sesons) Age Group (yers) Amount Consumed 5 nd under nd over L/dy % Numer % Numer % Numer > TOTAL Includes tpwter nd foods nd everges derived from tpwter. Source: Cndin Ministry of Ntionl Helth nd Welfre, groups. Prticipnts monitored wter intke for 2-dy 1.38 L/dy, nd the 9th percentile rte ws 2.41 L/dy s period (1 weekdy, nd 1 weekend dy) in oth lte summer determined y grphicl interpoltion. These dt follow of 1977 nd winter of All 97 individuls lognorml distriution. The intke dt for mles, femles, prticipted in oth the summer nd winter surveys. The nd oth sexes comined s function of ge nd expressed mount of tpwter consumed ws estimted sed on the in the units of milliliters (grms) per kilogrm ody weight respondents' identifiction of the type nd size of everge re presented in Tle 3-2. The tpwter survey did not continer used, compred to stndrd sized vessels. The include ody weights of the prticipnts, ut the ody survey questionnires included pictoril guide to help weight informtion ws tken from Cndin helth prticipnts in clssifying the sizes of the vessels. For survey dted 1981; it verged 65.1 kg for mles nd 55.6 exmple, smll glss of wter ws ssumed to e kg for femles. Intke rtes for specific ge groups nd equivlent to 4. ounces of wter, nd lrge glss ws sesons re presented in Tle 3-3. The verge dily totl ssumed to contin 9. ounces of wter. The study lso tpwter intke rtes for ll ges nd sesons comined ws ccounted for wter derived from ice cues nd popsicles, 1.34 L/dy, nd the 9th percentile rte ws 2.36 L/dy. nd wter in soups, infnt formul, nd juices. The survey The summer intke rtes re nerly the sme s the winter did not ttempt to differentite etween tpwter consumed intke rtes. The uthors speculte tht the reson for the Pge Exposure Fctors Hndook 3-2 August 1997

4 Volume I - Generl Fctors Chpter 3 - Drinking Wter Intke smll sesonl vrition here is tht in Cnd, even in the summer, the mient temperture seldom exceeded 2 degrees C nd mrked increse in wter consumption with high ctivity levels hs een oserved in other studies only when the mient temperture hs een higher thn 2 degrees. Averge dily totl tpwter intke rtes s function of the level of physicl ctivity, s estimted sujectively, re presented in Tle 3-4. The mounts of tpwter consumed tht re derived from vrious foods nd everges re presented in Tle 3-5. Note tht the consumption of direct rw tpwter is lmost constnt cross ll ge groups from school-ge children through the oldest ges. The increse in totl tpwter consumption eyond school ge is due to coffee nd te consumption. Tle 3-2. Averge Dily Tpwter Intke of Cndins (expressed s milliliters per kilogrm ody weight) Averge Dily Intke (ml/kg) Age Group (yers) Femles Mles Both Sexes < Totl Popultion Source: Cndin Ministry of Ntionl Helth nd Welfre, Tle 3-3. Averge Dily Totl Tpwter Intke of Cndins, y Age nd Seson (L/dy) Age (yers) < <55 All Ages Averge Summer Winter Summer/Winter th Percentile Summer/Winter Includes tpwter nd foods nd everges derived from tpwter. Source: Cndin Ministry of Ntionl Helth nd Welfre, Tle 3-4. Averge Dily Totl Tpwter Intke of Cndins s Function of Level of Physicl Activity t Work nd in Spre Time (16 yers nd older, comined sesons, L/dy) Work Spre Time Activity Consumption Numer of Respondents Consumption Numer of Respondents Level L/dy L/dy Extremely Active Very Active Somewht Active Not Very Active Not At All Active Did Not Stte TOTAL The levels of physicl ctivity listed here were not defined ny further y the survey report, nd ctegoriztion of ctivity level y survey prticipnts is ssumed to e sujective. Includes tpwter nd foods nd everges derived from tpwter. Source: Cndin Ministry of Ntionl Helth nd Welfre, Tle 3-5. Averge Dily Tpwter Intke y Cndins, Apportioned Among Vrious Beverges (oth sexes, y ge, comined sesons, L/dy) Exposure Fctors Hndook Pge August

5 Volume I - Generl Fctors Chpter 3 - Drinking Wter Intke Age Group (yers) Under nd Over Totl Numer in Group Wter Ice/Mix Te * Coffee.1 * "Other Type of Drink" Reconstituted Milk Soup Homemde Beer/Wine * * Homemde Popsicles * * By Formul, etc..9 * * * * * TOTAL Includes tpwter nd foods nd everges derived from tpwter. * Less thn.1 L/dy Source: Cndin Ministry of Ntionl Helth nd Welfre, Dt concerning the source of tpwter (municipl, s "ll wter from the household tp consumed directly s well, or lke) ws presented in one tle of the study. This everge or used to prepre foods nd everges." Totl ctegoriztion is not pproprite for mking conclusions wter ws defined s tpwter plus "wter intrinsic to foods out consumption of ground versus surfce wter. nd everges" (i.e., wter contined in purchsed food nd This survey my e more representtive of totl everges). The uthors showed tht the ge, sex, nd tpwter consumption thn some other less comprehensive rcil distriution of the surveyed popultion closely surveys ecuse it included dt for some tpwter- mtched the estimted 1977 U. S. popultion. contining items not covered y other studies (i.e., ice Dily totl tpwter intke rtes, expressed s ml cues, popsicles, nd infnt formul). One potentil source (grms) per dy y ge group re presented in Tle 3-6. of error in the study is tht estimted intke rtes were These dt follow lognorml distriution. The sme dt, sed on identifiction of stndrd vessel sizes; the ccurcy expressed s ml (grms) per kg ody weight per dy re of this type of survey dt is not known. The cooler climte presented in Tle 3-7. A summry of these tles, of Cnd my hve reduced the importnce of lrge showing the men, the 1th nd 9th percentile intkes, tpwter intkes resulting from high ctivity levels, expressed s oth ml/dy nd ml/kg-dy s function of therefore mking the study less pplicle to the United ge, is presented in Tle 3-8. This shows tht the men Sttes. The uthors were not le to explin the nd 9th percentile intke rtes for dults (ges 2 to 65+) surprisingly lrge vritions etween regionl tpwter re pproximtely 1,41 ml/dy nd 2,28 ml/dy nd for intkes; the lrgest regionl difference ws etween Ontrio ll ges the men nd 9th percentile intke rtes re 1,19 (1.18 liters/dy) nd Queec (1.55 liters/dy). ml/dy nd 2,9 ml/dy. Note tht older dults hve Ershow nd Cntor (1989) - Totl Wter nd greter intkes thn do dults etween ge 2 nd Tpwter Intke in the United Sttes: Popultion-Bsed Estimtes of Quntities nd Sources - Ershow nd Cntor (1989) estimted wter intke rtes sed on dt collected y the USDA Ntionwide Food Consumption Survey (NFCS). Dily intke rtes for tpwter nd totl wter were clculted for vrious ge groups for mles, femles, nd oth sexes comined. Tpwter ws defined Pge Exposure Fctors Hndook 3-4 August 1997

6 Exposure Fctors Hndook Pge August Age (yers) Numer of Oservtions Men SD Tle 3-6. Totl Tpwter Intke (ml/dy) for Both Sexes Comined S.E. of Men Percentile Distriution < * * * * Infnts (ges <1) Children (ges 1-1) Teens (ges 11-19) Adults (ges 2-64) Adults (ges 65+) All Totl tpwter is defined s "ll wter from the household tp consumed directly s everge or used to prepre foods nd everges." * Vlue not reported due to insufficient numer of oservtions. Source: Ershow nd Cntor, Chpter 3 - Drinking Wter Intke Volume I - Generl Fctors

7 Pge Exposure Fctors Hndook 3-6 August 1997 Age (yers) Actul Count Numer of Oservtions Weighted Count Tle 3-7. Totl Tpwter Intke (ml/kg-dy) for Both Sexes Comined Men SD S.E. of Men < * * * * Infnts (ges <1) Children (ges 1-1) Teens (ges 11-19) Adults (ges 2-64) Adults (ges 65+) All Totl tpwter is defined s "ll wter from the household tp consumed directly s everge or used to prepre foods nd everges." * Vlue not reported due to insufficient numer of oservtions. Source: Ershow nd Cntor, Chpter 3 - Drinking Wter Intke Volume I - Generl Fctors

8 Volume I - Generl Fctors Chpter 3 - Drinking Wter Intke Tle 3-8. Summry of Tpwter Intke y Age Age Group Intke (ml/dy) Intke (ml/kg-dy) Men 1th-9th Percentiles Men 1th-9th Percentiles Infnts (<1 yer) Children (1-1 yers) , Teens (11-19 yers) , Adults (2-64 yers) 1, , Adults (65+ yers) 1, , All ges 1, , Source: Ershow nd Cntor (1989) 65, n oservtion ering on the interprettion of the femles; the vrition of ech from the comined-sexes Cntor, et l. (1987) study which surveyed popultion tht men ws out 8 percent. ws older thn the ntionl verge (see Section 3.3). Ershow nd Cntor (1989) lso presented dt on Ershow nd Cntor (1989) lso mesured totl wter totl wter intke nd tpwter intke for children of vrious intke for the sme ge groups nd concluded tht it ges. They found, for infnts nd children etween the ges verged 2,7 ml/dy for ll groups comined nd tht of 6 months nd 15 yers, tht the totl wter intke per unit tpwter intke (1,19 ml/dy) is 55 percent of the totl ody weight incresed smoothly nd shrply from 3 wter intke. (The detiled intke dt for vrious ge ml/kg-dy ove ge 15 yers to 19 ml/kg-dy for ges groups re presented in Tle 3-9). Ershow nd Cntor less thn 6 months. This proly represents metolic (1989) lso concluded tht, for ll ge groups comined, requirements for wter s dietry constituent. However, the proportion of tpwter consumed s drinking wter, they found tht the intke of tpwter lone went up only foods, nd everges is 54 percent, 1 percent nd 36 slightly with decresing ge (from 2 to 45 ml/kg-dy s percent, respectively. (The detiled dt on proportion of ge decreses from 11 yers to less thn 6 months). Ershow tpwter consumed for vrious ge groups re presented in nd Cntor (1989) ttriuted this smll effect of ge on Tle 3-1). Ershow nd Cntor (1989) lso oserved tht tpwter intke to the lrge numer of lterntive wter mles of ll ge groups hd higher totl wter nd tpwter sources (esides tpwter) used for the younger ge groups. consumption rtes thn Age (yers) Tle 3-9. Totl Tpwter Intke (s percent of totl wter intke) y Brod Age Ctegory, Percentile Distriution Men < Does not include pregnnt women, lctting women, or rest-fed children. Totl tpwter is defined s "ll wter from the household tp consumed directly s everge or used to prepre foods nd everges." = Less thn.5 percent. Source: Ershow nd Cntor, Exposure Fctors Hndook Pge August

9 Volume I - Generl Fctors Chpter 3 - Drinking Wter Intke Tle 3-1. Generl Dietry Sources of Tpwter for Both Sexes, Age (yers) Source Men % of Tpwter Stndrd Devition <1 Food c Drinking Wter Other Beverges All Sources Food c Drinking Wter Other Beverges All Sources Food c Drinking Wter Other Beverges All Sources Food c Drinking Wter Other Beverges All Sources Food c Drinking Wter Other Beverges All Sources All Food c Drinking Wter Other Beverges All Sources Does not include pregnnt women, lctting women, or rest-fed children. Individul vlues my not dd to totls due to rounding. c Food ctegory includes soups. = Less thn.5 percent. Source: Ershow nd Cntor, With respect to region of the country, the northest sttes hd slightly lower verge tpwter intke (1,2 ml/dy) thn the three other regions (which were pproximtely equl t 1,4 ml/dy). This survey hs n dequtely lrge size (26,446 individuls) nd it is representtive smple of the United Sttes popultion with respect to ge distriution, sex, rcil composition, nd residentil loction. It is therefore suitle s description of ntionl tpwter consumption. The chief limittion of the study is tht the dt were collected in 1978 nd do not reflect the expected increse in the consumption of soft drinks nd ottled wter or chnges in the diet within the lst two decdes. Since the dt were collected for only three-dy period, the extrpoltion to chronic intke is uncertin. Roseerry nd Burmster (1992) - Lognorml Distriutions for Wter Intke - Roseerry nd Burmster (1992) fit lognorml distriutions to the wter intke dt reported y Ershow nd Cntor (1989) nd estimted popultion-wide distriutions for totl fluid nd totl tpwter intke sed on proportions of the popultion in ech ge group. Their puliction shows the dt nd the fitted log-norml distriutions grphiclly. The men ws estimted s the zero intercept, nd the stndrd devition ws estimted s the slope of the est fit line for the nturl logrithm of the intke rtes plotted ginst their Pge Exposure Fctors Hndook 3-8 August 1997

10 Volume I - Generl Fctors Chpter 3 - Drinking Wter Intke corresponding z-scores (Roseerry nd Burmster, 1992). Lest squres techniques were used to estimte the est fit stright lines for the trnsformed dt. Summry sttistics for the est-fit lognorml distriution re presented in Tle In this tle, the simulted lnced popultion represents n djustment to ccount for the different ge distriution of the United Sttes popultion in 1988 from the ge distriution in 1978 when Ershow nd Cntor (1989) collected their dt. Tle 3-12 summrizes the quntiles nd mens of tpwter intke s estimted from the est-fit distriutions. The men totl tpwter intke rtes for the two dult popultions (ge 2 to 65 yers, nd 65+ yers) were estimted to e 1.27 nd 1.34 L/dy. Tle Summry Sttistics for Best-Fit Lognorml Distriutions for Wter Intke Rtes ln Totl Fluid Group Intke Rte (ge in yers) F F R 2 < ge < # ge < # ge < # ge < # ge All ges Simulted lnced popultion ln Totl Tpwter Group Intke (ge in yers) F F R 2 < ge < # ge < # ge < # ge < # ge All ges Simulted lnced popultion These vlues (ml/dy) were used in the following equtions to estimte the quntiles nd verges for totl tpwter intke shown in Tles percentile intke rte = exp [F + (1.96 F)]. 75 percentile intke rte = exp [F + (.6745 F)] 5 percentile intke rte = exp [F]. 25 percentile intke rte = exp [F - (.6745 F)]. 2.5 percentile intke rte = exp [F - (1.96 F)]. 2 Men intke rte - exp [F +.5 F )] Source: Roseerry nd Burmster, These intke rtes were sed on the dt originlly presented y Ershow nd Cntor (1989). Consequently, the sme dvntges nd disdvntges ssocited with the Ershow nd Cntor (1989) study pply to this dt set RELEVANT GENERAL POPULATION STUDIES ON DRINKING WATER INTAKE Ntionl Acdemy of Sciences (1977) - Drinking Wter nd Helth - NAS (1977) clculted the verge per cpit wter (liquid) consumption per dy to e 1.63 L. This figure ws sed on survey of the following literture sources: Evns (1941); Bourne nd Kidder (1953); Wlker et l. (1957); Wolf (1958); Guyton (1968); McNll nd Schlegel (1968); Rndll (1973); NAS (1974); nd Pike nd Brown (1975). Although the clculted verge intke rte ws 1.63 L per dy, NAS (1977) dopted lrger rte (2 L per dy) to represent the intke of the mjority of wter consumers. This vlue is reltively consistent with the totl tpwter intkes rte estimted from the key studies presented previously. However, the use of the term "liquid" ws not clerly defined in this study, nd it is not known whether the popultions surveyed re representtive of the dult U.S. popultion. Consequently, the results of this study re of limited use in recommending totl tpwter intke rtes nd this study is not considered key study. Hopkins nd Ellis (198) - Drinking Wter Consumption in Gret Britin - A study conducted in Gret Britin over 6-week period during Septemer nd Octoer 1978, estimted the drinking wter consumption rtes of 3,564 individuls from 1,32 households in Englnd, Scotlnd, nd Wles (Hopkins nd Ellis, 198). The prticipnts were selected rndomly nd were sked to complete questionnire nd diry indicting the type nd quntity of everges consumed over 1-week period. Totl liquid intke included totl tpwter tken t home nd wy from home; purchsed lcoholic everges; nd non-tpwter-sed drinks. Totl tpwter included wter content of te, coffee, nd other hot wter drinks; homemde lcoholic everges; nd tpwter consumed directly s everge. The ssumed tpwter contents for these everges re presented in Tle Bsed on responses from 3,564 prticipnts, the men intke rtes nd frequency distriution dt for vrious everge ctegories were estimted y Hopkins nd Ellis (198). These dt re listed in Tle The men per cpit totl liquid intke rte for ll individuls surveyed ws 1.59 L/dy, nd the men per cpit totl tpwter intke rte ws.95 L/dy, with 9th percentile Exposure Fctors Hndook Pge August

11 Volume I - Generl Fctors Chpter 3 - Drinking Wter Intke Tle Estimted Quntiles nd Mens for Totl Tpwter Intke Rtes (ml/dy) Age Group Percentile Arithmetic (yers) Averge <ge < # ge < , # ge < ,128 2, # ge < ,122 1,561 2,926 1, # ge ,198 1,651 3,44 1,341 All ges ,377 2,721 1,18 Simulted Blnced Popultion ,411 2,954 1,129 Totl tpwter is defined s "ll wter from the household tp consumed directly s everge or used to prepre foods nd everges." Source: Roseerry nd Burmster, 1992 Beverge Tle Assumed Tpwter Content of Beverges Cold Wter Home-mde Beer/Cider/Lger Home-mde Wine Other Hot Wter Drinks Ground/Instnt Coffee: Blck White Hlf Milk All Milk Te Hot Milk Coco/Other Hot Milk Drinks Wter-sed Fruit Drink Fizzy Drinks Fruit Juice 1 Fruit Juice 2 Milk Minerl Wter c Bought cider/eer/lger Bought Wine % Tpwter Blck - coffee with ll wter, milk not dded; White - coffee with 8% wter, 2% milk; Hlf Milk - coffee with 5% wter, 5% milk; All Milk - coffee with ll milk, wter not dded; Fruit juice: individuls were sked in the questionnire if they consumed redy-mde fruit juice (type 1 ove), or the vriety tht is diluted (type 2); c Informtion on volume of minerl wter consumed ws otined only s "numer of ottles per week." A ottle ws estimted t 5 ml, nd the volume ws split so tht 2/7 ws ssumed to e consumed on weekends, nd 5/7 during the week. Source: Hopkins nd Ellis, 198. vlue of out 1.3 L/dy (which is the vlue of the percentile for the home tpwter lone in Tle 3-14). Liquid intke rtes were lso estimted for mles nd femles in vrious ge groups. Tle 3-15 summrizes the totl liquid nd totl tpwter intke rtes for 1,758 mles nd 1,8 femles grouped into six ge ctegories (Hopkins nd Ellis, 198). The men nd 9th percentile totl tpwter intke vlues for dults over ge 18 yers re, respectively, 1.7 L/dy nd 1.87 L/dy, s determined y pooling dt for mles nd femles for the three dult ge rnges in Tle This clcultion ssumes, s does Tle 3-14 nd 3-15, tht the underlying distriution is norml nd not lognorml. The dvntge of using these dt is tht the responses were not generted on recll sis, ut y recording dily intke in diries. The ltter pproch my result in more ccurte responses eing generted. Also, the use of totl liquid nd totl tpwter ws well defined in this study. However, the reltively short-term nture of the survey mke extrpoltion to long-term consumption ptterns difficult. Also, these dt were sed on the popultion of Gret Britin nd not the United Sttes. Drinking ptterns my differ mong these popultions s result of vrying wether conditions nd socio-economic fctors. For these resons this study is not considered key study in this document. Interntionl Commission on Rdiologicl Protection (ICRP) (1981) - Report to the Tsk Group on Reference Mn - Dt on fluid intke levels hve lso een summrized y the Interntionl Commission on Rdiologicl Protection (ICRP) in the Report of the Tsk Group on Reference Mn (ICRP, 1981). These intke levels for dults nd children re summrized in Tle The mount of drinking wter (tpwter nd wter-sed drinks) consumed y dults rnged from out.37 L/dy to out 2.18 L/dy under "norml" conditions. The levels for children rnged from.54 to.79 L/dy. Becuse the popultions, survey design, nd intke ctegories re not clerly defined, this study hs limited usefulness in developing recommended intke rtes for use in exposure ssessment. It is reported here s relevnt study ecuse the findings, lthough poorly defined, re consistent with the results of other studies. Pge Exposure Fctors Hndook 3-1 August 1997

12 Exposure Fctors Hndook Pge August Beverge Men Intke Approx. Std. Error of Men Tle Intke of Totl Liquid, Totl Tpwter, nd Vrious Beverges (L/dy) All Individuls Consumers Only Approx. 95% Confidence Intervl for Men 1 nd 9 Percentiles 1 nd 99 Percentiles Percentge of Totl Numer of Individuls Men Intke Approx. Std. Error of Men Approx. 95% Confidence Intervl for Men Totl Liquid Totl Liquid Home Totl Liquid Awy Totl Tpwter Totl Tpwter Home Totl Tpwter Awy Te Coffee Other Hot Wter Drinks Cold Wter Fruit Drinks Non Tpwter Home-rew Bought Alcoholic Beverges Consumers only is defined s only those individuls who reported consuming the everge during the survey period. Source: Hopkin nd Ellis, 198. Chpter 3 - Drinking Wter Intke Volume I - Generl Fctors

13 Pge Exposure Fctors Hndook 3-12 August 1997 Beverge Totl Liquid Intke Totl Tpwter Intke Age Group (yers) Source: Hopkin nd Ellis, 198. Tle Summry of Totl Liquid nd Totl Tpwter Intke for Mles nd Femles (L/dy) Numer Men Intke Approx. Std. Error of Men Approx 95% Confidence Intervl for Men 1 nd 9 Percentiles Mle Femle Mle Femle Mle Femle Mle Femle Mle Femle Chpter 3 - Drinking Wter Intke Volume I - Generl Fctors

14 Volume I - Generl Fctors Chpter 3 - Drinking Wter Intke Tle Mesured Fluid Intkes (ml/dy) Suject Totl Fluids Milk Tpwter Wter-Bsed Drinks Adults ("norml" conditions) Adults (high environmentl temperture to 32EC) ± SD = 9 Adults (modertely ctive) 37 Children (5-14 yr) c. 2 c Includes te, coffee, soft drinks, eer, cider, wine, etc. "Norml" conditions refer to typicl environmentl temperture nd ctivity levels. Source: ICRP, Gillies nd Pulin (1983) - Vriility of Minerl Intkes from Drinking Wter - Gillies nd Pulin (1983) conducted study to evlute vriility of minerl intke from drinking wter. A study popultion of 19 dults (75 femles; 34 mles) rnging in ge from 16 to 8 yers (men ge = 44 yers) in New Zelnd ws sked to collect duplicte smples of wter consumed directly from the tp or used in everge preprtion during 24-hour period. Prticipnts were sked to collect the smples on dy when ll of the wter consumed would e from their own home. Individuls were selected sed on their willingness to prticipte nd their ility to comprehend the collection procedures. The men totl tpwter intke rte for this popultion ws 1.25 (±.39) L/dy, nd the 9th percentile rte ws 1.9 L/dy. The medin totl tpwter intke rte (1.26 L/dy) ws very similr to the men intke rte (Gillies nd Pulin, 1983). The reported rnge ws.26 to 2.8 L/dy. The dvntge of these dt re tht they were generted using duplicte smpling techniques. Becuse this pproch is more ojective thn recll methods, it my result in more ccurte response. However, these dt re sed on short-term survey tht my not e representtive of long-term ehvior, the popultion surveyed is smll nd the procedures for selecting the survey popultion were not designed to e representtive of the New Zelnd popultion, nd the results my not e pplicle to the United Sttes. For these resons the study is not regrded s key study in this document. Pennington (1983) - Revision of the Totl Diet Study Food List nd Diets - Bsed on dt from the U.S. Food nd Drug Administrtion's (FDA's) Totl Diet Study, Pennington (1983) reported verge intke rtes for vrious foods nd everges for five ge groups of the popultion. The Totl Diet Study is conducted nnully to monitor the nutrient nd contminnt content of the U.S. food supply nd to evlute trends in consumption. Representtive diets were developed sed on 24-hour recll nd 2-dy diry dt from the U.S. Deprtment of Agriculture (USDA) Ntionwide Food Consumption Survey (NFCS) nd 24-hour recll dt from the Second Ntionl Helth nd Nutrition Exmintion Survey (NHANES II). The numer of prticipnts in NFCS nd NHANES II ws pproximtely 3, nd 2,, respectively. The diets were developed to "pproximte 9 percent or more of the weight of the foods usully consumed" (Pennington, 1983). The source of wter (ottled wter s distinguished from tpwter) ws not stted in the Pennington study. For the purposes of this report, the consumption rtes for the food ctegories defined y Pennington (1983) were used to clculte totl fluid nd totl wter intke rtes for five ge groups. Totl wter includes wter, te, coffee, soft drinks, nd soups nd frozen juices tht re reconstituted with wter. Reconstituted soups were ssumed to e composed of 5 percent wter, nd juices were ssumed to contin 75 percent wter. Totl fluids include totl wter in ddition to milk, redy-to-use infnt formul, milk-sed soups, cronted soft drinks, lcoholic everges, nd cnned fruit juices. These intke rtes re presented in Tle Bsed on the verge intke rtes for totl wter for the two dult ge groups, 1.4 nd 1.26 L/dy, the verge dult intke rte is out 1.15 L/dy. These rtes should e more representtive of the mount of source-specific wter consumed thn re totl fluid intke rtes. Becuse this study ws designed to mesure food intke, nd it used oth USDA 1978 dt nd NHANES II dt, there ws not necessrily systemtic ttempt to define tpwter intke per se, s distinguished from ottled Exposure Fctors Hndook Pge August

15 Volume I - Generl Fctors Chpter 3 - Drinking Wter Intke wter. For this reson, it is not considered key tpwter study in this document. Tle Intke Rtes of Totl Fluids nd Totl Tpwter y Age Group Averge Dily Consumption Rte (L/dy) Age Group Totl Fluids Totl Tpwter 6-11 months 2 yers yers 25-3 yers 6-65 yers Includes milk, "redy-to-use" formul, milk-sed soup, cronted sod, lcoholic everges, cnned juices, wter, coffee, te, reconstituted juices, nd reconstituted soups. Does not include reconstituted infnt formul. Includes wter, coffee, te, reconstituted juices, nd reconstituted soups. Source: Derived from Pennington, U.S. EPA (1984) - An Estimtion of the Dily Averge Food Intke y Age nd Sex for Use in Assessing the Rdionuclide Intke of the Generl Popultion - Using dt collected y USDA in the NFCS, U.S. EPA (1984) determined dily food nd everge intke levels y ge to e used in ssessing rdionuclide intke through food consumption. Tpwter, wter-sed drinks, nd soups were identified suctegories of the totl everge ctegory. Dily intke rtes for tpwter, wter-sed drinks, soup, nd totl everge re presented in Tle As seen in Tle 3-18, men tpwter intke for different dult ge groups (ge 2 yers nd older) rnged from.62 to.76 L/dy, wter-sed drinks intke rnged from.34 to.69 L/dy, soup intke rnged from.3 to.6 L/dy, nd men totl everge intke levels rnged from 1.48 to 1.73 L/dy. Totl tpwter intke rtes were estimted y comining the verge dily intkes of tpwter, wter-sed drinks, nd soups for ech ge group. For dults (ges 2 yers nd older), men totl tpwter intke rtes rnge from 1.4 to 1.47 L/dy, nd for children (ges <1 to 19 yers), men intke rtes rnge from.19 to.9 L/dy. These intke rtes do not include reconstituted infnt formul. The totl tpwter intke rtes, derived y comining dt on tpwter, wter-sed drinks, nd soup should e more representtive of sourcespecific drinking wter intke thn the totl everge intke rtes reported in this study. These intke rtes re sed on the sme USDA NFCS dt used in Ershow nd Cntor (1989). Therefore, the dt limittions discussed previously lso pply to this study. Cntor et l. (1987) - Bldder Cncer, Drinknig Wter Source, nd Tpwter Consumption - The Ntionl Cncer Institute (NCI), in popultion-sed, cse control study investigting the possile reltionship etween ldder cncer nd drinking wter, interviewed pproximtely 8, dult white individuls, 21 to 84 yers of ge (2,85 cses nd 5,258 controls) in their homes, using stndrdized questionnire (Cntor et l., 1987). The cses nd controls resided in one of five metropolitn res (Atlnt, Detroit, New Orlens, Sn Tle Men nd Stndrd Error for the Dily Intke of Beverges nd Tpwter y Age Age (yers) Tpwter Intke Wter-Bsed Drinks Soups Totl Beverge Intke (ml) (ml) (ml) (ml) All ges ± ± ± ± 13.7 Under ± ± ± ± to ± ± ± ± to ± ± ± ± to ± ± ± ± to ± ± ± ± to ± ± ± ± to ± ± ± ± to ± ± ± ± to ± ± ± ± nd over ± ± ± ± 32.8 Includes wter-sed drinks such s coffee, etc. Reconstituted infnt formul does not pper to e included in this group. Includes tpwter nd wter-sed drinks such s coffee, te, soups, nd other drinks such s soft drinks, fruitdes, nd lcoholic drinks. Source: U.S. EPA, Pge Exposure Fctors Hndook 3-14 August 1997

16 Volume I - Generl Fctors Chpter 3 - Drinking Wter Intke Frncisco, nd Settle) nd five Sttes (Connecticut, Iow, surfce versus groundwter since lrge frction (24 New Jersey, New Mexico, nd Uth). The individuls percent) of municipl wter intke in this survey could not interviewed were sked to recll the level of intke of e specificlly ttriuted to either ground or surfce wter. tpwter nd other everges in typicl week during the winter prior to the interview. Totl everge intke ws divided into the following two components: 1) everges Tle Averge Totl Tpwter Intke Rte y Sex Age, nd Geogrphic Are derived from tpwter; nd 2) everges from other Averge Totl Numer of Tpwter Intke,, sources. Tpwter used in cooking foods nd in ice cues Group/Sugroup Respondents L/dy ws pprently not considered. Prticipnts lso supplied Totl group 5, informtion on the primry source of the wter consumed Sex (i.e., privte well, community supply, ottled wter, etc.). Mles 3, The control popultion ws rndomly selected from the Femles 1, Age, yers generl popultion nd frequency mtched to the ldder cncer cse popultion in terms of ge, sex, nd geogrphic , loction of residence. The cse popultion consisted of , Geogrphic re Whites only, hd no people under the ge of 21 yers nd Atlnt percent were over the ge of 65 yers. The fluid intke Connecticut rtes for the ldder cncer cses were not used ecuse Detroit their prticiption in the study ws sed on selection Iow New Jersey 1, fctors tht could is the intke estimtes for the generl New Mexico popultion. Bsed on responses from 5,258 White controls New Orlens (3,892 mles; 1,366 femles), verge tpwter intke rtes Sn Frncisco Settle for "typicl" week were compiled y sex, ge group, nd Uth geogrphic region. These rtes re listed in Tle Stndrd devitions not reported in Cntor et l. (1987). The verge totl fluid intke rte ws 2.1 L/dy for men Totl tpwter defined s ll wter nd everges derived from of which 7 percent (1.4 L/dy) ws derived from tpwter, tpwter. nd 1.72 L/dy for women of which 79 percent (1.35 L/dy) Source: Cntor et l., ws derived from tpwter. Frequency distriution dt for the 5,81 controls, for which the uthors hd informtion on oth tpwter consumption nd cigrette smoking hits, re presented in Tle 3-2. These dt follow lognorml Tle 3-2. Frequency Distriution of Totl Tpwter Intke Rtes distriution hving n verge vlue of 1.3 L/dy nd n upper 9th percentile vlue of pproximtely 2.4 L/dy. Consumption Rte (L/dy) Frequency (%) Cumultive Frequency (%) These vlues were determined y grphiclly interpolting # the dt of Tle 3-2 fter plotting it on log proility grph pper. These vlues represent the usul level of intke for this popultion of dults in the winter. $ A limittion ssocited with this dt set is tht the popultion surveyed ws older thn the generl popultion Represents consumption of tpwter nd everges derived from nd consisted exclusively of Whites. Also, the intke dt tpwter in "typicl" winter week. Extrcted from Tle 3 in Cntor et l. (1987). re sed on recll of ehvior from the winter previous to the interview. Extrpoltion to other sesons nd intke Source: Cntor, et l., durtions is difficult. The uthors presented dt on person-yers of residence with vrious types of wter supply sources AIHC (1994) - Exposure Fctors Hndook - The (municipl versus privte, chlorinted versus Exposure Fctors Sourceook (AIHC, 1994) presented nonchlorinted, nd surfce versus well wter). Unfortuntely, these dt cn not e used to drw conclusions out the Ntionl verge pportionment of Exposure Fctors Hndook Pge August

17 Volume I - Generl Fctors Chpter 3 - Drinking Wter Intke drinking wter intke rte recommendtions for dults. Although AIHC (1994) provided little informtion on the studies used to derive men nd upper percentile recommendtions, the references indicte tht severl of the studies used were the sme s ones ctegorized s relevnt studies in this hndook. The men dult drinking wter recommendtions in AIHC (1994) nd this hndook re in greement. However, the upper percentile vlue recommended y AIHC (1994) (2. L/dy) is slightly lower thn tht recommended y this hndook (2.4 L/dy). Bsed on dt provided y Ershow nd Cntor (1989), 2. L/dy corresponds to only pproximtely the 84th percentile of the drinking wter intke rte distriution. Thus, slightly higher vlue is pproprite for representing the upper percentile (i.e., 9 to 95th percentile) of the distriution. AIHC (1994) lso presents simulted distriutions of drinking wter intke sed on Roseerry nd Burmster (1992). These distriutions re lso descried in detil in Section 3.2 of this hndook. AIHC (1994) hs een clssified s relevnt rther thn key study ecuse it is not the primry source for the dt used to mke recommendtions for this document. USDA (1995) - Food nd Nutrient Intkes y Individuls in the United Sttes, 1 Dy, USDA (1995) collected dt on the quntity of "plin drinking wter" nd vrious other everges consumed y individuls in 1 dy during 1989 through The dt were collected s prt of USDA's Continuing Survey of Food Intkes y Individuls (CSFII). The dt used to estimte men per cpit intke rtes comined one-dy dietry recll dt from 3 survey yers: 1989, 199, nd 1991 during which 15,128 individuls supplied one-dy intke dt. Individuls from ll income levels in the 48 conterminous sttes nd Wshington D.C. were included in the smple. A complex three-stge smpling design ws employed nd the overll response rte for the study ws 58 percent. To minimize the ising effects of the low response rte nd djust for the sesonlity, series of weighting fctors ws incorported into the dt nlysis. The intke rtes sed on this study re presented in Tle Tle 3-21 includes dt for: ) "plin drinking wter", which might e ssumed to men tpwter directly Sex nd Age (yers) Mles nd Femles: Under & Under Mles: nd over 2 nd over Femles: nd over 2 nd over Tle 3-21 Men Per Cpit Drinking Wter Intke Bsed on USDA, CSFII Dt From (ml/dy) Plin Drinking Wter Coffee Te < < Fruit Drinks nd Ades All individuls ,15 Includes regulr nd low clorie fruit drinks, punches, nd des, including those mde from powdered mix nd frozen concentrte. Excludes fruit juices nd cronted drinks. Source: USDA, Totl ,247 1,386 1,481 1,525 1,61 1,414 1,295 1, ,74 1,244 1,43 1,431 1,418 1,291 1,38 1,288 Pge Exposure Fctors Hndook 3-16 August 1997

18 Volume I - Generl Fctors Chpter 3 - Drinking Wter Intke consumed rther thn ottled wter; ) coffee nd te, For oth individuls who drnk tpwter nd which might e ssumed to e constituted from tpwter; individuls who drnk juices reconstituted with tpwter, nd 3) fruit drinks nd des, which might e ssumed to e the numer of glsses rnged from 1 to 2. The highest reconstituted from tpwter rther thn cnned products; percentge of the popultion (37.1 percent) who drnk nd 4) the totl of the three sources. With these tpwter consumed 3-5 glsses nd the highest percentge ssumptions, the men per cpit totl intke of wter is of the popultion (51.5 percent) who consumed juice estimted to e 1,416 ml/dy for dult mles (i.e., 2 yers reconstituted with tpwter drnk 1-2 glsses. Bsed on the of ge nd older), 1,288 ml/dy for dult femles (i.e., 2 ssumption tht ech glss contined 8 ounces of wter yers of ge nd older) nd 1,15 ml/dy for ll ges nd (226.4 ml), the totl volume of tpwter nd juice with oth sexes comined. Although these ssumptions pper tpwter consumed would rnge from.23 L/dy (1 glss) resonle, close reding of the definitions used y USDA to 4.5 L/dy (2 glsses) for respondents who drnk (1995) revels tht the word tpwter does not occur, nd tpwter. Using the sme ssumption, the volume of this uncertinty prevents the use of this study s key study tpwter consumed for the popultion who consumed 3-5 of tpwter intke. glsses would e.68 L/dy to 1.13 L/dy nd the volume The dvntges of using these dt re tht; 1) the of juice with tpwter consumed for the popultion who survey hd lrge smple size; 2) the uthors ttempted to consumed 1-2 glsses would e.23 L/dy to.46 L/dy. represent the generl United Sttes popultion y Assuming tht the verge individul consumes 3-5 glsses oversmpling low-income groups nd y weighting the dt of tpwter plus 1-2 glsses of juice with tpwter, the to compenste for low response rtes; nd 3) it reflects rnge of totl tpwter intke for this individul would more recent intke dt thn the key studies. The rnge from.9 L/dy to 1.64 L/dy. These vlues re disdvntges re tht: 1) the response rte ws low; 2) the consistent with the verge intke rtes oserved in other word tpwter ws not defined nd the ssumptions tht studies. must e used in order to compre the dt with the other The dvntges of NHAPS is tht the dt were tpwter studies might not e vlid; 3) the dt collection collected for lrge numer of individuls nd tht the dt period reflects only one-dy intke period, nd my not re representtive of the U.S. popultion. However, reflect long-term drinking wter intke ptterns; nd 4) dt evlution of drinking wter intke rtes ws not the on the percentiles of the distriution of intkes were not primry purpose of the study nd the dt do not reflect the given. totl volume of tpwter consumed. However, using the Tsng nd Klepeis (1996) - Ntionl Humn Activity Pttern Survey (NHAPS) - The U.S. EPA collected informtion on the numer of glsses of drinking wter nd ssumptions descried ove, the estimted drinking wter intke rtes from this study re within the sme rnges oserved for other drinking wter studies. juice reconstituted with tpwter consumed y the generl popultion s prt of the Ntionl Humn Activity Pttern Survey (Tsng nd Klepeis, 1996). NHAPS ws conducted 3.4. PREGNANT AND LACTATING WOMEN Ershow et l. (1991) - Intke of Tpwter nd etween Octoer 1992 nd Septemer Over 9, Totl Wter y Pregnnt nd Lctting Women - Ershow individuls in the 48 contiguous United Sttes provided dt et l. (1991) used dt from the USDA NFCS to on the durtion nd frequency of selected ctivities nd the estimte totl fluid nd totl tpwter intke mong time spent in selected microenvironments vi 24-hour pregnnt nd lctting women (ges yers). Dt for diries. Over 4, NHAPS respondents lso provided 188 pregnnt women, 77 lctting women, nd 6,21 noninformtion of the numer of 8-ounce glsses of wter nd pregnnt, non-lctting control women were evluted. The the numer of 8-ounce glsses of juice reconstituted with prticipnts were interviewed sed on 24 hour recll, nd wter thn they drnk during the 24-hour survey period then sked to record food diry for the next 2 dys. (Tles 3-22 nd 3-23). The medin numer of glsses of "Tpwter" included tpwter consumed directly s tpwter consumed ws 1-2 nd the medin numer of everge nd tpwter used to prepre food nd tpwterglsses of juice with tpwter consumed ws 1-2. sed everges. "Totl wter" ws defined s ll wter from tpwter nd non-tpwter sources, including wter contined in food. Estimted totl fluid nd totl tpwter intke rtes for the three groups re Exposure Fctors Hndook Pge August