by Debra Sass

It turns out that society is willing to pay about $6.1 million for the chance to save one life.

Even though that's one statistical life they're saving, it's just those types of faceless statistics that form the basis of the U.S. Environmental Agency's process when developing new standards for drinking water. Willingness to pay, along with myriad other social and scientific factors come into play when EPA sets limits for allowable level of contaminants in drinking water.

The standard setting process, first formalized by the U.S. Safe Drinking Water Act (SDWA) in 1974 and most recently amended in 1996, recognizes that the best-of-all-possible-worlds—where life is priceless and zero risk resides—may not be possible. This allows scientific, economic, and technological considerations to be factored into drinking water regulations.

The link between water and health has been recognized for centuries. Methods for treating drinking water have been traced to 15th century BC where information was found written on Egyptian walls.

"While some might argue for a policy of greater health protection that comes with standards that don't consider cost in the equation, the Legislature has decided otherwise in crafting a statutory framework in which we set standards," explains Dave Spath, Chief of the Drinking Water Division and Environmental Management for the California Department of Health Services (DHS). "The Legislature has said that it is appropriate public policy to consider costs as well as benefits."

Until the SDWA, there were no consistent standards for public drinking water nationwide; requirements varied from state to state. Today, EPA administers the SDWA. States can develop and implement their own safe drinking water programs with the federal standards as their baseline. California is one of the states that have adopted standards stricter than the federal rules.

"There is no question that drinking water quality has improved since the turn of the century when waterborne disease caused widespread epidemics," said Ephraim King, Director of the Standards and Risk Management Division in EPA's Office of Groundwater and Drinking Water. "With the establishment of public water systems, new treatment technologies and more research, we have made tremendous strides in public health protection."

In 1996 some elements of the SDWA were modified and an entirely new step added to the standard setting process. For all future drinking water standards, EPA is required to conduct a cost-benefit analysis to see whether the costs of a new standard are justified bygains in public health. If not, a proposed standard may be adjusted to achieve that cost-benefit balance.

California's Department of Health Services follows a similar process in establishing new regulations.

"We define the best available technology and then try to assess the cost to treat to various levels, beginning with a level at which the risk is considered insignificant and working up from there," explains Spath. "We look at cost factors including the capital cost of treatment, operation and maintenance costs and other considerations such as the cost to purchase land for new facilities and the administrative costs for hiring additional personnel to run these operations. Then we look at the benefits side and consider the health benefits of setting a standard at a level where there would be no expected health risks as well as a range of other less stringent levels."

Once EPA decides to regulate a new contaminant it must issue a final national primary drinking water regulation within 3½ years. Primary drinking water standards are for contaminants that may be unhealthy at certain levels such as nitrates, arsenic and chromium. There are also secondary standards for contaminants that affect the appearance, taste and smell of water. They include corrosivity, copper, iron and zinc.

In establishing a new regulation, the EPA sets a Maximum Contaminant Level Goal (MCLG) after reviewing health effects studies.

The MCLG is the level of a contaminant in drinking water at which no known or anticipated adverse effect on health would occur, coupled with a considerable margin for safety. The state counterpart of the MCLG is a Public Health Goal or PHG. Neither the MCLG nor the PHG are enforceable. They focus only on health protection and do not consider the limits of detection and treatment technology, or cost.

The standard that is actually enforceable is called the Maximum Contaminant Level or MCL. State law requires MCLs be set as close to the MCLGs as feasible.

"Feasible is the operative word," explains Spath. "We are required to consider the technological and economic feasibility of compliance including the cost to the customer."

A majority of the money spent for compliance comes with the cost for installing and operating new treatment facilities.

An example where a PHG was the starting point for development of a standard is the chemical pesticide dibromochloropropane, which has contaminated hundreds of wells in the Central Valley. The PHG is 0.002 parts per billion and the standard is 0.2 parts per billion. Enforceable standards have to factor treatment technologies and affordability into the equation for public health protection.

Some public interest groups, like the California Public Interest Research Group (CALPIRG) would argue that drinking water standards should be set at the PHG level to be truly protective of even the most vulnerable in our population.

"If drinking water standards were set at the PHG levels, then we as a general public would be assured that the commitment to drinking water safety is being realized, but that's not happening now," explains Matt Shaffer, CALPIRG's Safe Drinking Water Advocate.

"It seems reprehensible to me that consumers in this country are at any given time afraid to drink water from the tap in their kitchens because we have not clearly identified all of the risks," he said.

Every year, water providers are required to produce and distribute an annual water quality report to show how their water supplies measure up to state and federal requirements for drinking water. Metropolitan, as well as most other water agencies, has to have this report prepared by July 1 every year.

"EPA absolutely does not ascribe a dollar value to human life," said King. "When we go through a cost-benefit analysis, we ask the question, "What is the public willing to pay to reduce the risk of illness or death from exposure to a contaminant?"

The answer is provided by EPA's National Center for Environmental Economics (NCEE), under the direction of Al McGartland.

NCEE's "Guidelines for Preparing Economic Analysis," published in 2000, explains how to estimate what society is willing to pay to reduce risk from contaminants.

It states: "EPA policies may reduce the risk of premature death, typically measured as the number of statistical lives 'saved' as a result of the policy action. The benefit of these risk reductions are usually measured as using the concept of the value of a statistical life.

"If 10,000 individuals are each willing to pay, for example, $500 for reduction in a risk of one in ten thousand , then the value of saving one statistical life equals $500 multiplied by 10,000—or $5 million. This does not mean that any identifiable life is valued at this amount, but rather that the aggregate value of reducing a collection of small individual risks is worth $5 million in this case."

To arrive at a dollar value for reducing risk, EPA drew from 26 existing studies that used well-established and respected methods to come up with a median value—$6.1 million in 2001 dollars.

"The real thing that we are valuing are very small changes in risk reduction," McGartland explains. "We are trying to ask the question: Are households willing to pay the costs of this regulation for the risk reductions that are achieved?"

Some are uncomfortable with using a mathematical equation to determine public health standards and allege that factors other than science are used.

"It's always a challenge to find ways to get politics out of a numerical standard," said CALPRIG's Shaffer. "It's frightening to see games played with our health."

There is no clearer example of social values and science influencing the standard-setting process than the current debate concerning arsenic.

The concern with arsenic is that high levels have been linked to greater incidences of bladder, lung and kidney cancers.

In the closing days of the Clinton administration, the arsenic standard for water was lowered from 50 parts per billion (ppb) to 10 ppb—coming in higher than the environmental community advocated at 3 ppb and lower than some impacted water agencies had hoped for. The new EPA administration felt that more time was needed to develop a standard and called for additional research.

Spath, who this year chairs EPA's National Drinking Water Advisory Council which provides policy guidance to the agency, has no predictions for where the arsenic debate will end.

According to New York Times columnist Gina Kolata ("Putting a Price Tag on the Priceless;" April 8, 2001), the EPA estimated that a standard at 10 ppb would prevent between 37 to 56 cases of bladder and lung cancer every year and 21 to 30 deaths.

By comparison, if the level were set at 5 ppb, 51 to 100 bladder and lung cases, and 29 to 54 deaths would be prevented, but the cost for treatment would be more than double the cost required to treat for 10 ppb (which was estimated at $32 per household per year).

"EPA can't show you anyone who has gotten cancer from trace amounts of arsenic in the water supply," argues Washington Times columnist Kenneth D. Smith ("Science Can Wait;" March 29, 2001). "But the money spent preventing these imaginary cancers won't be available to prevent real cancers. That $5 billion happens to be more than the government now spends on breast and prostate cancer prevention."

By contrast, CALPIRG's Matt Shaffer wonders why regulators don't take the safest route and go with the lowest standard possible.

"We have not only dragged our feet for so long to set an adequate (arsenic) standard, but we continue to play these political games that put the health of consumers at further risk," Shaffer says. "It baffles me that regulators respond to the cries of cost burden by weakening standards rather than pursue the money to get the needed treatment."

Echoes of this same debate can be heard in reference to chromium 6, a presently unregulated contaminant that popped up unexpectedly on the public radar. Until there is enough time for good science to be developed to create a new standard, the state is working towards establishing an interim standard.

King said EPA plans to make a final decision on how to proceed as quickly as possible after receiving reports due this August from three expert panels that include the National Academy of Science.

"I wish that the scientific research process could move faster, be less expensive and provide a greater degree of certainty than sometimes appears," King said "But that is the reality of scientific research."

The scientific process has its own life cycle that is far different from ours. Where the two intersect is the point at which theory becomes personal and guidelines reveal their limitations.

View the "Annual Water Quality Report", http://www.mwdh2o.com/mwdh2o/pages/yourwater/ccr/ccr01.html.

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