Public Health Bulletin Water and Public Health Volume 4, Number 2, July 2007 Guest Editorial David Cunliffe Principal Water Quality Adviser South Australian Department of Health Safe water is essential for life. This issue of the Public Health Bulletin deals with a broad range of issues relating to the benefits of safe water, the harm of unsafe water and the pressures imposed by climate variations. Water is associated with two of the ten great public health achievements of the 20th century identified by the US Centres for Disease Control and Prevention. 1 The first was the contribution of safe drinking water to the ‘epidemiological transition’ away from infectious disease mortality in much of the developed world. Drinking water treatment and disinfection was the largest contributor to the completion of the transition in the first half of the 20th century. The importance of safe water is illustrated by the high mortality from infectious diseases in the developing world, where 1.8 million people die each year from diarrhoeal illness largely attributed to unsafe water and poor sanitation. Safe water supports a longer life spent in improved health and also supports improved productivity and higher standards of living. The second achievement was fluoridation. Drinking water fluoridation remains the most effective and socially equitable means of delivering the caries-preventive impact of fluoride to all sectors of the community. While safe drinking water provides substantial benefits it should not be taken for granted, as the potential for harm remains. Drinking water disease outbreaks still occur regularly in developed countries with some involving deaths. In 2003–2004 there were 30 outbreaks identified in the United States. 2 Safe recreational waters also have substantial benefits and play an important role in Australia’s lifestyle. Yet there is also a potential for harm associated with coastal waters and rivers. Again in the United States in 2003–2004 there were 62 outbreaks of illness attributed to contaminated coastal waters. 2 The key to ensuring safety is an awareness of public health risks. This is the first step in developing mechanisms to reduce and control those risks. Hence it is important to be aware of risks posed by contamination of drinking water > South Australia ISSN 1449–485X Contents Public health benefits of safe drinking water 1 Using health risk assessment in the development of guidelines for recreational coastal waters 4 Water as a basic human right: Striving for equity in remote, rural and Indigenous South Australian water supplies 6 Water recycling in South Australia: Overview from a public health perspective 9 How safe is rainwater consumption? 11 Bottled water: Some health considerations 13 Water fluoridation 17 The drought: What does it mean for water quality in the River Murray? 21 Climate change and water-borne diseases 23 Blue-green algae: Toxicity and public health significance 25 An investigation of mosquito communities in northern South Australia 29 Legionella and warm water system management 34 Communicable Disease Control Branch Report 1 January to 31 March 2007 36