Guest Columnists

How clean water protects public health


In recent years, Iowa has been building a culture of health through efforts like the Healthiest State Initiative and community-level Blue Zones Iowa, both which seek to make the healthy choice the easy choice. State and local public health departments are engaging multiple partners across sectors through these and other initiatives to improve the health and well-being of our communities, helping to make Iowa an even more desirable place to live, work and raise a family. Behavior-change is never easy, but Iowans across our state are pulling in the same direction to improve public health.

Water, a natural resource on which we all depend for our survival, has a profound influence on health. For over 50 years, we’ve known that elevated levels of nitrate in water used for baby formula can cause methemoglobinemia, or blue-baby syndrome, a serious, potentially fatal condition that decreases the blood’s ability to carry vital oxygen through the body. Thanks to U.S. EPA drinking water standards for nitrates enacted in the 1960s, blue-baby syndrome is rare. However, research conducted here in Iowa and worldwide indicates the health risks associated with consumption of nitrate in drinking water may extend beyond blue-baby syndrome.

The Iowa Environmental Council has just released a report, “Nitrate in Drinking Water: A Public Health Concern for All Iowans” that reviews some of the most concerning research findings on nitrate pollution and health. The report focuses on adverse health outcomes that multiple studies conducted here in Iowa and abroad have associated with nitrate from drinking water, including birth defects, bladder cancer and thyroid cancer. Many of the research projects gathered detailed information on large cohorts, or study groups, followed over years or even decades.

Most of the problems have been found when nitrate levels are higher than the drinking water standard, though some research suggests that long-term exposure to nitrate concentrations below the drinking water standard may be harmful. Iowans are particularly vulnerable to the potential health impacts from nitrate pollution because nitrate concentrations in our streams and groundwater rank among the highest in the country, according to the U.S. Geological Survey. This makes it increasingly important for us to come together to protect and improve our shared, precious water resources.

Many Iowans are aware that high levels of nitrate are a problem for the drinking water in Des Moines, leading the Des Moines Water Works to file a lawsuit against three drainage districts that are contributing to the problem. But nitrate pollution is not just a central Iowa problem: Elevated nitrate are a persistent problem for public water supplies and private wells across the state

While more research will better specify the health risks of nitrate exposure, the potential concerns for nitrate in drinking water provide compelling reasons to act now to reduce pollution. Solving these problems will take time. Iowa’s Nutrient Reduction Strategy (INRS) is a valuable “toolbox” that is starting to guide implementation of a science-based initiative to prevent and treat nitrate (and phosphorus) pollution. With substantial, sustainable funding and an accountable watershed-based approach that brings urban and rural communities together to find solutions, we can have cleaner, safer water.

Iowa’s public health professionals have long been inspired by the metaphor of old-fashioned barn raising, where neighbors helped each other, and in the process, built community. Iowa’s history of coming together to do cooperatively what we cannot easily accomplish independently is a proud part of our values and culture. As Iowans, we also collectively share the value of health: the health of our children, communities and our economy.


These basic values of cooperation and health can be galvanizing forces, bringing us together to assure that all Iowans have safe, affordable drinking water. Doing so will benefit the health and well-being of our families, neighbors and those downstream.

• Ann Robinson, agricultural policy specialist at the Iowa Environmental Council, works to promote conservation and water quality. Jeneane Moody, executive director of the Iowa Public Health Association, works to connect and convene individuals and organizations to collaborate for health. More information:

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