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on September 4, 2007
In my life I have drunk water from a lot of sources. At one point when I was a teenager we discovered water bugs flowing out of a tap in Arizona! We were drinking nearly untreated river water! From then on my mother added chlorine to our drinking water and her treatment was worse than any city supply! I have drunk water from a spring in the mountains (delicious I must say) and (using a filter) from Mexican city taps. So far I am still here, but the message of the "The Blue Death: Disease, Disaster, and the Water we Drink" by Robert D. Morris, is that I have been very lucky.

Water is an absolute necessity and the modern water treatment plant is our defense, however tenuous, against epidemic diarrheal disorders, including the granddaddy of them all- cholera. Still diarrheal diseases are one of the major killers worldwide, ranking with malaria and AIDS. It is especially hard on children. We in the developed world have become so used to having a "safe" water supply that we don't even think about it. But safe water is one of the many unexciting aspects of necessary infrastructure (like bridges and levees) that are closer to the breaking point than any of us want to contemplate. Morris (who is a medical researcher and teacher) has done us all a great favor by pointing out the precarious position that we are all in.

He starts with the history of the famous removal of the Broad Street pump handle in London in the mid 1850s. This removal apparently stopped an epidemic of cholera cold. He points out that even this step was controversial, with "sanitarians" not convinced of the connection between water and disease. Microorganisms had yet to be directly connected to disease in humans and many thought the problem lay in the miasmas the emanated from the swamps, sewers and cesspools in and around the city. The sanitarians solution was to wash all the waste into the river, thus creating more epidemics of diarrheal diseases, including cholera.

We have come a long way since the days of the Broad Street pump, but only in the developed world. In most of the planet, drinking water is not safe and in some places, such as the war-torn Congo, drinking any but bottled water may be a death sentence. Even bottled water, as Morris points out, is not safe as there are no standards and some is simply high priced tap water. Beside, the plastic is dumped back into our landfills and its safe production takes more water than a bottle holds!

Morris has a number of recommendations that should be followed, if we are to secure our drinking water. He also points out that we ignore the Third World's water problems at our own peril, as diseases seldom stop at borders. This is a must read book for anybody who drinks the stuff - i.e. all of us!
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I get hit on a lot by authors and publishers, and one out of a hundred "leads" is actually worthwhile. This is such a lead. The author called me (the dumb ones send their stuff to create landfill) and I was absolutely interested in this topic. I list some other books below.

There are two bottom lines to this book:

1) Chlorine cannot kill all threats and causes its own damage. It specifically cannot kill cryptosporidium, which can quickly sicken tens of thousands and kill hundreds.

2) Your drinking water is not safe to drink, there are some things you can do, but on balance, the Nation needs a *major* campaign to salvage its entire drinking water and sewage treatment system.

I really, really, like this book. The author is gifted at presenting important information in an easy to understand and almost poetic manner. He really puts life into history, and urgency into current concerns.

I have a note: 5 stars. Truly EXCITING, gripping at every point.

He taught me the value of meta-analysis, and I am going to migrate that to the EarthGame that we are building with Medard Gabel, the brilliant cohort to Buckminster Fuller, whose forthcoming book, Seven Billion Billionaires, I strongly recommend.

Although I have read and strongly recommend Pandora's Poison: Chlorine, Health, and a New Environmental Strategy, the author does an excellent "snapshot" job of alerting us to the dangers of chlorine by pointing out that Chlorine Gas killed tens of thousands, and that as late as 1974 there was no real understanding of its pathologies, and as recently as 1996, there was no real program to address the many deficiencies of our drinking water supplyl.

I draw from this book early on the importance of NOT privatizing water services. Corporations seeking profit cut corners and are most definitely not interested in reducing the risk of death if it impacts on their bottom line. Throughout the book, one finds that BOTH the corporate sector AND the Environmental Protection Agency (EPA) are in a sympiotic relationship intended to increase profits, lower costs, and kill Americans lightly.

The book provides a number of eye-opening facts, a few of which I list here:

1) Cholera is unique to humans and so tests on animals yield nothing.
2) Safe water is not an end but a constant process.
3) Chicago "yards" are the ultimate poisoneer--manure into water is our death bell.
4) As of 1992, USA water distribution is a disaster waiting to happen.
5) Usefully documents how denial and incompetence increased the death tolls time and again, around the world. Hamburg took 33 years to finally realize that it MUST filter its water.
6) I now understand the value of Environemtnal Epidemiology and will try to factor that into the EarthGame. This author does a superb job of making statistics exciting and meaningful.
7) He tars the EPA and other US Government elements for consistently lying to the public for reasons of money and politics. He makes the case for HONEST SCIENCE. See The Republican War on Science
8) He documents the need for real-time data. I am a proponent of 114 and 119 numbers, and believe that all citizens should be able to call in medical symptoms to a central database, e.g. dial 114-D for diahrea, 114-V for vomit.
9) The author is utterly compelling in describing how very hard it is to track down waterborne diseases, this is literally the needle in the haystack problem, where one might find 10 oocysts in a litter of water--ten *transparent* oocysts.
10) Katrina shut down 1200 water treatment plants and 269 sewage treatment plants.
11) Drinking water distribution is every city's weak link; Al Qaeda has studied US water distribution systems (remember, Bin Laden was an engineer), and they KNOW that enough bags of manure into the system post-filtration will do a great deal of damage.
12) Home filtration systems are ESSENTIAL to guarding against contamination, and boiling water is ESSENTIAL at the first sign of a bio-chemical attack through the water distribution system.
13) The author provides a heart-rending account of how cholera killed 60,000 in Zaire in one week, with corpses piled up 2-3 deep along the road, and the feces from the weak survivors running down the hill into the lake to contaminate that water so that many more might die.
14) The USA has up to TEN MILLION cases of waterborne disease each year.
15) The inter-state and inter-agency process related to water (and I surmise, to every other topic) is completely broken.
16) Washington "action" is "a glacier on steroids."
17) 861 BILLIOIN gallons of SEWAGE go into US rivers in any given year.
18) Bottled water is not only NOT safer or cleaner than tap water, but it costs one thousand times as much, and the water needed to create the throw-away plastic bottle is GREATER than the water contained in the bottle.

The author ends rather quietly, suggesting that dialog, no secrets, and research are needed, and he provides several meritorious recommendations at the end, but I put the book down feeling that my best defense is localized resilience. Neither the federal nor the state not the local governments can be trusted. They have all been corrupted. Until the public realizes that it is drinking poisoned water, one is best off not drinking the water at all.

SUPERB BOOK!!!!! Bravo. See also:
The Health of Nations: Infectious Disease, Environmental Change, and Their Effects on National Security and Development
Betrayal of Trust: The Collapse of Global Public Health
Diet for a Small Planet
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on July 31, 2007
Morris is an extraordinary writer and storyteller turning what could be a dry (no pun intended) topic into a page turner that is tough to put down. He unfolds his case that water is a environmental issue we all should be seriously concerned about not just globally, but in our own back yards, with histical and real life stories that are fascinating and chilling. Add it to your summer reading list!
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on October 27, 2007
If you think your public water supply is safe because "THEY" are taking care of it, then think again. This book profiles the history of water borne diseases as well as Dr. Robert Morris's initial entry into the world of public water as a college researcher. Initially naively thinking that public health was the most important issue, he soon learns that ego, competing intersts, and the politics of "not raising taxes" are far more important to many politicians, public water works directors, and even the EPA, than the truth. He explains how ego, politics, money, lack of education, and just general organizational structures in city, regional, and national governments often mitigate against protecting the public health in regard to the drinking water supply. Real life examples of full scale water disasters in the city of Milwaukee, Walerton Ontario, and New Orleans should serve as a "wake up call" to many cities around the world.

Other important issues addressed include the fact that the target is always moving because the microbial world is constantly evolving and now new organisms have emerged which can survive chlorine treatment....such as in the case of Milwaukee. And yet public officials still refuse to change the standards after huge disasters like this.

The first half of the book includes the valuable background on the history of water born diseases such as cholora, and just how devastating the death toll was before researchers discovered the connection. While this first half of the book has a lot of valuable information, it's unfortuanately written in a dramatized historical novel style which I personally found annoying.

In spite of this style issue in the first half, the second half is so incredible that it competely over rides this minor issue, and takes this book to the top of my "must read" list. I give this book 4 Stars and HIGHLY recommend it. It should be mandatory reading for every public official as well as the public at large. No scare tactics or hype here, just the facts laid out for the average person to read and decide.
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on September 8, 2007
This book is absolutely a MUST read for all water utility employees, water board members, as well as local community, state and federal government officials. Dr. Morris captures the reader from the very beginning with his descriptive writing style and historic detail. His forthright approach to provide the truth is remarkably candid. There is no sugar-coating when Morris points his pen directly at the EPA for failing to immediately make public specific studies from the 1970's indicating a link between the use of chlorine and cancer. The negative role that politics and big business play in overall health issues and water quality is quite apparent, not only in America but worldwide. Every community in America (and especially Hawaii) should be concerned about their water source(s), water quality and utility management - concerned enough to demand well-educated water directors and alternatives to chemical treatment be researched, implemented and continually tested. Be proactive - buy a copy for your water director, Mayor and Governor today.
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on August 12, 2007
An absolutely engrossing read, this is a wonderful book that educates the reader with a fascinating history of water-borne diseases and mankind's quest for drinking water. This is one of the best nonfiction books I've read!
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on August 22, 2007
Reviewed by Barron H. Lerner in the Washington Post on Wednesday, August 22, 2007; along with another book: POISONED NATION: Pollution, Greed, and the Rise of Deadly Epidemics, by Loretta Schwartz-Nobel.

With all the recent talk about childhood obesity and juvenile diabetes, it is hard to remember that the modern public health movement began with the Great Sanitary Awakening of the mid-19th century. Reformers in England and elsewhere convincingly argued that the environment served as a major source of disease and needed to be cleaned up. Now two new books remind us that toxins and other waste products are producing new and frightening threats to public health. Like Al Gore's arguments about oil dependence and the ozone layer, these concerns are surely inconvenient. But are they also true?

The hero of Robert D. Morris's "The Blue Death" is John Snow, the British epidemiologist who proved in the 1850s that epidemic cholera was spread by waste products in drinking water. Snow reached his conclusions, which initially were mocked, decades before the discovery of the cholera bacillus. His work eventually led to the modern system of purifying tap water, which involves both filtering and treatment with chlorine.

But success has bred complacency, according to Morris. His book is full of examples of recent health problems traceable to inadequate supervision of our water supply. For instance, the majority of pipes that supply major urban centers -- including Washington -- are close to 100 years old and full of leaks that allow contamination. Morris puts into this broader context the now-familiar story of what happened in the District in 2004, when officials added phosphoric acid to the city's water system in an attempt to reduce lead levels and instead created a new headache by loosening a layer of slime and microorganisms, known as the biofilm, and flooding the system with bacteria. He also describes how a 1993 outbreak of diarrhea in Milwaukee was caused by cryptosporidium, an organism experts insisted could not be present.

Morris is no impartial observer. An epidemiologist who specializes in drinking water, he is the author of a controversial paper suggesting that chlorine might increase the rates of several cancers. Indeed, some of his narrative describes his David-like efforts to challenge the Goliaths of water, ranging from the Environmental Protection Agency to the drinking-water industry, which he suggests are cutting corners on water purification to save money.

Still, it is hard not to be sympathetic to Morris's claims, which rely in part on the same crack epidemiological detective work used by Snow 150 years ago. Indeed, I switched from tap to bottled water while reading his book (although Morris also warns that bottled water "is less closely regulated than tap water and is not required to meet stricter standards for purity").

Loretta Schwartz-Nobel is a journalist, not a scientist, but if anything her outrage is even greater than Morris's. In "Poisoned Nation," she describes a series of diseases, ranging from asthma to cancer, that she believes are on the rise due to pollution. Her book has a much more conspiratorial tone. She is largely uninterested in presenting both sides of the issues in question, even when defenders of the status quo are respected scientists and government agencies.

For example, she tells the now familiar story of how childhood vaccines containing the mercury additive thimerosal supposedly led to an enormous rise in cases of autism. Similarly, she charges that companies in the forefront of breast cancer awareness campaigns produce the very environmental toxins that cause the disease.

To be sure, Schwartz-Nobel is right when she points out how profits and politics led industry to conceal the potential dangers of mercury in tuna and other foods. Similarly, the breast cancer movement only recently has turned from a focus on mammography and chemotherapy to investigating the connection between toxic waste and cancer rates. And she tells compelling stories about individuals with autism and breast cancer whose diseases seem to have emerged just after a toxic exposure. One such person was Chris, a bright 2-year-old who, after a reaction to a vaccine, "could no longer concentrate on his books or anything else for more than a few seconds." Eventually, he was diagnosed as having severe learning disabilities.

But what does one do with this information when organizations such as the esteemed Institute of Medicine, one of the four U.S. National Academies, have found no association between thimerosal and autism? Or when the Long Island Breast Cancer Study did not find evidence that toxins were responsible for high rates of the disease? It is hard to accept, as Schwartz-Nobel apparently does, that the scientists involved in these studies make decisions based mostly on industrial connections and political pressure.

A big part of the problem, both books acknowledge, is the difficulty of achieving definitive scientific proof when trying to determine causes of disease outbreaks. Such studies, which rely on retrospective data and participants' recollections, are notoriously difficult to carry out.

So it is disappointing that neither book mentions the so-called precautionary principle, a moral and political argument often invoked by activists when there is no scientific consensus about potential harms. In this case, the principle would argue that society should err on the side of cleaning up possibly toxic environmental waste.

Rather than characterizing industry as villains, it is time for critics such as Morris and Schwartz-Nobel to enlist activists, government and business in constructive partnerships. But this effort will require engaging the public, which can then put pressure on politicians. In making this point, Schwartz-Nobel quotes longtime breast cancer activist Barbara Brenner: "We figured that if people really knew what was happening with the Cancer Industry, they would be furious."

Unfortunately, such anger has not yet materialized over breast cancer or other diseases with possible environmental causes. If, despite their limitations, these books alert the public to such environmental connections, they are doing a great service.
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on October 7, 2007
Blue Death reads like a mystery novel. I couldn't put it down and read it over the weekend. Beneath seemingly innocuous transparency, Dr Morris describes a labyrinth of potential danger inherent in our water sources. This book is a cogent and facscinating story of the complexity of securing the safety a vital element of human life and the habit of humans to ignore nature's inherent resistance to defeat. Anyone who has ever thought it might be a good a idea to put a filter on their tap should read this.
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on March 16, 2008
Engaging, enlightening -- could not put the book down. If you drink water you must educate yourself and read this book. Dr Morris weaves his points with medical research history and brings you to the present conclusion, our water is still not safe, millions still die each year from drinking it. His conclusions inspire you to do something about it locally and globally. Thank you for the references, too. I am inspired to read more about these topics and subtopics.
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on December 11, 2007
This book is a great read. It provides an interesting and exciting history of the search to find the cause of cholera. It then goes on to discuss the status of drinking water in the US up to the present. Dr. Morris provides science to the reader in the form of a fast moving novel. I would reccomend it to anyone.
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