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Is it safe to drink the tap water in Cairo?

As the summer heats up and water cuts become a daily fact of life for millions of Egyptians, the simple act of opening a tap and having an uninterrupted flow of water is something to be grateful for. But with reports of contaminated tap water and safety problems in bottled water facilities all too common, it’s natural to question the quality of the drinking water available. Is it safe to drink the tap water in Cairo — especially for the young, the elderly or people with compromised immune systems?

In the absence of a consensus from experts the answer is: probably. Tap water in Cairo is unlikely to cause acute illness, but in the long term it’s probably healthier not to regularly drink it without filtration.

Plant vs. pipes

Household water quality has two factors: the purity of the water when it leaves the treatment plant, and the purity of water when it finally comes out of the tap.

By and large, experts agree that water is fit to drink — if somewhat over-chlorinated — when it comes out of Greater Cairo’s water treatment plants. This isn’t the case throughout Egypt, notes water researcher Ayman Ayad. In the Delta region, especially in high summer when Nile flows are lowest, water can have higher concentrations of salts and ammonia than treatment stations can handle.

In Cairo and other cities further upstream, most water is suitable for consumption “according to Egyptian standards issued by the Ministry of Health,” Ayad says.

Ahmed Moawad, vice chairperson of the Holding Company for Water and Wastewater, which supplies Cairo’s tap water, is adamant that the water leaving treatment plants is safe. “We have set control values for the water quality produced, which adheres to [World Health Organization] standards. We are monitored by the Ministry of Health too,” he says. Water quality is also checked by the Holding Company’s “Reference Lab,” which Moawad says is one the best labs in the Middle East.

Problems with water quality are more likely to arise as water travels from the treatment plant to the drinking glass. Studies show that as much as 35 percent of Egypt’s residential water supply simply leaks into the ground, which says a great deal about the deterioration of municipal pipes. “Networks are exhausted. They were not designed for a huge explosion in urban development,” says Ayad. Leakage, breaks and contamination are all potential issues, he adds, and while there haven’t been major outbreaks in recent years, “there are incidents here or there.”

Once water gets to the meter for residential or commercial buildings, it’s no longer the water company’s responsibility. “Internal pipes, elevated tanks, the cleaning of the tanks and so forth is the responsibility of the customers,” Moawad says. This means household consumers have to put their faith in the construction firms and building maintenance upholding health standards.

Believing in the integrity of residential water pipes can be particularly dangerous in older buildings. “In Egypt, especially in the 1970s, lots of pipes were made of asbestos cement,” says Ayad. There is still debate about whether properly maintained asbestos pipes pose a health risk — the risks of inhaling asbestos are well documented, but data is less clear when it comes to ingestion. But studies have shown that as pipes deteriorate, more asbestos gets into water.

There’s almost no lead in the main water network, but lead-based solder has been used to repair pipes in some older buildings, Ayad says.

Water tanks, which sit on the roofs of many large buildings, are also an issue. If not cleaned properly, they can be breeding grounds for bacteria. Sitting all day in the sun, the tanks themselves can leech chemicals or minerals into water.

In the mid-2000s, a two-year study of drinking water quality in Maadi found that “tap water quality in Maadi-Cairo satisfied most Egyptian and international water quality standards and guidelines for the majority of samples” — a generally positive if less-than-glowing assessment. Edward Smith and Sally Komos, the study’s authors, found that Maadi tap water was hard, but usually within “standard acceptable limits.”

The study did highlight water quality problems, however, even in that upscale district. Some water samples contained concentrations of lead that exceeded international standards and, in general, chlorine values that were “high relative to the United States and, especially, European practice, but were normally within drinking water limits.”

It also found a high volume of total trihalomethanes (TTHMs) — some 15 percent of samples exceeded Egyptian standards, while more than 37 percent exceeded United States standards. Long-term exposures to TTHMs, a disinfection byproduct that forms when organic and inorganic materials react to disinfectants like chlorine, can contribute to liver, kidney and nervous system problems, as well as an increased cancer risk.

A separate 2000 study of drinking water in Heliopolis, Matareya, Zeitoun, Salam City and Marg found heavy elevated of levels metals including lead, copper and nickel in tap-water samples collected from the homes of people suffering renal failure, liver cirrhosis, hair loss and chronic anemia.

So what should people do?

Unfortunately, there is no universal answer: Households have to make their own assessments of risks and costs.

One area of clear consensus is that household consumers should pay attention to the state of their buildings’ water tanks. The water holding company offers a cleaning service, Moawad notes. Customers can call its hotline at 15 and ask the local company to come clean the tank for a very cheap price, he says.

Smith and Komos’ study of water quality in Maadi, which also monitored the effectiveness of household filters, strongly supports the use of a cheap and simple activated carbon filter. When it comes to reducing water hardness and alkalinity, simple carbon filters were found to be less effective than reverse osmosis and distillation units. But carbon filters were found to do a better job of removing lead, and were nearly as effective in removing chlorine and TTHMs — for a much lower price.

This is the option Moawad says he uses in his own home: a simple carbon filter on one sink. “We have this because of the tank,” he says. He does not recommend reverse osmosis filters, which remove healthy minerals and salts from water along with unhealthy contaminants.

Ayad is also not a fan of household reverse osmosis filters. If users don’t follow a strict maintenance regime, hi-tech filters can be “more threat than benefit,” he says. Overall, he is skeptical that anything less than a professional-grade filtration system really makes much of a difference, and to him the math doesn’t work out. “What you need is two to three liters per person per day of drinking water,” he says. “For cooking, showering and non-drinking uses, you really don’t need to filter all that water.”

Ayad says he buys large bottles of water, which he uses for drinking water, tea and coffee, and which works out far cheaper than a top-of-the-line filter. He is confident in water quality if he sticks to known brands and avoids shops that stockpile large quantities of water and store them in the sun.

Isabel Esterman