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Level 3 – Drinking Water
Source Booklet
Tuesday 23 March 2004
• This booklet contains source material for the Level 3 Communication test, March 2004 • The test questions will be based on this material • You must hand in this Source Booklet at the end of the test, along with your The Level 3 Communication test will assess your ability to: • select and read material that contains the required information • identify accurately, and compare, the lines of reasoning and main points from the • synthesise the key information in a form that is relevant to the purpose • select and use a form and style of writing that is appropriate to the purpose and • organise relevant information clearly and coherently, using specialist vocabulary • ensure text is legible and spelling, grammar and punctuation are accurate so that Water Gate
AS every diet book, fashion magazine and even detected 30 of the 60 pharmaceutical compounds doctor will tell us, we should be drinking more water. Two litres a day, to be precise, which Perhaps this isn’t so astonishing. The ways drugs works out as six to eight glasses. It’s vital for all can make their way into our waterways are many our bodily processes and, so we are told, will and various. Medical and veterinary drugs are help us to clearer skin, brighter eyes and all- excreted in the normal way, once they have been processed in the body. There is also potentially a But as you smugly reach for glass number eight, problem with waste from hospitals and the pause a moment and think what’s actually in the pharmaceutical industry. And people who think tumbler. You might expect infinitesimal traces of they are performing a service by flushing lead, aluminium and other naturally occurring minerals. But Prozac? Aspirin? Powerful anti- contributing unwittingly to the problem.
People allergic to specific drugs might have a As testing methods have improved, a truer reaction from drinking water. Different genetic picture is emerging of what actually makes its make-ups may make people susceptible to even way out of our taps. The substances may be tiny doses of a drug. And the global problem of present in quantities so small that they are barely antibiotic resistance – already blamed for the detectable – definitely within so-called “safe emergence of superbugs that cannot be treated levels” – but more and more experts suggest with antibiotics – may also be exacerbated.
these pharmaceutical residues might have acumulative effect. “Does this harm humans? Farm animals are potentially another problem.
That’s the $60 million question,” says Canadian Think of an upland reservoir and chances are researcher Professor Chris Metcalfe. “I’d have to you’ll imagine a few dozy sheep wandering say I’m sitting on the fence. But that’s not to nearby. But these sheep could have been dipped suggest we shouldn’t be more cautious. There is in organophosphates, for example, which could concern that these substances are being released similarly make their way into the reservoir.
into the environment. We don’t know what their And it’s not only farmers with pesticides and biological significance is for humans but we do sheep dips who could be altering our water’s suspect they are already having an effect on fish chemistry. In bathrooms across the land, those who use toothpaste with the whitener titanium Previous research in Germany has also shown a oxide could be causing this chemical to form part possibility that the heart drug clofibric acid is of treated sewage sludge, which might then go on present in some drinking-water sources. There is to be used as a fertiliser. Who knows whether this concern worldwide that the water in rivers and will then make its way into the food chain, and lakes and, ultimately, going through treatment plants, could contain traces of drugs. TheGerman finding was published 10 years ago and since then researcher Thomas Ternes has found Company agrees: “We lose eight glasses a day that the amount of pharmaceuticals and personal urinating, sweating, breathing – more if we drink care products entering the environment annually fizzy drinks, alcohol, tea and coffee. We is about equal to the amount of pesticide used constantly need to replace this with the purest Earlier, Ternes had been surprised when he Evans believes there is not enough being done at conducted tests into what happened to drugs a national level to improve water quality, though once they left the body. Expecting to find only a she concedes that more action is being taken now few in the water he was testing, he actually Source: The Scotsman 9 October 2001 BUPA Health News
Test monitors hormone levels in our rivers Scientists have developed a highly sensitive method of measuring levels of the female hormoneoestrogen in river water following health fears about the safety of drinking water.
The technique, which was developed by a collaborative project between the University of the West ofEngland (UWE) and the Environment Agency, can detect minute traces of oestrogen and can alsodetermine whether it has been produced naturally or as a result of the contraceptive pill.
Dr David McCalley who led the study said: “We can now detect quantities of oestrogen down to levelsequivalent to a pinch of sugar in an Olympic swimming pool.” Although levels of oestrogen in riversare minute, they have proved to be enough to cause signs of sex changes in male fish.
However, of greater concern is the possibility that these low levels of oestrogen could be reintroducedinto drinking water and have a negative effect on male fertility. There has been speculation thatoestrogen in drinking water is responsible for a reduction in male fertility.
Rupert Kruger, environment and scientific adviser at Water UK, which represents all UK watersuppliers and wastewater operators, believes that there is no cause for alarm.
He explained, “Oestrogen is naturally produced by everyone in the population, men as well as women, and it’s true that although some of it is removed by treatment works, invariably some does end up inriver water. However, any water that is extracted from the surface of rivers like the Thames and isintended as drinking water, goes through a number of barriers to ensure that impurities such asoestrogen are removed to make it safe.
“We work closely with the Environment Agency and the Drinking Water Inspectorate to ensure that tapwater is safe for human consumption,” Mr Kruger continued.
In order to ensure absolute safety, Dr McCalley recommends that standards on maximum oestrogenlevels in drinking water be introduced. He concluded, “Our detection method could certainly be used tomonitor levels in drinking water…which might lead to these standards being set.” Source: BUPA Health News – 20 August 2001 guardians of drinking water quality
Information Leaflet
Tap Water
In England and Wales, two thirds of drinking Water is not taken from sources that arewater comes from surface water, including highly polluted, and water for drinking isreservoirs, lakes and rivers, and the rest from drawn only from good quality surface andground waters. Water is treated at water treatment works But all water must still be treated before it isbefore flowing through water mains, safe to drink. Contaminants can come fromsometimes over considerable distances, to agriculture or industry. They may, forarrive at your home. Samples are taken at example, include treated sewage effluents,each stage of treatment and distribution along and traces of agricultural chemicals in areasthe way, and tested by the water company to where farming is practised. All sources aremake sure that you receive high quality water. disinfected to kill germs, known scientifically as pathogens, which may have entered water tap. Some waters require more specialisedsources from human or animal wastes.
Waters in large lakes or storage reservoirs Ion exchange is used to remove nitrate from
undergo a natural purification stage – factors ground water and is very similar to the
such as sunlight help eliminate pathogens process used in domestic water softeners,
naturally. These waters are usually retained where water is passed through a bed of
for up to six months before being treated.
Activated carbon, often in association with
ozone, is used to remove organic substances.
Some of these occur naturally and others are
contaminants that occur because of man’s
activities, such as use of pesticides.
The water quality regulations set legalstandards for water, which must be met bywater companies in England and Wales. Mostof these are based on a European Communitydirective, but some UK standards are morestringent. Many of the standards are based on There is a wide variety of water treatment include very wide safety margins. processes available. Those used are tailoredto the quality of the water source that has tobe treated. Ground waters usually requirevery little treatment. River water tends torequire more comprehensive treatment toremove chemical pollutants. All sourcesrequire disinfection with chlorine to killpathogens, including bacteria and viruses. Clarification is a complex process that
removes silt, algae, colour, manganese and
aluminium, and various other matter that may
be present in the raw water. These are
removed either by settling them out
(sedimentation) or by using air to float them
to the surface (flotation).
Filtration is also used to remove iron and
manganese from ground water sources.
As the ‘guardians of drinking water quality’,the main role of the Drinking Water Disinfection is essential to eliminate any Inspectorate is to enforce the regulations and
bacteria in the water. Water companies have check that water companies in England and to ensure that enough chlorine remains in the Wales supply water that is safe to drink and water after it leaves the treatment works to meets the standards set in the regulations.
help keep the water safe on its journey to the Source: Drinking Water Inspectorate 12 June 2001 BLANK PAGE
First published in 2004.
Qualifications and Curriculum Authority 2004.
Reproduction, storage, adaptation or translation, in any form or by any means, of this publication is prohibited without prior written permission of thepublisher, unless within the terms of licences issued by the Copyright Licensing Agency. Printed in Great Britain.
The Qualifications and Curriculum Authority is an exempt charity under Schedule 2 of the Charities Act 1993.
Qualifications and Curriculum Authority, 83 Piccadilly, London W1J 8QA. ComSB/L3/2.1/P3



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Reich_list of publications september 201

Original articles in peer reviewed journals 2011 (In Press) Reich K , Schenkel B, Zhao N, Szapary P, Augustin M, Bourcier M, Guenther L, Langley RG. Ustekinumab decreases work limitations, improves work productivity, and reduces work days missed in patients with moderate-to-severe psoriasis: results from PHOENIX 2. J Dermatolog Treat. 2010 Oct 31. [Epub in Medline ahead of print] 20

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