When Good Foods Go Bad: Water, Ice, Fountains

water faucet


Nutritionists and health enthusiasts alike admonish us to drink lots of fluids especially water. While I agree, water is the “life blood” of our bodies, too much, and contamination risks require us to take a cautious look.

You can drink too much water and then it becomes a poison.

Water intoxication or water poisoning, is potentially fatal when the balance of body electrolytes fall outside safe limits by too much fluid.

As a physician, I have seen patients literally drown by drinking too much water. Patients on certain medications, athletes replacing sweat losses with only water and overzealous health enthusiasts are at greatest risk. There is no absolute for the amount of water to drink.

  • Monitor you fluid output if taking suspect meds or excessive sweat losses.
  • Replace fluids to match what you lose.
  • If the urine color looks like water, slow down consumption.

Are you really going to squeeze that lemon into your drink?

In one microbiology study, nearly 70% of lemon slices produced bacterial, either from the rind, the flesh, or both. The bacteria, found on the lemon samples, all cause infectious diseases.

Swabbed samples of the flesh and rind of lemon slices on the rims of beverage glasses were analyzed. Seventy-six lemons from 21 restaurants were sampled during 43 visits. Fifty-three (69.7 percent) of the lemon slices produced microbial growth.

While the results cannot be extrapolated to the entire food industry there are cautions.

  • Bartenders/food servers need to pay additional attention during preparation to washing hands, washing the lemon outside and keeping the cutting surface clean.
  • It is virtually impossible for a server to wash their hands before every lemon slice is applied to a glass rim, so I have personally chosen to squeeze the lemon but not put it in the glass.

Ice is a food

Ice is considered a food by the FDA. As such, it needs to be stored, handled with no bare hand touching like any other food. An Indianapolis TV station, WTHR, sponsored a study where ice samples were collected from 25 popular bars and restaurants and taken it to a state-certified laboratory for analysis. The results showed at 13 of the 25 bars and restaurants tested, at least one ice sample tested positive for the presence of coliform bacteria.

Here again we cannot extrapolate the results across the entire food industry but some key points to remember:

  • Store ice only in properly cleaned containers.
  • Don’t store anything in the ice. Bottles, cups, scoops, food containers contaminate.
  • Handle the ice with clean utensils and never let it touch your bare hands.

Remember when traveling in sparsely populated areas, the restaurant or bar may be using local well water. Approximately 15 percent of Americans rely on private drinking water, and these supplies are not subject to EPA standards. While it may be great water, it may not be to the cleanliness standards of a larger community water system.

Consider whether the soda/water fountain is clean.

In an article published in FoodSafetyMagazine.com, Powitz, Ph.D., M.P.H., R.S., C.F.S.P., discusses some of the challenges to keeping ice making equipment clean. Additionally, researchers from Virginia tested 90 water/soda fountains and analyzed for bacterial contamination. Stool bacteria were detected in 48 percent. The potentially deadly bacteria, E. coli was found in 11 percent of the tested drinks. Nearly half of the 90 beverages from soda fountain machines in one area in Virginia tested positive for coliform bacteria — which could indicate possible stool contamination.

This study is several years old but the lessons become a constant reminder:

  • Soda/water fountains require meticulous attention to cleanliness.
  • If not, they become a source of food borne illness.

Clean, balanced fluids and especially water are critical to good health. But they are “foods” and need the same food safety attention as all foods.


Author: Dr. Harlan Stueven, MD

Harlan Stueven M.D. is a Board-Certified Emergency physician with sub-specialization in Environmental Toxicology and Board Certification in Medical Toxicology. Starting his career in the USAF, he served as a Flight Surgeon and Environmental Health Consultant Physician where one of his duties was monitoring food safety. In his nearly 40-year practice, he treated a range of medical, surgical and poisoning emergencies. He has been a Medical Director and/or Chairman of several hospital-based Emergency Medicine Departments, served as the President of Emergency and Environmental Medicine consulting group, a physician group Chief Financial Officer and sat on many national, state and local committees. Dr. Stueven founded Dining Grades and the Dining Safety Alliance to improve food safety by increasing awareness of food borne illness and the formation of partnerships within the food industry. He is a consultant to the Wisconsin Retail Food Establishment Grading Work Group; a Co-investigator in a CDC funded “Evaluation of Health Department Restaurant Inspection Programs” project. He has presented at several National, State and Regional conferences on restaurant grading and food safety. He is an accomplished leader, medical researcher, a champion of process improvement, author, and national and international speaker.

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