The Expert meeting on improving tap water consumption for decreasing the intake of sugar-sweetened beverages and reducing the environmental footprint, organized by the WHO Regional Office for Europe in Moscow, Russian Federation, on 27–28 February 2020, provided the Autonomous Province of Trento (Trentino), Italy, with a unique opportunity to illustrate its policies on promoting the consumption of tap water. On the same occasion, Trentino, a member of the WHO Regions for Health Network (RHN), presented the latest results of the Italian national behavioural risk factor surveillance system (PASSI).
Use of local tap water in Italian households
Thanks to the inclusion of a special module on environment and health in the PASSI questionnaire, it has been possible to estimate the prevalence of tap-water use in different Italian regions. This has revealed links with a perception of environmental safety and trust in public institutions at the local level.
The study showed remarkable differences in water consumption at the sub-regional and local levels in Italy. For instance, in areas with environmental challenges, such as northern Naples (illegal waste dumps) or the city of Siracusa in Sicily (petrochemical industry), it is the widespread belief at all levels of society that drinking tap water is high risk; therefore, despite regular testing by the responsible water authorities or providers, levels of tap-water consumption are low. In other words, safety concerns prevail as a reason for not drinking tap water, even if these are unrelated to the actual quality of the water.
In addition, comparison between the PASSI data and those resulting from another national survey on physical activity and nutrition in childhood – “Okkio alla salute” – reveals an inverse correlation between the consumption of tap water and that of sugary drinks. In cities and provinces with low levels of tap-water consumption, the percentage of sugary drinks consumed (at least once a day) by children aged 8–9 years is higher than in regions or provinces with high levels of tap-water consumption. Further analysis is needed, however, since other factors may play into this relationship.
Here are some of the main takeaways:
- Socioeconomic factors (age group, income or educational level) are not very relevant to tap water consumption: where people live is much more important.
- Huge variations in tap-water consumption exist even within the same region; data appear to be significant only at the local level (local health unit/province).
- Perception of safety (with respect to tap water consumption) counts,more than actual safety.
- Trust in governmental institutions is key; mistrust (even if unrelated to water issues) may have an impact on tap-water consumption.
About the expert meeting and input from Trentino
The meeting convened experts in the field and representatives of selected countries, local settings (cities/provinces/regions) and nongovernmental organizations across Europe. With the development of a toolbox for local authorities in mind, participants discussed data available in the WHO European Region on patterns of and barriers to tap-water consumption and exchanged practical measures of promoting it.
In addition to introducing the Italian national behavioural risk factor surveillance system (PASSI), the Trentino region showcased its health behaviour surveillance system and plans for the promotion of tap-water use in the public and private sectors. The region has adopted a whole-of-government approach to these endeavours and has set up a working group on the promotion of tap water that brings all governmental departments together. There is, however, a challenge: on the one hand, Trentino, with its mountainous landscape, offers safe, high-quality water; on the other hand, huge amounts of packaged water (mainly in plastic bottles) are consumed in the region.
An interesting initiative recently implemented in Trentino consists of the design of an eco-label, which is granted to restaurants and bars committing to specific targets (for example, related to waste reduction, use of local and/or organic/fair-trade products, energy saving, use of tap water). The eco-label has already generated a 12% increase in tap-water orders in its first year, and additional efforts are being made to increase its outreach and adoption.
Next steps include a multistakeholder communication campaign to promote tap water among the general public, tourists, restaurants and governmental departments. The campaign will address issues, such as quality, the reduction of plastic waste and, in general, the need to improve compliance with the United Nations Sustainable Development Goals.