Water quality laws and waterborne diseases: Cryptosporidium and other emerging pathogens

Waterborne diseases, such as cryptosporidiosis, cause many cases of serious illness in the United States annually. Water quality is regulated by a com plex system of federal and stare legal provisions and agencies, which has b een poorly studied. The authors surveyed state and territorial agencies responsible for water q uality about their laws, regulations, policies, and practices related to wa ter quality and surveillance of cryptosporidiosis related to drinking water . In this commentary they review the development and current status of fede ral drinking water regulations, identify conflicts or gaps in legal authori ty between federal agencies and state and territorial agencies, and describ e court-imposed limitations on federal authority with regard to regulation of water quality. Recommendations are made for government actions that would increase the eff iciency of efforts to ensure water quality; protect watersheds; strengthen waterborne disease surveillance; and protect the health of vulnerable popul ations.