Reducing Exposure to Nontuberculous Mycobacteria (NTM)

Posted by Armando @bolso1, Sep 16, 2021

Please see the attached document prepared by Dr. Joseph O. Falkinham, III, a world authority on the management of NTM dispersion.

Shared files

Reducing Exposure to Nontuberculous Mycobacteria (Reducing-Exposure-to-Nontuberculous-Mycobacteria.pdf)

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

@sueinmn

As to the filter, I don't know - my husband takes care of it. It has a prefilter and a .2 micron filter.

And I think the question about bottled spring water is a great one. I will begin by saying my "risk tolerance" may be higher or lower than yours.

If I open a bottle of water or another beverage, drink from it and recap it, I will drink from it the next day. If I open a bottle or can of water, drink from it and leave it open, I assume it gets contaminated from the atmosphere, and toss it.

What about anyone else?

Sue

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Thank you !

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@sueinmn

As to the filter, I don't know - my husband takes care of it. It has a prefilter and a .2 micron filter.

And I think the question about bottled spring water is a great one. I will begin by saying my "risk tolerance" may be higher or lower than yours.

If I open a bottle of water or another beverage, drink from it and recap it, I will drink from it the next day. If I open a bottle or can of water, drink from it and leave it open, I assume it gets contaminated from the atmosphere, and toss it.

What about anyone else?

Sue

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Hello. One of the hosts of the recent BronchamdNTM360 Social/coffee hour was adamant that bottled spring water (would this also include my beloved cans of seltzer?!) was potentially unsafe, generally, but one could check with the company to see if they use reverse osmosis. This seems to differ from what I have read from Prof. Falkinham, and I wonder if anyone else has info here? Thanks!

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@wsbme74

Hello. One of the hosts of the recent BronchamdNTM360 Social/coffee hour was adamant that bottled spring water (would this also include my beloved cans of seltzer?!) was potentially unsafe, generally, but one could check with the company to see if they use reverse osmosis. This seems to differ from what I have read from Prof. Falkinham, and I wonder if anyone else has info here? Thanks!

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I read the same info where Dr. Falkinham tested several waters and they were safe. I just got back from NJH and Spring Water is all they offer us. It can be so confusing at times.

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@wsbme74

Hello. One of the hosts of the recent BronchamdNTM360 Social/coffee hour was adamant that bottled spring water (would this also include my beloved cans of seltzer?!) was potentially unsafe, generally, but one could check with the company to see if they use reverse osmosis. This seems to differ from what I have read from Prof. Falkinham, and I wonder if anyone else has info here? Thanks!

Jump to this post

First, you are right Dr. Joe Falkinham does say they have tested spring water and found it safe. He is my go-to-guy on matters of water, studying it is his career.

Remember that the hosts on most web-based chats (like the mentors here on Mayo Connect) are not necessarily medical or scientific professionals. They are volunteers who have done a lot of reading and research (like me), so can be a helpful source of information. Every commenter filters 😉 the information they read through their own brain full of knowledge, experience, perception, values and opinions.

Let me give you a pertinent example. It is very difficult for me to engage in discussions about water I occasionally sip from a bottle, or the put ice in my drinks in a restaurant. MY brain does not believe that kind of incidental exposure to NTM/MAC is a high risk. But I may have a higher "risk acceptance" than other people, so I try to step carefully. However, I do pay attention to the water in my home, where I use it all day every day.

Having a host suggest that one check to see if a bottler is using reverse osmosis, which does not remove NTM, is the opposite of good information one would hope to receive in a chat. See this article:
"Reverse osmosis(RO) filters and granular activated carbon (GAC) filters, which are often used to remove chemicals from potable water, adsorb nutrient materials and may provide a means through which NTMs can multiply to infectious levels." https://cfpub.epa.gov/si/si_public_record_Report.cfm?Lab=NERL&dirEntryID=18293#:

I have never sat in on one of the socials in that group, but may do so just to get a feeling for the quality of the advice. Have you found them helpful on other issues?
Sue

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@sueinmn

First, you are right Dr. Joe Falkinham does say they have tested spring water and found it safe. He is my go-to-guy on matters of water, studying it is his career.

Remember that the hosts on most web-based chats (like the mentors here on Mayo Connect) are not necessarily medical or scientific professionals. They are volunteers who have done a lot of reading and research (like me), so can be a helpful source of information. Every commenter filters 😉 the information they read through their own brain full of knowledge, experience, perception, values and opinions.

Let me give you a pertinent example. It is very difficult for me to engage in discussions about water I occasionally sip from a bottle, or the put ice in my drinks in a restaurant. MY brain does not believe that kind of incidental exposure to NTM/MAC is a high risk. But I may have a higher "risk acceptance" than other people, so I try to step carefully. However, I do pay attention to the water in my home, where I use it all day every day.

Having a host suggest that one check to see if a bottler is using reverse osmosis, which does not remove NTM, is the opposite of good information one would hope to receive in a chat. See this article:
"Reverse osmosis(RO) filters and granular activated carbon (GAC) filters, which are often used to remove chemicals from potable water, adsorb nutrient materials and may provide a means through which NTMs can multiply to infectious levels." https://cfpub.epa.gov/si/si_public_record_Report.cfm?Lab=NERL&dirEntryID=18293#:

I have never sat in on one of the socials in that group, but may do so just to get a feeling for the quality of the advice. Have you found them helpful on other issues?
Sue

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Very well put. Yes the hosts are themselves patients and have been for many years

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I am a little confused about the filtered water from a refrigerator. Is bottled water saver than filtered water? All I drink is water; no coffee, tea, alcohol, and would really like an alternative but I have acid reflux as well as MAC so choices are water!

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@lauraadam2425

I am a little confused about the filtered water from a refrigerator. Is bottled water saver than filtered water? All I drink is water; no coffee, tea, alcohol, and would really like an alternative but I have acid reflux as well as MAC so choices are water!

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I would not drink my filtered water from Refrigerator. Dr. Falkinham has tested Spring Water and Poland Spring had been tested and had little to no MAC (I order mine online). Also, I order Rose Water and use my Steripen to get 99% of the bacteria out before drinking (it is a nice change from plain water). I make coffee from my LifeStraw pitcher which is very helpful.

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@tconz

I would not drink my filtered water from Refrigerator. Dr. Falkinham has tested Spring Water and Poland Spring had been tested and had little to no MAC (I order mine online). Also, I order Rose Water and use my Steripen to get 99% of the bacteria out before drinking (it is a nice change from plain water). I make coffee from my LifeStraw pitcher which is very helpful.

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Hi! I am "new and confused", too! It sounds like you are saying you order Poland Springs water but then also use a Steripen on it or a LifeStraw pitcher? I age the LifeStraw pitcher but was hoping it is enough to clear the bacteria from tap water with it. Is this not the case? Thanks!

REPLY
@sueinmn

First, you are right Dr. Joe Falkinham does say they have tested spring water and found it safe. He is my go-to-guy on matters of water, studying it is his career.

Remember that the hosts on most web-based chats (like the mentors here on Mayo Connect) are not necessarily medical or scientific professionals. They are volunteers who have done a lot of reading and research (like me), so can be a helpful source of information. Every commenter filters 😉 the information they read through their own brain full of knowledge, experience, perception, values and opinions.

Let me give you a pertinent example. It is very difficult for me to engage in discussions about water I occasionally sip from a bottle, or the put ice in my drinks in a restaurant. MY brain does not believe that kind of incidental exposure to NTM/MAC is a high risk. But I may have a higher "risk acceptance" than other people, so I try to step carefully. However, I do pay attention to the water in my home, where I use it all day every day.

Having a host suggest that one check to see if a bottler is using reverse osmosis, which does not remove NTM, is the opposite of good information one would hope to receive in a chat. See this article:
"Reverse osmosis(RO) filters and granular activated carbon (GAC) filters, which are often used to remove chemicals from potable water, adsorb nutrient materials and may provide a means through which NTMs can multiply to infectious levels." https://cfpub.epa.gov/si/si_public_record_Report.cfm?Lab=NERL&dirEntryID=18293#:

I have never sat in on one of the socials in that group, but may do so just to get a feeling for the quality of the advice. Have you found them helpful on other issues?
Sue

Jump to this post

I too had heard or read that reverse osmosis does not kill NTM and granulated charcoal filters grow NTM. I think Dr. Falkinham says spring water is safer than other bottled water (purified, etc) and has tested certain brands (only a few) that have been shown not to have NTM. If you can find out it is filtered through a .2 micron filter, then it should be safe. Some people with GERD and reflux are especially careful about their water and ice because of the chance of aspiration of stomach acid which apparently does not kill NTM. I pretty much follow Sue’s way of consuming water and ice, but then I don’t have gerd or reflux.

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I Do Not use Steripen on bottled Spring Water only on the Rose Water I order. I Do Not use Steripen on any of my LifeStraw Pitcher water either. Hope this helps.

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