Nontuberculous Mycobacteria (NTM) Contamination in Drinking Water Systems – And How to Avoid It

What is Nontuberculous Mycobacteria?

Nontuberculous mycobacteria (NTM) is an opportunistic pathogen that can lead to pulmonary and other infections such as skin and soft tissue infections. People with pre-existing conditions and the immuno-compromised are particularly at risk, and NTM often causes post-operative infections. Additionally, “otherwise healthy elderly, slender, and taller women and men are at increased risk for NTM infection.

Nontuberculous mycobacteria (NTM) commonly infects lungs through drinking water and shower water.

How Nontuberculous Mycobacteria Spreads?

NTM does not spread from person-to-person. Instead, the main source of transmission of nontuberculous mycobacteria is through the water supply. Both drinking water and shower water have been identified as possible sources of NTM infection. NTM can reach the lungs through aspiration of drinking water or through the inhalation of aerosol particles from shower water.

The Prevalence of NTM Water Contamination in the US

NTM contamination is fairly common in the US water supply. In a study of water samples from 21 states, nontuberculous mycobacteria was found in “54% of the ice samples and 35% of the public drinking-water samples.” No NTM was detected in samples of bottled water, so the main source appears to be the public water supply. But bottled water is not always practical. Not only is it bad for the environment, but single-use plastic water bottles also contain a ton of microplastic. Studies show 93% of bottled water contains microplastic.

Image: Public drinking water source.

How to Avoid NTM Contamination in Your Water?

With the widespread prevalence of nontuberculous mycobacteria in the US water supply, how can you avoid exposure to NTM contamination? Studies have shown that standard disinfectants used in US drinking water treatment systems, such as chlorine, are staggeringly ineffective” against NTM.

As mentioned above, bottled water generally seems to be safe from NTM contamination, so that is a potential option. However, relying on bottled water is not an environmentally friendly solution.

A better option is to filter your water. However, granulated activated charcoal filters have been proven to be ineffective against NTM, and can even cause colonies of NTM to grow. Instead, a “filter with a pore size of 0.22 μm” is required to be effective in preventing NTM from passing through.
More recently, game-changing zero-waste UVC light purification has been shown to effectively “cause lethal damage to microbial biomolecules” and could be effective against nontuberculous mycobacteria as well, although NTM tends to be more resistant to ultraviolet radiation than some other bacteria.

Image: Woman activating CrazyCap bottle to destroy various water contaminants including NTM.

CrazyCap utilizes UVC light to purify water and is proven effective against nontuberculous mycobacteria. A recent study conducted using a ISO-certified third-party laboratory shows that CrazyCap Pro kills 99.8% of NTM from water in Pro Mode (which is a three minute cycle). Click here to access the lab report. We are also testing the effectiveness on our more advanced systems like HydroCap and PureMax which use 4X times higher UVC dosage than CrazyCap. We will publish the results very soon. 

Therefore, to protect yourself from NTM contamination, a physical water filter with a small pore size or a UVC light purifier, such as CrazyCap, HydroCap, LYT, and PureMax, are excellent choices. Shop WAATR products here.


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