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The risk of contamination of drinking water supplies with microbial pathogens is minimised by modern approaches to water management, but continues to be the major public health concern. Chemical contaminants usually pose little health risk except at very high levels, but debate continues over the potential adverse health effects of low-level, chronic exposure to compounds such as disinfection byproducts. Recreational water contact can be associated with adverse health outcomes either from microbial infections or exposure to cyanobacterial toxins. Environmental issues such as increasing salinity and global warming are likely to affect the sustainability of our current drinking water supplies and increase the threat of waterborne disease outbreaks. New technologies, use of alternative water sources, such as rainwater tanks, water reuse and restrictions will undoubtedly be part of the solution to our diminishing water resources, but have the potential to introduce new health threats.

Strains of Pseudomonas aeruginosa resistant to gentamicin, tobramycin, streptomycin, and sulphonamide have been isolated from patients at two Sydney hospitals. The multiple resistance of all these strains was due to a transmissible plasmid. The significance of the identification of this plasmid, in this variety of strains and at two hospitals, for the treatment of Ps. aeruginosa infections is discussed.