Murky waters: how ‘clean’ drinking water may be costing us long-term

Recent findings from the University of the North West have uncovered traces of pharmaceutical pollutants in South Africa’s water systems, a worrying indicator of how modern medical and industrial practices are colliding with environmental health.

While these chemical remnants, ranging from antibiotics to antidepressants, may be present in low concentrations, their cumulative effect over time could become one of the defining risk factors for the health insurance industry in the decades to come.

At 1Life Insurance, we view this development through the lens of long-term health and risk management. As insurers, we are often asked whether environmental findings like these translate into immediate underwriting concerns. The short answer is: not yet. But the more considered answer is that the implications may lie just beyond the underwriting horizon.

The silent shift in risk
Pharmaceutical contaminants in drinking water are not about acute toxicity. They are about chronic, low-level exposure that can subtly shift biological baselines. Over the next 10–20 years, this exposure could:

• Accelerate the onset of chronic, insurable illnesses such as endocrine disorders, metabolic diseases, and cancers - particularly in vulnerable groups such as children, the elderly, and individuals with pre-existing conditions.

• Create diagnostic uncertainty, as illnesses emerge from a complex mix of environmental and genetic factors. This complicates treatment and challenges the predictability of health outcomes, cornerstones of underwriting precision.

• Shift population-level morbidity curves, as younger, previously low-risk groups begin showing symptoms of diseases traditionally associated with older demographics or lifestyle factors.

• Increase long-term insurance claims, placing additional strain on risk pools, with potential ripple effects on premium pricing, policy terms, and the sustainability of cover across socioeconomic segments.

Prevention, awareness and the role of insurers
We are entering a phase where the environment itself becomes a determinant of insurability. As such, insurers need to begin considering environmental exposures, water, air, food quality, as part of a broader ecosystem of risk. While regulators and public health authorities must lead the charge on monitoring and remediation, the insurance sector has a unique role to play in driving awareness, supporting wellness education, and advocating for more robust environmental health standards.

More immediately, we also need to strengthen our risk modelling and scenario planning, building in variables that consider the long-term effects of environmental toxins. These are not hypothetical risks, they are unfolding in real time, though often unnoticed.

Looking ahead
The conversation around insurance is no longer just about individual behaviours like smoking, diet or exercise. It is increasingly about systems, the ones we live in, drink from, and depend on. If our water carries a growing pharmacological load, then we must begin asking difficult questions now, rather than waiting for answers when claims begin to rise.

The findings by the University of the Free State should not spark panic, but they should spur strategic foresight. At 1Life, we are committed to being part of that conversation, because protecting life is not just about reacting to disease, but anticipating the conditions that cause it.