Metals entering the distribution system via cross-connections can cause what health effects?

• A. Kidney failure and anemia
• B. Heart attack and stroke
• C. Nervous system damage, liver damage, and vomiting
• D. Skin irritation

Answer: (C)

Metals in drinking water from cross-connections can cause toxic effects that involve multiple organ systems, reflecting the broad impact of heavy metal exposure. When metals such as lead, arsenic, or copper enter the water supply, they can harm the nervous system, cause liver damage, and provoke gastrointestinal symptoms like vomiting. Lead and arsenic, in particular, are known for neurotoxicity and hepatic effects, while vomiting is a common GI response to metal exposure. This combination—nervous system damage, liver damage, and vomiting—best captures the range of health effects these metals can cause.

Other options don’t fit as well because kidney failure and anemia are not the primary or most consistent acute effects across common metal exposures in water, heart attack and stroke are not typical direct acute toxic outcomes of drinking-water metals, and skin irritation isn’t a primary health effect associated with metals entering via cross-connections.