Not the Silver Bullet: Uncovering the Unexpected Limited Impacts of Silver-Containing Showerheads on the Drinking Water Microbiome.

The incidence of waterborne disease outbreaks in the United States attributed to drinking water-associated pathogens that can cause infections in the immunocompromised DWPIs (e.g., , nontuberculous mycobacteria (NTM), and , among others) appears to be increasing. An emerging technology adopted to reduce DWPIs are point-of-use devices, such as showerheads that contain silver, a known antimicrobial material. In this study, we evaluate the effect of silver-containing showerheads on DWPI density and the broader microbiome in shower water under real-use conditions in a full-scale shower system, considering three different silver-modified showerhead designs: (i) silver mesh within the showerhead, (ii) silver-coated copper mesh in the head and hose, and (iii) silver-embedded polymer composite compared to conventional plastic and metal showerheads. We found no significant difference in targeted DWPI transcriptional activity in collected water across silver and nonsilver shower head designs. Yet, the presence of silver and how it was incorporated in the showerhead influenced the metal concentrations, microbial rare taxa, and microbiome functionality. Microbial dynamics were also influenced by the showerhead age (i.e., time after installation). The results of this study provide valuable information for consumers and building managers to consider when choosing a showerhead meant to reduce microorganisms in shower water.