It is widely recognized that climate change will impact upon human health in a variety of ways. Assessing these impacts and identifying adaptation opportunities requires appropriate monitoring. To identify the need for reinforced surveillance in metropolitan France, we defined a conceptual framework of how climate change could impact upon health risks in relation to drinking water. Three types of climate change-related impacts were identified: changes in raw water quality, changes in water treatment processes and changes in human determinants of exposure in relation to consumers" behaviour. This framework was applied to existing risks and exposure situations in France. An increase in the health burden attributable to drinking water intake is expected due to increased exposure to faecal pathogens, disinfection by-products and cyanobacteria as a result of a combination of natural, technical and human factors. Current sources of health and water data should satisfy surveillance requirements. However, we believe that the creation of a sustainable database comprising behavioural and water management data would be valuable in following and understanding emerging trends.