High quality drinking water exits modern treatment works, yet water quality degradation such as discolouration continues to occur within drinking water distribution systems (DWDS). Discolouration is observed globally, suggesting a common process despite variations in source, treatment, disinfection and network configurations. The primary cause of discolouration has been identified as mobilisation of particulate material from pipe walls and the verified Prediction of Discolouration in Distribution Systems (PODDS) model uses measurable network hydraulics to simulate this response. In this paper the cohesive properties of discolouration material are explored and it is hypothesised that in simulating the turbidity response, the PODDS model is actually describing the development and cohesive strength behaviour of biofilms. Applying this concept can therefore facilitate a rapid and simple assessment of DWDS biofilm activity. A review of the findings from PODDS studies conducted internationally is presented, focussing on the macro or observable aspects of discolouration. These are compared and contrasted with associated biofilm studies which consider discolouration material at the micro-scale. Combining the results from these (past) studies to improve the understanding of interactions between microbial ecology and discolouration are discussed with a view to DWDS operational strategies that safeguard and optimise drinking water supply.