Dangers of Sulfiting Agents in Food and Pharmaceuticals
Whereas sulfiting agents in foods and pharmaceuticals can cause a wide spectrum of adverse reactions including severe asthmatic attacks and anaphylactic reactions1-3 and,
Whereas such reactions may be potentially fatal4, even in patients not yet diagnosed and thus unable to pay attention to package labelling and,
Whereas since under present laws and regulations which prohibit the use of sulfites only on fruits and vegetables sold or served raw to consumers and require labelling of sulfites only on pre-packaged foods (excluding alcoholic beverages) and drugs5, a susceptible individual may still be exposed to ingestible sulfites under a variety of circumstances and often without any labelling of their presence (i.e. bulk food, alcoholic beverages, sulfites carried over from one preparation to another),
It is hereby resolved by the Canadian Society of Allergy and Clinical Immunology that:
- The Department of Health and Welfare be asked to take immediate action in order,
1a. to ban the use of sulfites in foods and pharmaceuticals as soon as acceptable alternatives are available or become available,
1b.to ensure mandatory labelling of all medications or foods containing sulfites,
1c. to include a warning statement in the product monograph of all human prescription drug products containing sulfites,
- Unpackaged food (i.e. food sold in bulk or food served in restaurants should not be allowed to contain sulfites unless a mechanism can be implemented whereby a warning of their presence is clearly visible to any consumer,
- A single or double blind oral provocative challenge test with sulfites following published protocols and carried out under the supervision of a qualified medical specialist is a valid method for diagnosing sulfite sensitivity. In view of the hazards associated with sulfite sensitivity as well as with sulfite provocative testing, clinical judgment must be exercised in each case in deciding whether sulfite testing is indicated,
- Educational programs be designed to alert public and health professionals of the manifestations of sensitivity to sulfiting agents,
- Documented cases should be reported to Food Additives, Contaminants and Chemical Evaluation Division, Bureau of Chemical Safety, Food Directorate, Tunney's Pasture, Health Protection Branch, Health and Welfare, Ottawa, Ontario, Canada K1A 0L2 and/or Adverse Reaction Program, Product Related Disease Division, Health Protection Branch, Ottawa, Ontario, Canada K1A 0L2.
Members: William H. Yang, MD, FRCPC (Principal author), Clinical Assistant Professor, Department of Medicine, University of Ottawa, Ottawa, Ontario; Jerry Dolovich, MD, FRCPC (Chairman), Professor, Department of Paediatrics, McMaster University, Hamilton, Ontario; Michel A. Drouin, MD, FRCPC, Clinical Assistant Professor, Department of Medicine, University of Ottawa, Ottawa, Ontario; E.C.R. Purchase, MD, FRCPC, Clinical Assistant Professor, Department of Medicine, University of Ottawa, Ottawa, Ontario.
- Yang WH, Purchase ECR: Adverse reactions to sulfites&endash;current review. Can. Med. Assoc. J. 133:865, 1985.
- Stevenson DD, Simon RA: Sensitivity to ingested metabisulfites in asthmatic subjects. J Allergy Clin Immunol 68:26, 1981.
- Simon RA: Adverse reactions to drug additives. J Allergy Clin Immunol 74:623, 1984.
- Yang WH, Purchase ECR, Rivington RN: Positive skin tests and Prausnitz-Kustner reactions in metabisulfite- sensitive subjects. J Allergy Clin Immunol 78:443, 1986.
- Food and Drugs Act: Prohibition of the addition of sulfite on fresh fruits and vegetables. The Canada Gazette Part 1:5863, 1986.
© The Canadian Society of Allergy and Clinical Immunology, First printing 1987, Second printing 1995