Benzene formation with vitamin C
When benzoic acid or its salts are present in the same drink as ascorbic acid (vitamin C), they can react, especially under heat or light exposure, to produce benzene. Benzene is an IARC Group 1 carcinogen, meaning there is sufficient evidence it causes cancer in humans, in particular acute myeloid leukaemia. In 2006 the UK Food Standards Agency tested 150 beverages and detected benzene in 43 of them, with four exceeding the WHO drinking water standard of 10 parts per billion. Manufacturers have since reformulated many products to avoid the combination, but the reaction remains a reason to read labels on drinks that list both a benzoate and vitamin C.
Benzene is classified as carcinogenic to humans (IARC Group 1), with sufficient evidence it causes acute myeloid leukaemia in adults and limited evidence for other blood cancers including non-Hodgkin lymphoma and multiple myeloma.
2018EstablishedIARC Monographs on the Identification of Carcinogenic Hazards to Humans, Volume 100F and subsequent 2018 evaluation
The UK FSA detected benzene in 43 of 150 beverages tested, with four samples exceeding the WHO drinking water guideline of 10 ppb; the highest contamination found in a single product was 87.9 ppb.
2006RegulatoryUK Food Standards Agency benzene in beverages survey, reported via Wikipedia Benzene in soft drinks and contemporaneous press
Benzene forms through decarboxylation of benzoic acid in the presence of ascorbic acid, transition metal ions (iron, copper) and heat or light; the FDA first became aware of this in 1990 and asked manufacturers to reformulate their beverages.
2006RegulatoryUS FDA, Questions and Answers on the Occurrence of Benzene in Soft Drinks and Other Beverages
Children exceeding the acceptable daily intake
The EFSA ANS Panel re-evaluated benzoic acid and its salts in 2016 and set an acceptable daily intake (ADI) of 5 milligrams per kilogram of body weight per day. The Panel found that in a 'brand-loyal' scenario, where toddlers or children regularly drink flavoured benzoate-preserved drinks, the ADI could be exceeded, and that additional exposure from benzoate used in other food categories could push intake two to three times above the ADI in high-level consumers. This means a child who regularly drinks several servings of benzoate-containing cordials or fizzy drinks may be getting more than the amount the regulator considers acceptable.
The EFSA ANS Panel set an ADI of 5 mg benzoic acid per kilogram body weight per day, derived from a no-observed-adverse-effect-level of 500 mg/kg/day in a four-generation reproductive study in rats with an uncertainty factor of 100.
2016Regulatory reviewEFSA ANS Panel, Scientific Opinion on the re-evaluation of benzoic acid (E210), sodium benzoate (E211), potassium benzoate (E212) and calcium benzoate (E213) as food additives, EFSA Journal 2016;14(3):4433
In a brand-loyal exposure scenario, the ADI was exceeded for toddlers and children consuming flavoured drinks regularly; when carry-over from other permitted food categories was added, high-level consumers could reach two to three times the ADI.
2016Regulatory reviewEFSA ANS Panel, EFSA Journal 2016;14(3):4433
Hypersensitivity and breathing reactions
People with aspirin or salicylate intolerance can react to benzoic acid and benzoates, experiencing hives, skin rashes, nasal symptoms, or asthma-like breathing difficulties. This is a pseudo-allergic reaction (not an immune antibody response) linked to disrupted prostaglandin pathways, the same mechanism underlying aspirin intolerance. Studies of asthmatic patients reported benzoate intolerance rates of around 11 per cent in those with asthma and 2.5 per cent in those with rhinitis. People with chronic urticaria (hives) are also at elevated risk.
Early oral provocation studies found that sodium benzoate induced urticaria and asthma in a subset of aspirin-sensitive patients, implicating a prostaglandin-mediated pseudo-allergic mechanism rather than a true IgE allergy.
1973ObservationalMichaelsson & Juhlin, Urticaria induced by preservatives and dye additives in food and drugs, British Journal of Dermatology, 1973; Rosenhall, Aspirin and food additive intolerance in urticaria and asthma
Intolerance to benzoate was reported in approximately 11.5% of asthmatic patients and 2.5% of rhinitis patients in oral challenge studies.
1986ObservationalVarious oral provocation studies cited in EFSA ANS re-evaluation 2016; also Hannuksela & Lahti review in Contact Dermatitis
Hyperactivity and attention in children
A 2007 randomised controlled trial commissioned by the UK FSA (the McCann or 'Southampton' study) found that mixtures containing six artificial colours plus sodium benzoate were associated with increased hyperactivity in both 3-year-olds and 8 to 9-year-olds. However, because the drinks contained a mixture of colours and benzoate together, it was not possible to separate the effect of benzoate from the colours. When EFSA reviewed the evidence in 2008, it concluded the study showed limited evidence of a small effect on activity and attention in some children, but that the inconsistency between age groups and drink mixes made it impossible to attribute the effect to any individual additive. No change to the ADI for benzoate was recommended, and the EU warning label requirement that followed ('may have an adverse effect on activity and attention in children') was applied to the six colours only, not to sodium benzoate.
A randomised double-blind placebo-controlled trial found that drinks containing a mixture of six synthetic colours and sodium benzoate were associated with significantly increased hyperactivity in both 3-year-old and 8 to 9-year-old children in the general population.
2007RCTMcCann et al., Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial, The Lancet 2007;370:1560-1567
EFSA AFC Panel concluded that because mixtures of additives were used, it was not possible to identify the effects of individual additives; no basis was found for changing the ADI for sodium benzoate.
2008Regulatory reviewEFSA AFC Panel, Assessment of the results of the study by McCann et al. (2007), EFSA Journal 2008;660:1-54
An observational cross-sectional study of 475 college students found that higher sodium benzoate-containing beverage intake was significantly associated with self-reported ADHD symptoms, though the design cannot establish cause and direction of effect.
2014ObservationalBeezhold, Johnston & Nochta, Sodium Benzoate-Rich Beverage Consumption is Associated With Increased Reporting of ADHD Symptoms in College Students, Journal of Attention Disorders 2014;18(3):236-241
Gut microbiome
A small ex vivo study published in 2025 exposed gut microbiome samples from 24 people across four age groups to a dose ten times the ADI for 24 hours and found only minimal effects on bacterial diversity and composition. An earlier mouse study found some shifts in specific bacterial species. The human-relevance of these laboratory findings at real-world food doses is not established.
An ex vivo gut fermentation model using samples from 24 donors across infant, toddler, adult and older adult groups found that sodium benzoate at ten times the ADI had minimal effects on alpha and beta diversity, with selective reductions in Escherichia coli and increases in butyrate-producing bacteria over 24 hours.
2025LabPMC12428287, The Effect of Sodium Benzoate on the Gut Microbiome Across Age Groups, 2025