Asthma and airway reactions
When sulphites meet stomach acid they generate sulphur dioxide gas, which travels up to the airways and can cause them to constrict. This is the best-established real-world concern. Sensitivity is concentrated in people who already have asthma: studies suggest 5 to 13 per cent of asthmatics react to sulphite exposure, compared with under 2 per cent of the general population. The reaction can include wheezing, chest tightness, and, in severe cases, an acute asthma attack within minutes of eating a sulphite-containing food.
Bronchoconstrictor responses to inhaled sodium metabisulphite were reproducible in 15 of 18 atopic subjects, and correlated with methacholine responsiveness, pointing to airway hyperresponsiveness as the underlying susceptibility factor.
1987ObservationalCharacterisation of bronchoconstrictor responses to sodium metabisulphite aerosol in atopic subjects with and without asthma, Thorax / PMC1020876
Sulphite sensitivity in the general population is estimated at under 2 per cent, rising to 5 to 13 per cent in people with asthma.
Regulatory reviewAllergy UK, Sulphites and Airway Symptoms factsheet
Regulatory concern: neurotoxic signals at high intake
In a 2022 follow-up assessment, EFSA's expert panel found animal evidence that high sulphite intake delayed nerve-signalling responses in the brain, an early marker of nervous system disruption. The panel withdrew the previous temporary acceptable daily intake because the toxicity data were inadequate to set a reliable limit. Instead it used a margin-of-exposure approach and found that calculated safety margins fell below the acceptable threshold for most population groups at high exposure levels, including children. EFSA called the situation a safety concern and asked for new toxicology data.
EFSA withdrew the temporary group ADI of 0.7 mg SO2 equivalents/kg body weight per day established in 2016 because the toxicity database was inadequate, and instead applied a margin-of-exposure approach with a benchmark dose lower confidence limit of 38 mg SO2 equivalents/kg body weight per day.
2022Regulatory reviewEFSA Panel on Food Additives and Flavourings, EFSA Journal 2022, 20(11):7594
Margins of exposure were below 80 (the threshold used to indicate a safety concern) for most population groups at high dietary sulphite exposure levels, with children aged 3 to 10 potentially exceeding reference points by up to 12.5 per cent and adults by up to 60 per cent.
2022Regulatory reviewEFSA Panel on Food Additives and Flavourings, EFSA Journal 2022, 20(11):7594
Animal studies showed a dose-dependent prolongation of visual evoked potential latency in sulphite-exposed rats, interpreted as an early sign of nervous system dysfunction and used as the critical endpoint for the 2022 EFSA risk assessment.
2016AnimalOzsoy et al., Toxicology and Industrial Health, PubMed 25342669; Yargicoglu et al., ScienceDirect (VEP and lipid peroxidation study)
Declarable allergen under UK food law
Sulphur dioxide and sulphites are one of the 14 major allergens that must be declared on UK food labels. Any product containing E227 at levels above 10mg/kg or 10mg/litre must carry an explicit statement. This is not an allergy in the classic IgE antibody sense but a sensitivity or intolerance that can cause significant respiratory and skin reactions in those affected.
Sulphur dioxide and sulphites are among the 14 allergens requiring mandatory declaration under UK food law. Emphasis on the label is required when present above 10mg/kg or 10mg/litre in the finished product.
RegulatoryUK Food Standards Agency, Food allergen labelling and information requirements technical guidance