TOXICOLOGICAL EVALUATION OF CERTAIN FOOD ADDITIVES WHO FOOD ADDITIVES SERIES 10 The evaluations contained in this document were prepared by the Joint FAO/WHO Expert Committee on Food Additives* Rome, 21-29 April 1976 Food and Agriculture Organization of the United Nations World Health Organization *Twentieth Report of the Joint FAO/WHO Expert Committee on Food Additives, Geneva, 1976, WHO Technical Report Series No. 599, FAO Food and Nutrition Series No. 1. NITRITE, POTASSIUM AND SODIUM SALTS Explanation These compounds have been evaluated for acceptable daily intake by the Joint FAO/WHO Expert Committee on Food Additives in 1961, 1964 and 1973 (see Annex I, Ref. No. 6, p. 72; No. 9, p. 37; and No. 33, p. 97). Since the previous evaluation, additional data have become available and are summarized and discussed in the following monograph. The previously published monographs have been expanded and are reproduced in their entirety below. BIOLOGICAL DATA BIOCHEMICAL ASPECTS Absorption, distribution and excretion Sodium nitrite is readily absorbed from the gut and rapidly disappears from the bloodstream. 30-40% of absorbed nitrite is excreted unchanged in the urine, the fate of 60-70% is not accurately known. It can combine with myoglobin to form nitrosomyoglobin and with haemoglobin to form methaemoglobin (MAFF, 1962). Following absorption of nitrites, the most important biochemical reaction that occurs is the conversion of haemoglobin to methaemoglobin. There is some controversy concerning the molar ratios involved in this reaction. Making an extreme assumption, it may be stated that 1 g of sodium nitrite could convert as much as 1855 g of haemoglobin to methaemoglobin (Lehman, 1958). Effects on enzymes and other biochemical parameters The sub-acute hazard of nitrites rests on the amount of methaemoglobin formed and on the ability of the body to reconvert this methaemoglobin back to haemoglobin. Inorganic nitrite is oxidized to nitrate by tissue homogenates. The reaction depends on catalase content and is mediated by probably a D amino acid oxidase or xanthine oxidase system linked with catalase. Hydrogen peroxide formed by the oxidation is used by the catalase for the coupled oxidation of nitrite (Heppel & Porterfield, 1949). Nitrite oxidizes in vivo haemoglobin in preference to glutathione which is protected by pentose cycles and prevents Heinz bodies formation in human erythrocytes (Harley & Robin, 1962). The formation of methaemoglobin by sodium nitrite in mice can be antagonized by the administration of methylene blue at levels of up to 20 mg/kg and this effect is enhanced by the administration of oxygen (Sheehy & Way, 1974). The in vitro conversion of nitrate to nitrite by preparations from parts of the gastrointestinal tract was studied. Relatively large conversions took place in monogenates of mucosa which had been treated with 0.9% hypochlorite and with caecal contents. However, more than 24 hours were needed for substantial conversions to take place; after five hours only traces of nitrite were produced in any of the preparations (Fritsch et al., 1975). Rats given for two to three weeks a diet deficient in vitamin A to deplete liver stores were then given for six days 0.3% sodium nitrite in the diet and on the third and fourth day vitamin A or carotene orally or s.c. Assay of liver levels on the sixth day showed reduced storage of vitamin A following oral but not s.c. vitamin A dosing. Nitrite is known to degrade carotene under acid conditions and may have caused this by direct action (Emerick & Olson, 1962). Calves receiving 4 ppm (0.0004%) nitrite in drinking-water alone or with E. coli or with a thyroid depressant showed interference with carotene utilization in all experiments (McIlwain & Schipper, 1963). Chicks receiving 0.4% potassium nitrite showed growth depression, reduced vitamin A storage in liver and enlargement of the thyroid gland despite dietary supplementation with vitamin A (Sell & Roberts, 1963). When chicks were given doses of 18-60 mg/kg/day of sodium nitrite over a few days the liver showed inhibition of vitamin A accumulation even if fed vitamin A-rich diets (Brüggemann & Tiews, 1964). TOXICOLOGICAL STUDIES Special studies on nitrosamines A. Carcinogenesis and nitrosamines Since the discovery of the carcinogenic property of dimethylnitrosamine (Magee & Barnes, 1956), many other nitrosamines have been found to induce malignant tumours in various species of laboratory animals (Magee & Barnes, 1967). There is growing concern with regard to certain nitrosamines as etiological agents for cancer in the human environment (Lijinsky & Epstein, 1970). It is generally accepted that the use of nitrite as a food preservative may be associated with the formation of nitrosamines in foods as well as in the animal organism. The nitrosamines vary in their carcinogenic potential. They can induce malignant tumours at very low levels, such as 2 ppm (0.0002%) in the diet of rats (Terracini et al., 1967), equivalent to daily doses of 0.1 mg/kg bw. A single oral dose of 30 mg/kg bw of nitrosamine proved to be carcinogenic in the rat (Druckrey et al., 1969). Tumours of the trachea developed in the offspring of hamsters treated either during pregnancy or lactation with nitrosamine (Mohr & Althof, 1971). 1. In vitro nitrosamine formation Nitrosamines are formed when sodium nitrite and various secondary amines are incubated with human gastric juice at pH 1.3 (Sander, 1967). DEN (diethylnitrosamine) was detected when diethylamine and sodium nitrite were incubated with gastric juices from man, rat, rabbit, cat and dog. Human and rabbit juices (pH 1-2) produced more DEN than the less acidic gastric juice (pH 4-5) of the rat (Sen et al., 1969). Dimethylamine and sodium nitrite incubated together in the molecular proportion 1:4 with the bacterial flora of the rat intestine under anaerobic condition at pH 7 gave rise to dimethylnitrosamine (DMN). DMN formation was enhanced by the addition of glucose and riboflavin, but suppressed by neomycin (Klubes et al., 1972). Ender & Ceh (1971) reported the formation of various nitrosamines when nitrite was incubated with alkylamines, heterocyclic amines, biogenic amines, certain amino acids and proteins from meat and fish respectively. Nitrosamine formation increased greatly at high incubation temperatures and at lower pH values. 2. In vivo nitrosamine formation Diphenylnitrosamine, at levels ranging from 0.5 to 11 µg/l, was detected in stomach contents of 11 out of 35 patients, following the intragastric administration of a test solution containing 300 mg sodium nitrate, 10 mg diphenylamine, 100 mg sodium bicarbonate and 1000 mg glucose (Sander & Seif, 1969). Synthesis of nitrosopiperidine from nitrite or nitrate and piperidine in the gastrointestinal tract of the rat was observed (Alam et al., 1971a, 1971b). Intragastric injection of sodium nitrite and sarcosine resulted in the detection of nitroso-sarcosine in the stomach wall of mice (Friedman, 1972). Wistar rats fed diets containing 0-4000 ppm dimethylamine or 0-8000 ppm pyrrolidine were given drinking-water containing sodium nitrite at levels of 0, 100, 1000 or 3000 ppm. Analysis of the stomach contents revealed that nitrosamines were formed only at levels greater than background if concentrations of the added amines exceeded 1000 ppm. The concentration of amine appeared to have a bigger influence on N-nitrosamine formation in the stomach of rats than the concentration (at levels of up to 1000 ppm) of nitrite in the drinking-water (Telling et al., 1976). 3. Carcinogenesis with the simultaneous administration of nitrite and various amines Sander & Bürkle (1969) reported the occurrence of oesophageal and hepatic tumours in rats fed N methyl-benzylamine or morpholine mixed with sodium nitrite in the diet. Sodium nitrite in the drinking-water given together with piperazine, morpholine and N, methylamine respectively to mice led to a highly significant increase of lung tumours (Greenblatt et al., 1971). Similarly the administration of methylurea or ethylurea with sodium nitrite resulted in the induction of lung adenomas in mice (Mirvish, 1971). Rats fed dimethylurea and 0.3% sodium nitrite for 36 days developed tumours of CNS, heart, thymus, kidney or thyroid in all animals (Sander, 1970). Mice given either methylurea (5360 ppm (0.536%)) or ethylurea (6360 ppm (0.636%)) with 1 g/l sodium nitrite for six months showed more lung adenomas in test animals (Mirvish et al., 1972). Concurrent administration of 0.1% sodium nitrite and 0.5% proline, hydroxyproline or arginine for 26 weeks produced no increase in lung adenomas (Greenblatt & Lijinsky, 1972). The effects of long-term feeding of diets containing 0-1000 ppm of nitrite and 0-1000 ppm morpholine or 0-50 ppm N-nitrosomorpholine to rats and hamsters were studied. Several combinations of nitrite and morpholine, as well as nitrosomorpholine itself, induced a high incidence of hepatocellular carcinoma in rats. The nitrite concentration in the diet appeared to have the greater influence on the incidence of angiosarcomas and hepatocellular carcinomas in the rat than the morpholine concentration. There was no significant increase in tumour incidence in hamsters receiving any of the treatments (Shank & Newborne, 1976). Diethylamine hydrochloride (2 or 4 g/l) and sodium nitrite (0.4 or 0.8 g/l) were administered simultaneously in the drinking-water of groups of 20 guinea-pigs for up to 30 months. There was no increase in the tumour incidence of these animals as a result of this treatment. However, 18 out of 20 guinea-pigs given 15 mg diethylnitrosamine/l in the drinking-water developed liver tumours within 12 months. It was suggested that the synthesis of diethylnitrosamine from the ingested amine and nitrite was low because of the strongly basic nature of diethylamine (Sen et al., 1975). 4. Nitrosamines in foods Of the unprocessed foods analysed, only mushrooms were shown to contain dimethylnitrosamine at levels ranging from 0.4 to 30 µg/kg (Ender & Ceh, 1968). The same authors analysed different smoked fish and meat products and found dimethylnitrosamine at levels of 0.5 to 15 µg/kg. Eighteen samples of smoked, and five of canned fish were analysed after cooking with or without sodium nitrite (up to 200 ppm (0.02%)). The results indicated that certain kinds of fish, especially those rich in amines, formed dimethylnitrosamine at levels ranging from 2.5 to 45 µg/kg during cooking with nitrite (Sen et al., 1970). Fifty-one samples of a variety of meat products contained 5 µg/kg or less dimethylnitrosamine (Fazio et al., 1971). Dimethylnitrosamine was found at levels of 10-80 µg/kg in five out of 59 samples of prepared meat products (Sen, 1972). Analyses of 40 samples of frankfurters from eight large producers in the United States of America revealed the presence of dimethylnitrosamine at levels of 2-84 µg/kg only in a small proportion of samples (Wasserman et al., 1972). Crosby et al. (1972) while analysing various bacons, fish and miscellaneous food products, found that frying or baking of fish products almost doubled their very low or undetectable dimethylnitrosamine content. Sen et al. (1973) reported that various samples of side bacon when fried contained 4-25 µg/kg nitrosopyrrolidine; without frying nitrosopyrrolidine was undetectable. B. Teratogenesis and nitrosamines A single i.v. dose of N-nitrosomethylurea to pregnant rats led to increased foetal deaths and reabsorptions and to malformations in those surviving (von Kreybig, 1965). It has been shown that N-nitroso- methylurea and N-nitrosoethylurea were potent teratogens and carcinogens in rats (Druckrey et al., 1966). C. Mutagenesis and nitrosamines Chromosomal aberrations and gene mutations were observed following the administration of N1-nitro-N-nitrosomethylguanidine and N-nitroso-methylurea (Magee & Barnes, 1967). Malling (1971) found that both dimethylnitrosamine and diethylnitrosamine were active mutagens in the mouse liver-microsome system. Four carcinogenic nitrosamines, dimethylnitrosamine, N-nitrosomethylurea, N-nitrosomethylurethane and N methyl-N-nitro-N-nitrosoguanidine proved to be effective in producing cell killing, chromatid breaks and chromatid rearrangements in Chinese hamster ovary cells (Kao & Puck, 1971). Special studies on reproduction and teratogenicity Rat The F1b generation of rats raised from parents fed from day 40, meat heat-processed with 0, 200, 1000 and 4000 ppm (0.0%, 0.02%, 0.1%, and 0.04%) sodium nitrite were sacrificed on day 21 and examined. Three control groups were used. Fertility, preimplantation loss and resorptions were in no way affected by nitrite. No difference from controls was seen regarding litter size, sex ratio and mean pup weight. No significant malformations were noted (Carstensen & Hasselager, 1972). Two groups of 12 pregnant rats received either 2000 or 3000 mg/l sodium nitrite in their drinking-water, a group of seven pregnant rats was the control. Anaemia was found in pregnant animals and there was greater mortality of newborn in the groups with nitrite (30% and 53% compared with 6% in controls). Treated pups also gained weight more slowly but had no methaemoglobinaemia. Nitrites were shown to pass the placental barrier (Gruener & Shuval, 1971). Guinea-pig Groups of three to four pregnant guinea-pigs were given 50 mg/kg or 60 mg/kg sodium nitrite s.c. once. Normal pregnancies ensued at the lower level. At the higher dose fetal mortality and abortion occurred within one to four days (Sinha & Sleight, 1971). Groups were given 300 to 10 000 ppm (0.03-1%) nitrite in their diet. Male fertility was unimpaired as all groups conceived. Food, water consumption, weight gain were normal except animals on 10 000 ppm (1%) which showed very reduced weight gain. No live births occurred at and above 5000 ppm (0.5%) and maternal deaths, abortions, fetal resorptions and mummification were seen. Histology showed degenerative placental lesions and inflammation of the uterus and cervix. No significant alterations in serum nitrite, blood urea or serum potassium were seen but haemoglobin was slightly reduced at higher levels. Methaemoglobin did not exceed 20% (Sleight & Atallah, 1968). Cattle Cows, pregnant two months, were given nitrite in their diet to produce 40-50% methaemoglobinaemia until they calved or aborted. Only one abortion occurred, the rest had normal pregnancies. No gross pathology was seen (Winter & Hokanson, 1964). Acute toxicity LD50 Animal Route (mg/kg bw) Reference Mouse oral 220 Greenberg et al., 1945 Mouse - female oral 175 Lehman, 1958 Rat - female oral 85 Lehman, 1958 Sodium nitrite has been used for therapeutic purposes as a vasodilating agent in dosages of 30-120 mg. The acute effects of nitrite include vasodilatation, lowering of blood pressure, reduction of vitamin A stores in the liver and disturbances of thyroid function. Dogs given a single dose of 1-2 mg/kg sodium nitrite in sausage showed a rise in respiration and heart rate, changes in ECG, methaemoglobinaemia within one to two hours, a rise in serum sodium, fall in serum potassium and a rise in SGOT (Myasnikov & Pravosudov, 1966). Short-term studies Mouse When mice were given sodium nitrite in their drinking-water at 0, 100, 1000, 1500 and 2000 mg/l their motor activity decreased especially at the highest level (Gruener & Shuval, 1971). Rat Rats given 0, 100, 300 and 2000 mg/l sodium nitrite in their drinking-water for two months showed in their EEG increased frequencies of background waves at the highest level and slightly reduced frequencies at lower levels. At all levels there was paroxysmal outbursts not seen in pretreatment period. After four months observation following treatment only the animals at the 100 mg/l level returned to normal EEGs, all higher levels continued to show EEG abnormalities (Gruener & Shuval, 1971). Rats given in their drinking-water for 200 days nitrite at levels of intake of 170 and 340 mg/kg/day showed methaemoglobinaemia, raised haematocrit, no Heinz bodies, raised spleen weights in females, raised heart weights in males, some changes in liver weight in females and in kidney weights of both sexes (Musil, 1966). Rats were fed a sodium nitrite supplement for a period up to 168 days. One rat received a total of 167 mg of sodium nitrite in 121 days. This represents 93 ppm (0.0093%) in the daily diet. No effects on growth or on the weights of important organs were noted (Tarr & Carter, 1942). Cat In a similar experiment with cats, one animal received a total of about 4100 mg of sodium nitrite during a period of 105 days. This represents approximately 390 ppm (0.039%) in the daily diet. No effects on the growth rate or on the weight of important organs were noted. No histopathological examination has been reported on any animal fed with nitrite (Tarr & Carter, 1942). Long-term studies Rat The continuous administration of sodium nitrite in the drinking- water at the rate of 100 mg/kg bw daily over the whole life span and in three successive generations (95 rats) resulted in spite of the high dosage (67% of the acute LD50) in only a slight inhibition of growth (10-20%) and in a shortening of the median life span from 740 to 640 days. Reproduction was normal. Neither the blood picture nor the organs showed any ill effects. The number of tumours observed in the test group (one thymoma and one hepatoma) was not greater than in the control group. Cumulative toxic effects were not observed (Lehman, 1958). Six groups of 30 male and 30 female rats were given standard diet (control) or 40% meat (control) or 40% meat heat-processed with 0.5% sodium nitrite, 0.5% sodium nitrate and 1% gluconodeltalactone, 0.02% sodium nitrite and 1% gluconodeltalactone for 116 weeks. Body weight was lower in the group with 0.5% sodium nitrite with or without GDL. Food intake was not affected anywhere. Behaviour was normal in all groups. Mortality rose equally in all groups after 18 months. No adverse effects on haematology were seen except that red cell counts were lower in the nitrite groups. BSP, SGPT and drug-metabolizing enzymes showed no evidence of liver damage. Spontaneous tumour incidence was high but no significant rise in organ tumours likely to be caused by nitrosamines appeared. DNA of liver cells nuclei was not increased, the ratio diploid/tetraploid cells was normal and alpha- feto-proteins in serum showed no evidence of liver tumours. The diet with 40% meat treated with 0.5% nitrite is equivalent to 20 ppb nitrosamines (= 1 mg/kg per day) (van Logten et al., 1972). The F1A generations of rats raised from parents fed from day 40 with meat heat-processed with 0, 200, 1000 and 4000 ppm (0.0, 0.02, 0.1 and 0.4%) sodium nitrite have been kept on diets containing 46% similarly treated meat as the sole protein source. The groups consist of 340, 120, 120 and 132 males and females and the minimum age so far is 583 days (Poulsen, 1973). Rats were fed 0.2% sodium nitrite for 18 months without adverse effects (Lijinsky, 1971). In another study five groups of eight male rats were given tap water or 5 mg/kg, 50 mg/kg, 100 mg/kg and 150 mg/kg sodium nitrite in their drinking-water for 24 months. There were no significant differences regarding growth, haemoglobin levels, blood glucose, pyruvate and lactate, methaemoglobin was about 5%, 10% and 20% in the highest levels and slightly raised for two months only at the 5 mg/kg level. Histopathology showed bronchopneumonia in a dose-related manner (non-SPF animals) and the highest group showed foci of myocardial degeneration. In all test groups but especially at the highest level the coronary vessels were thin and dilated (Gruener & Shuval, 1971). Long-term feedings studies in rats with nitrite-cured meat are in progress in the FDA (FDA, 1972). Groups of between 96-159 rats and 16-40 hamsters received 0 or 1000 ppm sodium nitrite in the diet for up to 129 weeks (rats) or 110 weeks (hamsters). Several groups received various concentrations of morpholine in addition to nitrite. A significant increase in the incidence of lymphoreticular tumours was found in the group of rats receiving nitrite alone but this was probably coincidental since no similar increase occurred in groups receiving morpholine in addition. The presence of nitrite in the diet of hamsters was not associated with an increased tumour incidence (Shank & Newborne, 1976). OBSERVATIONS IN MAN Many cases have been reported of accidental poisoning resulting from the presence of sodium nitrite in food products. From this information it is possible to deduce that the oral lethal dose in man varies from 0.18 to 2.5 g, the lower figures being those for children and old people (Naidu & Venkratrao, 1945; Greenberg et al., 1945; Schmidt et al., 1949; Schrader & Gessner, 1943). The presence of nitrite in human saliva has been known for many years. The concentrations found are fairly consistent (usually between 6 and 10 ppm) and do not appear to be influenced by the composition of the meals consumed by the individuals studied. This nitrite is thought to originate from microbial reduction of nitrate, naturally present in saliva (Tannenbaum et al., 1974). Other observations have shown that consumption of vegetables rich in nitrate sometimes raised salivary nitrite concentrations to levels of several hundred ppm (Ashiwata et al., 1975). Comments The dose causing inhibition in the long-term studies cited, appears to give the best approximation to the threshold dose level. From the studies referred to and from others in the literature it is evident that (a) many N-nitroso compounds are carcinogenic in several species of animal, (b) N-nitroso compounds can be formed when nitrites and secondary amines are incubated at pH 1-3 (as exists in the human stomach), (c) N-nitroso compounds formation from nitrites and amines occurs in vivo, and (d) N-nitroso compounds have been reported as reaction products of nitrites and food components. While there are indications of a dose-response relationship in N-nitroso compounds induced tumour formation, a no-effect level for N-nitroso compounds has not yet been established. The possibility of N-nitroso compound formation in food or in animals does not depend solely on added nitrite. Some nitrate occurs naturally in many foods and may be converted to nitrite by micro- organisms. Nitrite also occurs in human saliva at 10 ppm or much higher concentrations. Nitrites are important as food additives mainly because of their ability to inhibit growth and toxin formation of Clostridium botulinum. This must be weighed against the potential risk associated with their role in N-nitroso compound formation. Examination of reports of a WHO task group and the IARC on N-nitroso compounds did not lead the Committee to change its evaluation. EVALUATION Level causing no toxicological effect From consideration of the long-term studies it can be concluded that this level was judged to be somewhat below 100 mg/kg bw per day. Estimate of acceptable daily intake for man1 0-0.2 mg/kg bw.2 Further work required These compounds should be kept under regular review of future meetings as new information becomes available. 1 Temporary. The Committee agreed that experimental data available on nitrite were sufficient to recommend an ADI for nitrite per se. Nevertheless, because of potential nitrosamine formation when nitrite is consumed or incorporated into food, it was recommended that the ADI should be temporary. The "temporary" status also reflected the Committee's view that the subject should be reviewed continually. However, evidence from some studies in which nitrite treated food containing nitrosamines at realistic levels failed to induce an increase in cancer incidence when fed to animals, gave reassurance that recommendation of an ADI was justified. More studies of this type are desirable. 2 Food for babies less than six months old should not contain added nitrite. REFERENCES Alam, B. S., Saporoschetz, I. B. & Epstein, S.S. (1971a) Nature, 232, 116 Alam, B. S., Saporoschetz, I. B. & Epstein, S.S. (1971b) Nature, 232, 199-200 Ashiwata, H., Boritoon, P., Nakamura, Y., Harada, M., Tanimura, A. & Ashidata, M. (1975) J. Fod. Hyg. Soc. Japan, 16, 19 Brüggemann, J. & Tiews, J. (1964) Int. Z. 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See Also: Toxicological Abbreviations