INTERNATIONAL PROGRAMME ON CHEMICAL SAFETY WORLD HEALTH ORGANIZATION SAFETY EVALUATION OF CERTAIN FOOD ADDITIVES AND CONTAMINANTS WHO FOOD ADDITIVES SERIES: 44 Prepared by the Fifty-third meeting of the Joint FAO/WHO Expert Committee on Food Additives (JECFA) World Health Organization, Geneva, 2000 IPCS - International Programme on Chemical Safety SODIUM IRON ETHYLENEDIAMINE TETRAACETIC ACID (EDTA) First draft prepared by Dr J.B. Greig Joint Food Safety & Standards Group, Department of Health, London, United Kingdom Explanation Biological data Toxicological studies Acute toxicity Short-term studies of toxicity Genotoxicity Developmental toxicity Special study of nutrition Observations in humans Comments Evaluation References 1. EXPLANATION The sodium iron salt of ethylenediamine tetraacetate (EDTA) was evaluated by the Committee at its forty-first meeting (Annex 1, reference 107), which provisionally concluded that sodium iron EDTA that met the tentative specifications prepared at the meeting would not present a safety problem when used in supervised food fortification programmes in iron-deficient populations. The Committee requested the results of additional studies to assess the site of deposition of iron administered in this form and to assess the metabolic fate of sodium iron EDTA after long-term administration. The Committee emphasized that its evaluation applied only to the use of sodium iron EDTA as a dietary supplement to be used under supervision, and expressed its concern about the potential for over-fortification of food because of the enhanced bioavailability of iron in this form. Several studies were submitted for consideration at the present meeting in response to the Committee's request. 2. BIOLOGICAL DATA 2.1 Toxicological studies 2.1.1 Acute toxicity A summary report of the results of determinations of the LD50 of sodium iron EDTA in rats and mice was submitted (Sichuan Provincial Sanitary and Anti-epidemic Station, 1998). 2.1.2 Short-term studies of toxicity Rats The experiment described below was conducted according to the OECD principles of GLP. After a pilot experiment, groups of 40 male Sprague-Dawley Crl:CD(R) BR rats aged five to six weeks were fed diets containing iron in the form of sodium ferric EDTA or ferrous sulfate heptahydrate (FeSO4) to provide iron at concentrations of 35, 70, or 140 mg/kg of diet. The mean daily intakes of iron at the low, intermediate, and high doses were 2.8, 5.7, and 12 mg/kg bw per day with FeSO4 and 2.8, 5.7, and 11 mg/kg bw per day with sodium iron EDTA. The animals were fed the diet for 31 days, at which time 20 animals in each group were killed, while the remaining 20 were continued on the diet for a further 30 days. A group of 10 untreated male rats were killed at the start of the experiment to establish the baseline levels of the parameters that were to be measured. The toxicolo-gical end-points that were studied included clinical signs, body weights, organ weights, food consumption, food conversion efficiency, haematological and clinical chemical end-points, and the pathological appearancce of the liver, spleen, and any gross lesions. The distribution of iron was evaluated by determining iron and total iron-binding capacity in plasma and non-haem iron in the liver, spleen, and kidneys. No deaths occurred during the experiment, and the clinical signs observed are commonly seen in laboratory rats. Occasional statistically significant changes in food consumption were not obviously related to treatment. Food conversion efficiency was variable but showed some small, statistically significant changes during the first four weeks. The iron content of the diets was within 10% of the intended value in 25 of the 26 batches prepared for both the pilot and main experiments, but the content of the 26th batch was 13% lower than the intended 70 mg/kg of iron. Administration of either FeSO4 or sodium iron EDTA resulted in increased non-haem iron concentrations in the liver, spleen, and kidney when compared with the baseline values after 31 or 61 days of feeding, and the changes were related to dose except in the spleen at 61 days. The non-haem iron concentra-tion in these organs resulting from administration of sodium iron EDTA was always either significantly lower or not significantly different from the concentration resulting from administration of FeSO4. The plasma iron concentration was statistically significantly higher after 31 days of the low dose of sodium iron EDTA than after the intermediate dose, but no other significant difference was seen at 31 or 61 days. There were no statistically significant differences in the total iron-binding capacity of blood plasma after 32 days of feeding, and the statistically significant differences seen at 62 days were minor and unrelated to administered dose or the iron compound. After 31 days of feeding, there were no statistically significant differences in terminal body weight or absolute or relative organ weights in treated animals. At 61 days, the absolute and relative thymus weights of rats given the low dose of sodium iron EDTA were significantly higher than those at the low dose of FeSO4 or at the other doses of sodium iron EDTA. No other significant changes in body weight or organ weight were observed. The haematological examinations showed a statistically significant difference in the mean corpuscular haemoglobin concentration at 32 days only between rats given sodium iron EDTA and those given the low dose of FeSO4, but the difference was less than 1.5% and no difference was seen between individual groups treated with sodium iron EDTA or at 62 days. At 32 days, animals given the high dose of sodium iron EDTA also had a statistically significantly increased eosinophil count, but it did not appear to be related to treatment or dose. No significant changes were found in any group at 62 days. Some inconsistent changes were seen in clinical chemical end-points in blood plasma collected on days 32 and 62. The activity of alkaline phosphatase was greater in all groups at day 32 than at day 62 and was greater in the FeSO4-treated groups than in those given sodium iron EDTA; although statistically significant differences were seen, there was no evidence of a dose-response relationship and the effect had disappeared by 62 days. A statistically significant increase in total bilirubin occurred at 32 days in the group given the intermediate dose of FeSO4, but no effect was seen at 62 days. Statistically significant differences in sodium ion concentration at 32 and 62 days and in chloride ion concentration at 32 days did not appear to be related to biologically significant changes. An apparently dose-related decrease in calcium ion concentration in both treated groups at 62 days was considered by the study authors to be associated with observed changes in albumin and hence total protein concentrations. Whereas liver damage might have been a cause of the decreased plasma albumin concentration, the absence of any other indicators of liver damage (such as liver-derived plasma enzyme activities and histological changes) led the study authors to conclude that the changes were of no toxicological significance. Histopathological examination of sections of the liver and spleen stained with haematoxylin and eosin did not reveal any dose-or treatment-related changes. Such observations as were made were considered to be unremarkable and occurred either sporadically or with a uniform distribution across all groups. At 32 days, the accumulation of iron did not result in a positive Prussian blue reaction in stained sections of the liver. A general increase was seen in the spleen in all groups, but the reaction tended to be confined to the red pulp and was classified as very slight to slight, although increased staining tended to be found in spleens from the groups fed the doses providing high concentrations of iron. At 62 days, the Prussian blue staining of the liver sections did not suggest a dose-or treatment-related effect. The changes seen in the spleens of all animals generally suggested a dose-and time-related increase in staining, with no evidence of a difference between the groups fed FeSO4 and sodium iron EDTA (Appel, 1999). A summary report of a 90-day study in rats given sodium iron EDTA in the diet was submitted (Su et al., 1999). 2.1.3 Genotoxicity A summary report of the results of tests for genotoxicity in vitro and in vivo was submitted (Sichuan Provincial Sanitary and Anti-epidemic Station, 1998). Table 1. Results of assays for the genotoxicity of sodium iron ethylenediamine tetraacetic acid (EDTA) End-point Test object Concentration Result Reverse S. typhimurium TA97a, Not reported Negativea mutation TA98, TA100, TA102, TA1535, TA1537, TA1538 Gene mutation Tk locus in mouse 0.03-325 mg/ml Positive and lymphoma L5178Y cells as Fe cytotoxic with S9; negative without S9 From Dunkel et al. (1999); sodium iron EDTA of 98% purity was used. S9, 9000 × g supernatant of rat liver 2.1.4 Developmental toxicity A summary report of the results of a study of teratogenicity in rats of sodium iron EDTA was submitted (Sichuan Provincial Sanitary and Anti-epidemic Station, 1998). 2.1.5 Special study of nutrition Rats Eight groups of eight weanling male Sprague-Dawley rats weighing about 45 g were randomized to receive a zinc-sufficient diet containing zinc at 30 mg/kg of diet or a zinc-deficient diet containing zinc at 6.1 mg/kg of diet. Three of the groups in each of these two blocks were fed a diet containing sodium iron EDTA, while the diet of the other group contained FeSO4. The iron content of all diets was 50.1 mg/kg, but two groups fed sodium iron EDTA in each block received a further dose of 300 or 800 mg/kg diet. After receiving the diets for 18 days, the animals were transferred to metabolism cages for three days to allow study of the balance of calcium, copper, and zinc. Animals that did not eat normally during this period were removed from the analysis, and, on day 21, all animals were killed and the right femur removed for analysis of calcium and zinc. The rats given the zinc-sufficient diets ate significantly more food, gained more weight, and had a higher femur zinc content than those given the zinc-deficient diets. Changing from FeSO4 to sodium iron EDTA had no significant effect on the zinc-sufficient rats but resulted in a significant increase in food intake and body-weight gain. Increasing the EDTA content of the diet significantly but inconsistently reduced the femur zinc content of the zinc-sufficient rats, while in the zinc-deficient rats increasing the EDTA content reduced both food intake and body-weight gain with no significant change in femur calcium or zinc content. Zinc absorption (intake minus faecal excretion) and retention (intake minus (faecal excretion plus urinary excretion)) were both greater in the rats given the zinc-deficient diet. Fortification with sodium iron EDTA increased both parameters and also urinary zinc excretion, although only the latter appeared to be related to the dose of EDTA. The dietary intake of zinc, the nature of the iron compound used to supplement the diet, and the concentration of EDTA had no marked effect on the absorption or excretion of either copper or calcium except for a small but significant dose-related effect of EDTA concentration on urinary calcium excretion (Hurrell et al., 1994). 2.1.6 Observations in humans The effect of various ratios of disodium EDTA to FeSO4 on the absorption of isotopically labelled FeSO4 was studied in 127 women, some of whom had depleted iron stores and some of whom were also anaemic. At molar ratios of EDTA:Fe of 1-0.25, the absorption of iron from a meal with low iron bioavaila-bility was increased (MacPhail et al., 1994). In a random, cross-over study, 10 healthy women aged 23-49 and weighing 40-70 kg received diets fortified with 10 mg Fe from either FeSO4 or sodium iron EDTA for 14 days, starting after a period of menstruation and with an interval of about four weeks. Other than the addition of sugar, butter, or jam to match the caloric requirements of each subject, each received a basal diet, and all of the water that was drunk was ultra-pure. The first five days of each arm of the study were used for dietary adaptation, and then a six-day chemical balance study was carried out in the course of which stable isotope-labelled calcium and zinc were administered. Significant enhancement of apparent zinc absorption was seen with sodium iron EDTA as compared with FeSO4 (34 ± 17% (SD) and 21 ± 4.4%). Urinary zinc excretion was also significantly increased, but the difference in zinc retention was not significant. Absorption of isotopic calcium was not affected by the iron compound used, although a small but statistically significant increase in urinary excretion of isotopic calcium was confirmed in the chemical balance study. Overall, no significant negative effect of sodium iron EDTA on the uptake and excretion of zinc was observed (Davidsson et al., 1994). After an overnight fast, test meals containing 5 mg of Fe as either FeSO4 or sodium iron EDTA and a radioisotopic 59Mn tracer were administered to one man and nine women, one of whom was post-menopausal. The activity of 59Mn excreted in urine was measured in seven consecutive 24-h samples, and whole-body retention of 59Mn was measured on days 0, 1, 2, 3, 4, 5, 6, 10, 14, 17, 21, 27, and 28. On day 28, the second arm of the cross-over study was started with feeding of the other iron compound and a second tracer dose of 59Mn in a similar protocol. No statistically significant difference in manganese retention or urinary excretion was seen with the two iron compounds (Davidsson et al., 1998). A double-blind intervention study was carried out in Guatemala over 32 months to test the efficacy in controlling iron deficiency of the addition of sodium iron EDTA to sugar. The study was carried out on a community basis and had been planned to involve two highland and two lowland communities of populations ranging from 1144 to 1726, with one community in each area as controls. It had been planned to obtain an age-and sex-stratified sample of 318 persons from each community for detailed dietary, parasitological, haematological, and biochemical studies. The detection of a high prevalence of anaemia in one of the planned control communities, however, resulted in its conversion to a treatment community. Additionally, although the initial response rates in the communities were 54-78%, application of exclusion criteria resulted in failure to achieve the target basal numbers. There were additional losses of subjects during the study. The sugar supply of the treated communities, which was already supplemented with vitamin A, was further fortified with sodium iron EDTA at 1 g/kg sugar, equivalent to an Fe concentration of 130 mg/kg sugar. Dietary surveys during the study showed that the mean (± SD) individual sugar intake ranged from 35 ± 16 to 38 ± 24 g/day. Biochemical measures of indicators of iron status--haemoglobin concentration, saturation of serum iron-binding capacity, free erythrocyte protoporphyin concentration, serum ferritin concentration, and iron store mass--were reported from the basal and final surveys. The changes observed indicated an improvement in iron status in the treated populations, with a reduction in iron-deficiency erythropoiesis. The authors reported that forti-fication of sugar with sodium iron EDTA resulting in the absorption of iron at 0.95-3.1 mg/day had no adverse effects on people of each sex of various ages (Viteri et al., 1995). 3. COMMENTS A study specifically designed to address the Committee's concerns involved feeding male rats diets containing iron in two forms, FeSO4 and sodium iron EDTA, each at three doses, for 62 days. The dietary concentrations provided iron intakes of 2.8, 5.7, and 11 mg/kg bw per day (sodium iron EDTA) or 12 mg/kg bw per day (FeSO4). Generally, there was a dose-related increase in the amount of non-haem iron stored in liver, spleen, and kidney, but smaller or equal amounts of iron were taken up from the sodium iron EDTA-containing diet in comparison with that containing FeSO4. There was no evidence that the total iron-binding capacity of blood plasma was altered by treatment with sodium iron EDTA. The Committee therefore concluded that there was no evidence that administra-tion of iron in the form of sodium iron EDTA would result in greater uptake of iron than from an equivalent dietary concentration of FeSO4 once the nutritional requirement for iron is satisfied. There was no evidence of adverse effects at the highest daily intake of iron, 11 mg/kg bw, which is 55 times greater than the proposed daily human intake of 0.2 mg/kg bw in food fortification programmes. Short-term studies in rats and humans have shown no adverse effects of dietary intake of sodium iron EDTA on the balance of other minerals such as calcium, copper, manganese, and zinc. The results of an intervention study in iron-deficient populations in Guatemala demonstrated the efficacy of a diet supplemented with sodium iron EDTA in reducing the prevalence of iron deficiency in humans. 4. EVALUATION The Committee considered that the data submitted satisfied its concerns about the use of sodium iron EDTA in food fortification programmes. It was aware of the results of studies of the acute toxicity, mutagenicity, teratogenicity, and 90-day toxicity in rats of sodium iron EDTA. Full reports of these studies were not available, but the information was not considered necessary for evaluating the safety of this compound. The Committee also received an assessment of the potential intake of sodium iron EDTA by consumers in the United States that would result from fortification of foodstuffs. The Committee was of the view that this assessment was not relevant to any proposed use of sodium iron EDTA as a food fortifier in areas of iron deficiency. The Committee concluded that sodium iron EDTA could be considered safe for use in supervised food fortification programmes, when public health officials had determined the need for iron supplementation of the diet of a population. Such programmes would provide daily iron intakes of approximately 0.2 mg/kg bw. 5. REFERENCES Appel, M.J. (1999) A feeding study to examine the disposition and accumulation of iron fed as sodium iron EDTA in rats. Unpublished report No. V99.426 from TNO Nutrition and Food Research Institute, Zeist, The Netherlands. Submitted to WHO by the International Life Sciences Institute. Davidsson, L., Kastenmayer, P. & Hurrell, R.F. (1994) Sodium iron EDTA [NaFe(III)EDTA] as a food fortificant: The effect on the absorption and retention of zinc and calcium in women. Am. J. Clin. Nutr., 60, 231-337. Davidsson, L., Almgren, A. & Hurrell, R.F. (1998) Sodium iron EDTA [NaFe(III)EDTA] as a food fortificant does not influence absorption and urinary excretion of manganese in healthy adults. J. Nutr., 128, 1139-1143. Dunkel, V.C., San, R.H.C., Seifried, H.E. & Whittaker, P. (1999) Genotoxicity of iron compounds in Salmonella typhimurium and L5178Y mouse lymphoma cells. Environ. Mol. Mutag., 33, 28-41. Hurrell, R.F., Ribas, S. & Davidsson, L. (1994) NaFe3+EDTA as a food fortificant: Influence on zinc, calcium and copper metabolism in the rat. Br. J. Nutr., 71, 85-93. MacPhail, A.P., Patel, R.C., Bothwell, T.H. & Lamparell, R.D. (1994) EDTA and the absorption of iron from food. Am. J. Clin. Nutr., 59, 644-648. Sichuan Provincial Sanitary and Anti-epidemic Station (1998) Acute toxicity, mutagenicity and teratogenicity of NaFeEDTA in rats and mice. Translation of unpublished report submitted to WHO by J. Chen. Su, Y.L., Chen, Z.L., Zhang, J. & Jiang, Z.C. (1999) A 90-day rat study on subchronic toxicity of NaFeEDTA. Translation of unpublished report submitted to WHO by J. Chen. Viteri, F.E., Alvarez, E., Batres, R., Torún, B., Pineda, O., Mejia, L.A. & Sylvi, J. (1995) Fortification of sugar with iron sodium ethylenediaminotetracetate (FeNaEDTA) improves iron status in semirural Guatemalan populations. Am. J. Clin. Nutr., 61, 1153.
See Also: Toxicological Abbreviations