29. Sulfites

  1. Dean D. Metcalfe MD3,
  2. Hugh A. Sampson MD4,
  3. Ronald A. Simon MD5,6 and
  4. Gideon Lack MBBCh (Oxon), MA (Oxon), FRCPCH7
  1. Steve L. Taylor1,
  2. Robert K. Bush2 and
  3. Julie A. Nordlee1

Published Online: 24 FEB 2014

DOI: 10.1002/9781118744185.ch29

Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition

Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition

How to Cite

Taylor, S. L., Bush, R. K. and Nordlee, J. A. (2013) Sulfites, in Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition (eds D. D. Metcalfe, H. A. Sampson, R. A. Simon and G. Lack), John Wiley & Sons Ltd, Chichester, UK. doi: 10.1002/9781118744185.ch29

Editor Information

  1. 3

    Chief, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

  2. 4

    Kurt Hirschhorn Professor of Pediatrics, Dean for Translational Biomedical Sciences, Director, Jaffe Food Allergy Institute Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA

  3. 5

    Head, Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, CA, USA

  4. 6

    Adjunct Professor, Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, CA, USA

  5. 7

    Professor of Paediatric Allergy, King's College London Clinical Lead for Allergy Service, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK

Author Information

  1. 1

    Food Allergy Research and Resource Program, Department of Food Science and Technology, University of Nebraska, Lincoln, NE, USA

  2. 2

    Division of Allergy, Immunology, Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

Publication History

  1. Published Online: 24 FEB 2014
  2. Published Print: 10 DEC 2013

ISBN Information

Print ISBN: 9780470672556

Online ISBN: 9781118744185



  • sulfite;
  • asthma;
  • diagnosis;
  • symptoms;
  • exposure;
  • food;
  • pharmaceuticals;
  • prevalence;
  • mechanism;
  • avoidance


Sulfites are commonly used additives in foods and pharmaceutical products. The ingestion of sulfites with foods or pharmaceutical products has been reported to elicit adverse reactions in sensitive individuals. Other routes of administration (inhalation, conjunctival, intravenous) have also been associated with adverse reactions to sulfites in pharmaceutical products. While many symptoms have been reported in association with sulfite ingestion (urticaria, contact dermatitis, anaphylaxis, gastrointestinal complaints, etc.), asthma is the most well-documented symptom. The diagnosis is optimally based upon blinded oral challenge with an assessment of decreased lung function. Sulfite-induced asthma occurs in less than 5% of asthmatic individuals and those individuals with severe, persistent asthma are at highest risk. Sulfite-induced asthma has caused several fatal reactions. Concerns about sulfites led the U.S. Food and Drug Administration to restrict sulfite use on fresh fruits and vegetables (in restaurants) and to implement clearer labeling of sulfites in foods.