IODIZED SALT WEDNESDAY, JUNE 11, 1947 HOUSE OF REPRESENTATIVES, SUBCOMMITTEE OF THE COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE, Washington, D. C. The subcommittee met at 10 a. m., pursuant to call, in room 1334, New House Office Building, Hon. Robert Hale presiding. Mr. HALE. The committee will come to order. The committee convened for the purpose of holding hearings on H. R. 2717, introduced by Mrs. Bolton, of Ohio, a bill to amend section 301 of the Federal Food, Drug and Cosmetic Act, so as to prohibit the introduction into interstate commerce of salt, for table use, not having a required content of iodides. (H. R. 2717 above referred to is as follows:) [H. R. 2717, 80th Cong., 1st sess.] A BILL To amend section 301 of the Federal Food, Drug and Cosmetic Act, so as to prohibit the introduction into interstate commerce of salt, for table use, not having a required content of iodides Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That paragraph (a) of section 301 of the Federal Food, Drug and Cosmetic Act, as amended (U. S. C., 1940 edition, title 21, sec. 331), is hereby amended by inserting "(1)" after "interstate commerce" and by striking out the period at the end of such paragraph and inserting a comma and the following: "or (2) of salt (sodium chloride) sold or to be sold for table use, unless it contains suitable iodides in a quantity equivalent to not less than 80 parts and not more than one hundred and sixty parts of iodine per million parts of such salt." SEC. 2. The amendment made by this Act shall take effect on the thirtieth day after the date of the enactment of this Act. Mr. HALE. The committee has received from the Federal Security Agency a report on the bill H. R. 2717, which will be made a part of the record at this point. (The letter from FSA is as follows:) Hon. CHARLES A. WOLVERTON, FEDERAL SECURITY AGENCY, Chairman, Committee on Interstate and Foreign Commerce, House of Representatives, Washington 25, D. C. DEAR MR. CHAIRMAN: Your letter of March 24, 1947, requested that we submit a report on H. R. 2717, a bill "To amend section 301 of the Federal Food, Drug, and Cosmetic Act, so as to prohibit the introduction into interstate commerce of salt, for table use, not having a required content of iodides." The bill would require the salt to contain suitable iodides in a quantity equivalent to not less than 80 parts and not more than 160 parts of iodine per million parts of such salt, and would become effective. 30 days after its enactment. 1 We believe that the enactment of Federal legislation requiring iodization of table salt is desirable as a public health measure in this country. Iodized salt has been used on a voluntary basis for many years for the purpose of preventing goiter. This has required continued educational efforts on the part of health authorities to secure widespread use of iodized table salt. In spite of these methods, uniodized table salt continues to have a widespread sale. Experts on the subject are convinced that the universal use of iodized table salt would be a desirable move toward the prevention of goiter in this country. Surveys have shown that goiter continues to be a very common condition. Experts also state that the quantity of iodine proposed in the bill is sufficient to exert a beneficial effect on the prevention of goiter and is still so small that there is no health danger involved. It may be regarded as a procedure which returns to purified table salt a trace of iodine such as is present in some natural sources. We understand that legislation of this character has the endorsement of the American Public Health Association, the American Medical Association, and the Food and Nutrition Board of the National Research Council. While we recommend the enactment of legislation embodying the general objectives of H. R. 2717, we would like to suggest certain changes in the bill which would render it more effective to achieve those objectives. As now written, the proposed bill would restrict regulatory action against the violative product to criminal prosecutions and injunctions. The seizure provisions of the Food, Drug and Comestic Act would not apply because table salt without iodides would not, under the proposed bill, be adulterated or misbranded. It appears further that criminal penalties for violations might easily be avoided. Section 303 (c) of the Federal Food, Drug and Cosmetic Act provides that no person shall be subject to the penalty for violating section 301 (a) of the act if he establishes a guaranty that the article is not adulterated or misbranded. interstate shipper of uniodized salt might obtain a guaranty from a person who produces the salt and thus not be subject to penalty. The issuer of the guaranty would not have violated section 301 (h) of the act, since the guaranty that the article was not adulterated or misbranded would not be false. An The proposed legislation could be more effectively and fairly administered and enforced if the bill were to define table salt failing to contain the prescribed amounts of iodine, as misbranded. This could be accomplished by adding a new paragraph to section 403 of the Food, Drug and Cosmetic Act, after paragraph (k) as follows: "(1) If it is salt (sodium chloride) sold or to be sold for table use, unless it contains suitable iodides in a quantity equivalent to not less than 80 parts and not more than 160 parts of iodine per million parts of such salt." We presume that it is not the intention of the proponents of the bill to exempt table salt from other reasonable requirements for such a food which might be provided through the establishment of standards under section 401 of the act. In order to remove all doubt on this score, it would be desirable for the committee to include in its report on the bill a declaration of congressional intent, such as that "nothing in this act shall be construed as preventing the Administrator from establishing a definition and standard of identity and standards of quality and fill of container for table salt, consistent with the provisions of this act and in accordance with the provisions of section 401 of the Federal Food, Drug and Cosmetic Act." As we interpret the proposed bill, it would not exempt table salt containing the prescribed amount of iodine from the present adulteration and misbranding provisions of the law. Some declaration in the committee's 'report to this effect, might also be desirable. With the changes suggested we would favor the enactment of the bill. The Bureau of the Budget advises that there is no objection to the submission of this report to your committee. Sincerely yours, MAURICE COLLINS, Mr. HALE. The Chair will say at the outset that the committee will ask Mrs. Bolton to explain the bill then call other witnesses who are here in behalf of the measure and then the opponents of the measure; but if there are any witnesses in town who are here for the purpose of being heard who desire to get away or who would be inconvenienced by inability to testify today, the Chair will take their personal convenience into consideration. It is hoped that the committee will be able to sit this afternoon, if necessary. Of course, afternoon sessions depend upon the business to be transacted in the House, roll calls, and what not. Mrs. Bolton. STATEMENT OF HON. FRANCES P. BOLTON, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF OHIO Mrs. BOLTON. Mr. Chairman, I very much appreciate the courtesy of the subcommittee in discommoding itself in order to make possible this hearing. Knowing the pressure under which the House is at the moment, I particularly appreciate it from this group. My interest in the iodine situation is of long standing and stems from the fact that so much of our food has had many of the essential parts removed from it. This fact has been recognized by the whole country, by the medical profession. The Army has done a good deal of experimenting. We all know that reinforced bread was needed by the Army as was iodized salt. We know that our refined sugar has had taken out of the sugar many of the things that are necessary, and although I will not go into the technical end of it, but will leave that to the professional men who are here, I do want to register the fact that I have been very deeply interested and aware of these matters for a very long time. The fact that so much of our country is at a great distance from the sea does have an effect upon our food. In our particular section of the country, northern Ohio, Michigan, and all through there, we live in what has been called the "goiter belt" and we have had to be experimenting. Michigan, I think, started it off. The schools in Akron and Cleveland took it up with controlled groups of children, some of them being given the iodine and some not. The result was a dramatic realization that the deficits of iodine in our food were very serious. Since the goiter studies are the basis of this whole matter, I will not go very far afield, but some 19 years ago I spent a good many months at the Peter Bent Bingham Hospital in Boston in close association with the eminent surgeon, Dr. Harvey Cushing, who took care of one of my sons who had broken his neck badly. Dr. Harvey Cushing then was professor of surgery at Harvard and later Sterling professor at Yale. I had a great many talks with him over the possible reasons for cretinism and feeble-minedness. He had grown intensely interested in food lacks in that regard, and had a great deal of knowledge of these food lacks as they pertain to cretins and feeble-minded. Many studies have since been made by different groups in the medical profession. I think you gentlemen already know that any upset to the glandular system of the body is a serious matter for one gland will, of course, put the others all out of whack. Iodine definitely is a necessary ingredient for thyroid which has a tremendous role to play in our normalcy. Perhaps we women are more aware of this than men, because we have to be very conscious of our physical selves, particularly when we are carrying children. We, therefore, know some of those lacks perhaps more dramatically than men do. So it has been of keen interest to me to play what part I can in bringing to pass action which will give all people the infinitesimal amount of iodine everyone needs which the salt producers, in conjunction with the goiter committee of the Public Health group have worked at for so long. As I understand the work that has been done all of these groups have been hoping for the time when there could be a more general use of iodine. Therefore there have been experiments made as to the possible bad effects of this infinitesimal bit of iodine upon people who get it in their foods as do seashore people like the chairman (Mr. Hale) and I think the professional men will bear me out that it has been quite conclusively shown that there are no bad effects also, that this is not a matter of medicinal assistance but that it is a putting back into our food one of the necessary substances which our complex civilization has removed from it. It was, therefore, with a great deal of interest, that I found the goiter committee of the Pubile Health organization had come to the point in their work with the Food and Drug Division at which they found that unless there were some legislation sodium iodide could not be made a regular part of table salt. The bill as written is in a way a very tentative measure thrown out to bring as much information to one point as was possible. I would like to say that I have been deeply appreciative of the cooperation given me by the salt producers and canners and so on, who came to my office for a very interesting conference at which I asked if we could include all salt used in the preparation of food. Should it mean the salt used in processing of foods, and if so what would that do to the canning of foods. It immediately developed that it would make great difficulties for the canners, that much experimentation would have to be required. So I asked them for information as to what, in their judgment, would be its effect on canned food? Would it discolor; would it perhaps affect the lasting qualities? There is a drying agent that is used, you know, and it is more the drying agent that is the problem than the tiny little scrap of iodine. Finding that there would be a very real problem were this required in our whole food preparation at this time, you will see that salt used in the canning industry is not included in my suggestions. I am going to suggest, gentlemen, that there be some changes made in the bill. I will very much appreciate your giving very real thought to a clearer definition of the salt that is involved. It was suggested by the Food and Drug people, and some of the other Government people who have been working with us, that it might be well to define it as "kitchen and table salt used for seasoning." That eliminates it completely from the processing areas. It would be my hope, however, that the canners, in their understanding of the increasing problems of physical defects would set about some research in the matter of canning food which in the near future would make it posible for us to have included the salt used in canned foods upon which so many people live, the required infinitessimal amount of this particular ingredient so necessary to normalcy and health, One of the difficulties in the bill is the last section in which it is suggested that the bill go into effect 30 days after it is passed. I think it is very clear that 30 days is not a workable suggestion and I am hoping that the salt producers will have definite suggestions for the committee in the matter of how much time might be required. Another thing that is involved for them would be the container for what is known as bag salt which is often the cooking salt, and I understand that there has been an airtight container developed for the Army that is quite satisfactory. The producers may have to make a few changes to conform to the legislation, still inasmuch as they have been working toward this end, I feel certain if we can give them the necessary time there will be no hesitation on their part to do their bit for the people of this country. I think those are the main things that I hope the committee will study and perhaps in the language of subcommittees "bring out a clean bill." Among the organizations and associations desiring this legislation are the following: the American Association for the Study of Goiter, American Public Health Association, United States Public Health Service, Food and Drug Administration, Federal Security Agency, American Medical Association, State and Territorial Health Office. Mr. Chairman, may I say that I have taken more time than I intended, I do not anticipate the testimony will take over long. Those who are here are, of course, very anxious to be heard, and I hope that we shall be able to expedite the matter so that there will be no need for an afternoon session. Mr. HALE. Thank you very much, Mrs. Bolton. Are there any questions of Mrs. Bolton? Mrs. BOLTON. Thank you. Mr. HALE. The Chair would like to inquire how many witnesses are here from out of the city. Will any witnesses who are here from out of the city kindly rise so that the Chair will know the number. (A number of people rose.) Mr. HALE. Thank you very much. STATEMENT OF DR. O. P. KIMBALL, CLEVELAND, OHIO Mr. HALE. Dr. Kimball, of Cleveland, Ohio. Will you give us the benefit of your views, Dr. Kimball? Dr. KIMBALL. Mrs. Bolton, Mr. Chairman, and gentlemen of the committee, first, we should define the term "endemic goiter" so that all of us will be thinking of the same thing in this discussion. A goiter is an enlarged thyroid gland. This enlargement is a physiological response to a deficiency of iodine. Each thyroid gland cell enlarges and at the same time changes shape; from a low, flat, single layer to a high columnar type and many cells thick. The hormal thyroid contains iodine, stored as thyroid hormone within the gland. This iodine always amounts to 1 milogram or more per gram of thyroid, and as soon as the iodine content gets below 1 milogram per gram of thyroid, the cellular changes begin and continue as long as there is a deficiency of iodine or to the exhaustion and atrophy of the gland. The cellular changes are properly called cellular hypertrophy and hyperplasia and the enlargement of these millions of cells produce an enlargement (hypertrophy) of the gland, or goiter. As stated above, these cellular changes are always due to a deficiency of iodine. Experimentally, you cannot produce a goiter, if the iodine content is 74353-48- -2 |