Heavy metal and pesticide levels in dairy products: Evaluation of human health risk

Is the milk we drink safe from elevated concentrations of prioritised heavy metals/metalloids? - A global systematic review and meta-analysis followed by a cursory risk assessment reporting

Milk has been globally recognised as a comprehensive and vital food source for centuries. However, the presence of heavy metals and metalloids (metal(loid)s) in milk is a global problem. As metal(loid)s are present in the soil due to natural geogenic and various anthropogenic activities, these metal(loid)s are bio-transferred into animal feed, which further results in the presence of metal(loid)s in milk due to bio transfer/accumulation. This systematic review collated information from published literature between 2000 and 2021. It focused on the global issue of metal(loid)s in milk, posing potential health risks. These contaminants enter the food chain through the bio-transfer/accumulation process from soil to animal feed to milk. The key metal(loid)s examined are arsenic (As), mercury (Hg), lead (Pb), and cadmium (Cd). A meta-analysis of 66 selected papers revealed the widespread presence of these contaminants in milk samples globally, with Pb being the most studied (43 %). This research estimated metal(loid)s levels or concentrations as 12.71 (95 % Confidence Interval (CI) = 0.16-25.26), 16.09 (95 % CI = 4.31-27.70), 197.04 (95 % CI = 75.28-318.18), 31.67 (95 % CI = 20.14-43.20) μg/kg (ppb) for As, Hg, Pb, and Cd, respectively using Stata™. The metal(loid) concentrations in milk were within the threshold limits other than Pb and Cd. Some studies in America, Africa, and Asia reported elevated Pb and Cd concentrations, raising health concerns. The simulated Risk Quotients (RQ) and Integrated Risk Quotient (IRQ) values generally remain above one, indicating potential human health risks. Notably, the IRQ value increases with more metal(loid)s consideration. Subgroup analysis indicates low-fat milk contains higher metal(loid)s concentrations. While metal(loid)s concentrations in milk largely comply with safety limits, some regions exhibit concerning concentrations. Therefore, continued surveillance to address potential health risks associated with metal(loid)s in milk is necessary to ensure dairy products' safety.

DNA damage in inhabitants exposed to heavy metals near Hudiara drain, Lahore, Pakistan

The current study was conducted on the inhabitants living in the area adjacent to the Hudiara drain using bore water and vegetables adjacent to the Hudiara drain. Toxic heavy metals badly affect human health because of industrial environmental contamination. Particularly hundreds of millions of individuals globally have faced the consequences of consuming water and food tainted with pollutants. Concentrations of heavy metals in human blood were elevated in Hudiara drainings in Lahore city, Pakistan, due to highly polluted industrial effluents. The study determined the health effects of high levels of heavy metals (Cd, Cu, Zn, Fe, Pb, Ni, Hg, Cr) on residents of the Hudiara draining area, including serum MDA, 8-Isoprostane, 8-hydroxyguanosine, and creatinine levels. An absorption spectrophotometer was used to determine heavy metals in wate water, drinking water, soil, plants and human beings blood sampleas and ELISA kits were used to assess the level of 8-hydroxyguanosine, MDA, 8-Isoprostane in plasma serum creatinine level. Waste water samples, irrigation water samples, drinking water samples, Soil samples, Plants samples and blood specimens of adult of different weights and ages were collected from the polluted area of the Hudiara drain (Laloo and Mohanwal), and control samples were obtained from the unpolluted site Sheiikhpura, 60 km away from the site. Toxic heavy metals in blood damage the cell membrane and DNA structures, increasing the 8-hydroxyguanosine, MDA, creatinine, and 8-Isoprostane. Toxic metals contaminated bore water and vegetables, resulting in increased levels of creatinine, MDA, Isoprostane, and 8-hydroxy-2-guanosine in the blood of inhabitants from the adjacent area Hudiara drain compared to the control group. In addition,. This study also investigated heavy metal concentrations in meat and milk samples from buffaloes, cows, and goats. In meat, cow samples showed the highest Cd, Cu, Fe and Mn concentrations. In milk also, cows exhibited elevated Cu and Fe levels compared to goats. The results highlight species-specific variations in heavy metal accumulation, emphasizing the need for targeted monitoring to address potential health risks. The significant difference between the two groups i.e., the control group and the affected group, in all traits of the respondents (weight, age, heavy metal values MDA, 8-Isoprostane, 8-hydroxyguaniosine, and serum creatinine level). Pearson's correlation coefficient was calculated. The study has shown that the level of serum MDA, 8-Isoprostane, 8-hydroxyguaniosine, or creatinine has not significantly correlated with age, so it is independent of age. This study has proved that in Pakistan, the selected area of Lahore in the villages of Laloo and Mohanwal, excess of heavy metals in the human body damages the DNA and increases the level of 8-Isoprostane, MDA, creatinine, and 8-hydroxyguaniosine. As a result, National and international cooperation must take major steps to control exposure to heavy metals.

Pesticides and Polychlorinated Biphenyls in Milk and Dairy Products in Croatia: A Health Risk Assessment

The aim of this study was to evaluate contamination levels and the frequency of detection of organochlorine (OCPs) and organophosphate pesticides (OPPs), pyrethroids, carbamates and polychlorinated biphenyls (seven PCB congeners) in a total of 534 samples of cow's, sheep's and goat's milk and dairy products from Croatia. Concentrations above the limit of quantification (LOQ) were measured for fourteen OCPs, nine OPPs, six pyrethroids, one carbamate and PCBs with a total of 172 results, and no concentrations exceeded the maximal residue levels defined by the European Union. The mean concentrations of pesticides and the sum of seven PCBs were determined in the ranges 0.92-17.4 μg/kg and 1.38-2.74 μg/kg. Pesticides were quantified in 27% of samples, and seven PCBs were quantified in 5.23% of samples. Among the three pesticide groups, the highest numbers of quantified results were found for OCPs (12.1-20.8%). The highest frequencies of detection were found for the sum of 4,4'-dichlorodiphenyltrichloroethane and its isomers (DDTs), hexachlorobenzene and seven PCBs. The sum of seven PCBs was quantified within the range of 3.3-6.67% of samples per milk type and dairy products. Among the OPPs, the highest frequency of detection was found for chlorpyrifos in cow's milk. Based on the estimated daily intakes, chronic risk characterisation showed no risk for adults or ten-year-old children for the consumption of cow's milk and dairy products.

Exposure to Nickel-Cadmium Contamination of Drinking Water Culminates in Liver Cirrhosis, Renal Azotemia, and Metabolic Stress in Rats

Drinking water polluted by heavy metals has the potential to expose delicate biological systems to a range of health issues. This study embraced the health risks that may arise from subchronic exposure of thirty-four male Wistar rats to nickel (Ni)-cadmium (Cd)-contaminated water. It was done by using the Box-Behnken design (BBD) with three treatment factors (Ni and Cd doses at 50-150 mg/L and exposure at 14-21-28 days) at a single alpha level, resulting in seventeen experimental combinations. Responses such as serum creatinine (CREA) level, blood urea nitrogen (BUN) level, BUN/CREA ratio (BCR), aspartate and alanine aminotransferases (AST and ALT) activities, and the De Ritis ratio (DRR), as well as malondialdehyde (MDA) level, catalase (CAT), and superoxide dismutase (SOD) activities, were evaluated. The results revealed that these pollutants jointly caused hepatocellular damage by raising AST and ALT activities and renal dysfunction by increasing CREA and BUN levels in Wistar rats' sera (p < 0.05). These outcomes were further supported by BCR and DRR values beyond 1. In rats' hepatocytes and renal tissues, synergistic interactions of these metals resulted in higher MDA levels and significant impairments of CAT and SOD activities (p < 0.05). In order to accurately forecast the effects on the responses, the study generated seven acceptable regression models (p < 0.05) with r-squared values of > 80% at no discernible lack of fit (p > 0.05). The findings hereby demonstrated that Wistar rats exposed to these pollutants at varied doses had increased risks of developing liver cirrhosis and azotemia marked by metabolic stress.

Emerging insights into the impacts of heavy metals exposure on health, reproductive and productive performance of livestock

Heavy metals, common environmental pollutants with widespread distribution hazards and several health problems linked to them are distinguished from other toxic compounds by their bioaccumulation in living organisms. They pollute the food chain and threaten the health of animals. Biologically, heavy metals exhibit both beneficial and harmful effects. Certain essential heavy metals such as Co, Mn, Se, Zn, and Mg play crucial roles in vital physiological processes in trace amounts, while others like As, Pb, Hg, Cd, and Cu are widely recognized for their toxic properties. Regardless of their physiological functions, an excess intake of all heavy metals beyond the tolerance limit can lead to toxicity. Animals face exposure to heavy metals through contaminated feed and water, primarily as a result of anthropogenic environmental pollution. After ingestion heavy metals persist in the body for an extended duration and the nature of exposure dictates whether they induce acute or chronic, clinical or subclinical, or subtle toxicities. The toxic effects of metals lead to disruption of cellular homeostasis through the generation of free radicals that develop oxidative stress. In cases of acute heavy metal poisoning, characteristic clinical symptoms may arise, potentially culminating in the death of animals with corresponding necropsy findings. Chronic toxicities manifest as a decline in overall body condition scoring and a decrease in the production potential of animals. Elevated heavy metal levels in consumable animal products raise public health concerns. Timely diagnosis, targeted antidotes, and management strategies can significantly mitigate heavy metal impact on livestock health, productivity, and reproductive performance.

Heavy metals in meat products from Shandong, China and risk assessment

In this study 13 heavy metals were analysed in representative livestock meat, poultry meat, livestock offal and poultry offal samples (20 per category) from marketplaces and retail stores in 16 cities in Shandong province, China. The investigated heavy metals were Cu, Cr, V, Ni, As, Se, Sn, Cd, Pb, Sb, Mn, Ba and Hg. Results revealed mean levels of total heavy metals in meat and offal of 1.56 mg/kg and 39.8 mg/kg, respectively. Cu, Cr, Mn, Ni, Se, Ba and Pb were found in all samples (100%), followed by Hg (95.0%), V (91.3%), Sn (73.8%), Cd (51.3%), As (21.3%) and Sb (11.3%). Hazard Quotient (HQ) and Hazard Index (HI) values showed that high meat intake can cause potential health risks. Thus, continuous monitoring of health risks and trends of heavy metals in meat products is needed, both for food safety and consumer's health.

Review of the Terminology, Approaches, and Formulations Used in the Guidelines on Quantitative Risk Assessment of Chemical Hazards in Food

This paper reviews the published terminology, mathematical models, and the possible approaches used to characterise the risk of foodborne chemical hazards, particularly pesticides, metals, mycotoxins, acrylamide, and polycyclic aromatic hydrocarbons (PAHs). The results confirmed the wide variability of the nomenclature used, e.g., 28 different ways of referencing exposure, 13 of cancer risk, or 9 of slope factor. On the other hand, a total of 16 equations were identified to formulate all the risk characterisation parameters of interest. Therefore, the present study proposes a terminology and formulation for some risk characterisation parameters based on the guidelines of international organisations and the literature review. The mathematical model used for non-genotoxic hazards is a ratio in all cases. However, the authors used the probability of cancer or different ratios, such as the margin of exposure (MOE) for genotoxic hazards. For each effect studied per hazard, the non-genotoxic effect was mostly studied in pesticides (79.73%), the genotoxic effect was mostly studied in PAHs (71.15%), and both effects were mainly studied in metals (59.4%). The authors of the works reviewed generally opted for a deterministic approach, although most of those who assessed the risk for mycotoxins or the ratio and risk for acrylamide used the probabilistic approach.

New method for risk assessment in environmental health: The paradigm of heavy metals in honey

The release of heavy metals into the natural environment creates problems due to their persistence. They can accumulate in the food chain presenting a dangerous sign for ecosystems and human health. The metals in honey could be of agrochemical or industrial origin. Regular consumption of honey and bee products contaminated with various pollutants in high concentrations can cause serious health problems due accumulation of toxic substances in the body. In the current study, we aimed to determine the concentrations of chromium, cadmium, zinc, copper, lead and nickel in four types of honey (linden, acacia, rapeseed and polyfloral honey) and soil collected from three regions with different degrees of pollution. For the risk characterization, we used a new methodology that calculated the corrected estimated daily intake and the source hazard quotient for each metal and the adversity-specific hazard index. There was a strong influence of the degree of environmental pollution on the level of contaminants in the honey samples. In the case of a single chemical assessment, an HQ above 10 was obtained for Cd in linden, rapeseed and polyfloral honey from area 1 and an HQ above 1 was obtained for Cd in the other honey samples from the 3 areas, for Cu in all honey samples from all the 3 areas, for Pb in linden, rapeseed and polyfloral honey from area 1 and for Cr in linden honey for area 2. HIA calculated as a sum of all HQS of heavy metals in food reveals an increase and moderate risk for nephrotoxicity, bone demineralisation, cardiotoxicity, developmental toxicity, small decrease in body weight or body weight gain after consumption of honey impurified with heavy metals. A strict monitorization of heavy metals in honey samples from farmers should be done in order to protect the consumers.

Human health risk assessment of potentially toxic elements and microplastics accumulation in products from the Danube River Basin fish market

The present study aimed to quantify the concentration levels of potentially toxic elements (PTEs) such as aluminum, arsenic, cadmium, chromium, copper, nickel, lead, zinc, and mercury, as well as microplastics occurrence in various tissues of fish and seafood species, commercialized in the Lower Danube River Basin. A health risk assessment analysis was performed based on the PTEs concentration levels in the muscle tissue. Estimated daily intake (EDI), target hazard quotient (THQ), hazard index (HI), and target cancer risk (TR) of PTEs were calculated. It was observed that the species within the seafood category registered the highest levels of PTEs. For instance, in the muscle tissue of bivalve Mytilus galloprovincialis (from the Black Sea), the highest value was observed in the case of Zn (37.693 mg/kg), and the presence of polystyrene polymer was identified. The values associated with EDI, THQ, HI, and TR of PTE exposure were significantly lower than 1.

Factors Affecting Toxic and Essential Trace Element Concentrations in Cow's Milk Produced in the State of Pernambuco, Brazil

The aim of this study was to provide information on the levels of toxic (Cd and Pb) and essential (Cu, Fe, and Zn) elements in cow's milk produced in the State of Pernambuco (Brazil). A total of 142 samples of raw milk were collected, and the concentrations of essential and toxic elements were determined using inductively coupled plasma-optical emission spectrometry. In almost 30% of the samples analyzed, the Pb content exceeded the maximum level established in the Brazilian legislation (0.05 mg/L). By contrast, in all the samples, the Cd content was below the maximum allowable level (0.02 mg/L). The essential trace elements Cu, Fe, and Zn were generally present at lower concentrations than reported in other studies and can be considered within the deficient range for cow's milk. Statistical and chemometric procedures were used to evaluate the main factors influencing the metal concentrations (proximity to major roads, presence of effluents, and milking method). The study findings demonstrate that the proximity of the farms to major roads influences the concentrations of Cd, Pb, and Cu and that this is the main factor explaining the Pb content of milk. In addition, the presence of effluents influenced the concentrations of Cu, while no relationship between the metal content and the milking method was observed. Thus, in accordance with the study findings, the consumption of cow's milk produced in the region can be considered a risk to public health due to the high concentrations of Pb and the low concentrations of other essential minerals such as Cu, Zn, and Fe in some of the milk samples.

A Study of the Interactions of Heavy Metals in Dairy Matrices Using Fourier Transform Infrared Spectroscopy, Chemometric, and In Silico Analysis

Heavy metals are among the toxic substances longest recognized by man. Today, due to the myriad sources of exposure, such as contaminated water, food, or air, they have become a major public health problem. This work presents the effects manifested in the infrared spectrum behavior caused by the presence of Cd²⁺, Cr⁶⁺, and Pb²⁺ at different concentrations in three different matrices: water, casein, and milk; observing that the spectral modifications in the regions of different vibrational modes of nucleophilic groups such as -OH, COO- and NH₂ depending on the nature of the metal and its concentration. These findings were correlated in-silico using optimized models in Gabedit software and structural optimization was performed with MOPAC 2016 showing stable structures between the metals and Gln, Hys, Glu, and Phe of casein. By applying chemometrics (Principal Component Analysis), it was possible to observe a good correlation between the experimental data and to discriminate between the type of metal, the matrix that contains it, and the concentration could be represented through linear models that showed adjustments with a value of r² ≥ 0.95.

Human health-risk assessment of heavy metal-contaminated soil based on Monte Carlo simulation

Soil contamination soils of by heavy metals (HMs) poses serious threats to the soil environment and enters the human body through exposure pathways such as ingestion and skin contact, posing a threat to human health. The purpose of this study was to analyze the sources and contributions of soil HMs, and to quantitatively assess the human health risks of soil HMs to different populations (i.e. children, adult females and adult males), and to analyze the human health risks caused by various sources of sensitive populations. 170 topsoil (0-20 cm) were collected from Fukang, Jimsar and Qitai on the northern slope of Tianshan Mountains in Xinjiang, China, and the contents of Zn, Cu, Cr, Pb and Hg were determined. This study used the Unmix model and a health-risk assessment (HRA) model to assess the human health risks of five HMs. The results showed that: (1) The mean values of Zn and Cr were lower than the background values of Xinjiang, the mean values of Cu and Pb were slightly higher than the background values of Xinjiang but lower than the national standard, and the mean value of Hg and Pb was higher than the background value of Xinjiang and the national standard. (2) The sources of soil HMs in the region were mainly traffic, natural, coal, and industrial sources. Moreover, the HRA model combined with Monte Carlo simulation showed similar trends in the health-risk status of all population groups in the region. Probabilistic HRA revealed that noncarcinogenic risks were acceptable for all populations (HI < 1) while carcinogenic risks were high (children: 77.52%; female: 69.09%; male: 65.63%). For children, carcinogenic risk from industrial and coal sources exceeded the acceptable threshold by 2.35 and 1.20 times, respectively, and Cr was the main element contributing to human carcinogenic risk. These findings suggest that carcinogenic risks from coal-based Cr emissions cannot be ignored, and the study area should aim to control Cr emissions from industrial sources. The results of this study provide support for the prevention of human health risks and the control of soil HMs pollution across different age groups.

Determination of Heavy Metal Levels and Health Risk Assessment of Raw Cow Milk in Guelma Region, Algeria

During the recent decades, adverse effects of unexpected contaminants, such as heavy metals on raw cow milk quality, have threatened human health. The objective of this study was to determine heavy metal levels in raw milk collected from autochthonous bovine breeds in the eastern region of Algeria. Eighty-eight pooled milk samples were analyzed using atomic absorption spectrometry for Pb, Cd, Cr, Cu, Ni, Fe, and Zn, and dietary risks were estimated for infants, children, and adults with minimum, average, and maximum milk consumption scenarios. Results revealed that Pb (0.94 ± 0.49 mg/kg), Cd (0.03 ± 0.01 mg/kg), and Cu (0.14 ± 0.08 mg/kg) levels in all analyzed samples were higher than their corresponding maximum residue levels (MRLs). The task hazard quotient (THQ) values suggest potential risk for infants in the three scenarios from Pb, Cd, and Cr; for children in the three scenarios from Pb and in the high scenario from Cr; and for adults in the medium and high scenarios from Pb. The hazard index (HI) values were higher than 1, and the contributions of each metal to the overall HI followed a descending order of Pb, Cr, Cd, Ni, Zn, Cu, and Fe with values of 68.19%, 15.39%, 6.91%, 4.94%, 3.42%, 0.88%, and 0.28%, respectively. Our results indicated that there may be a potential risk of heavy metals, especially Pb, for infants through raw cow milk consumption. Moreover, data actualization and continuous monitoring are necessary and recommended to evaluate heavy metal effects in future studies.

Carcinogenic and non-carcinogenic risk assessment induced by pesticide residues in fresh pistachio in Iran based on Monte Carlo simulation

This research is aimed at the analysis of 87 pesticides in 30 fresh pistachio samples prepared from stores in Iran by QuEChERS-ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). The results showed at least one pesticide was in 67% of fresh pistachio samples. Kresoxim methyl residue was detected in 20 samples with average of 0.11 mg kg^-1; this average is 2.2 times more than maximum residue limit (MRL). Buprofezin was recognized in five samples with average of 0.17 mg kg^-1 was observed with 3.4 times more than MRL; hexaconazole and permethrin were recognized in three samples lower than MRL with an average residue of 0.030 and 0.028 mg kg^-1, respectively. In addition, potential non-carcinogenic and carcinogenic health risk assessments were evaluated using probabilistic methods performed with the Monte Carlo simulation algorithm. The order of pesticide ranking based on hazard quotient (HQ) was hexaconazole > buprofezin > permethrin > kresoxim methyl. Total HQ (HI) was 2.0E-4 and for children, 9.0E-4. Hence, it means fresh pistachio consuming maybe not have significant short-term health risks for consumer. Ranking based on cancer risk (CR) was hexaconazole > kresoxim methyl > metalaxyl > permethrin > buprofezin. However, total CR due to pesticide residues was not higher than 1E-6 value (1.09E-9); therefore, consumers were not at significant risk of carcinogenicity in this product.

Assessment of health risks associated with pesticide and heavy metal contents in Fritillaria thunbergii Miq. (Zhe Beimu)

Fritillaria thunbergii Miq. (Zhe Beimu, F. thunbergii) is widely cultivated in China's Zhejiang province, and pesticides and heavy metals are two major factors affecting its quality and safety. A total of 106 F. thunbergii samples from six main production areas were analyzed for 76 pesticides and four heavy metal content (As, Cd, Hg, and Pb). The pesticide detection rate of the samples was 66.98%; overall, the pesticide residues were very low, and residue levels ranged from 0.010 to 0.231 mg kg^-1. The detection rates of As, Cd, Hg, and Pb were 95.3%, 100%, 76.4%, and 100%, respectively. A risk assessment of human exposure to pesticides and heavy metals via intake of F. thunbergii was performed, and the results revealed that the pesticide residues and heavy metal content detected in F. thunbergii does not pose a potential risk to human health, either in the long or short term. The exposure assessment showed that the levels of pesticides and heavy metals in F. thunbergii were safe for human consumption. These results provide useful information on F. thunbergii consumption.

Framework for defining pesticide maximum residue levels in feed: applications to cattle and sheep

BACKGROUND

Pesticide residues in animal feed can endanger animal health and compromise the safety of livestock products for human consumption. Even though policymakers such as the European Union and the World Health Organization have established maximum residue levels (MRLs) for pesticides in both human food and animal feed, there is no systematic management of pesticides in animal feed that considers the entire supply chain. In response, we propose a framework for defining consistent MRLs for pesticides in animal feed that assesses the impact of defined MRLs on upstream (e.g., MRLs in feed crops) and downstream (e.g., MRLs in livestock products) sectors of the livestock-product supply chain.

RESULTS

The MRLs determined for the selected pesticides in the feed of cattle and sheep as case study animals indicate that lipophilic pesticides tend to have lower MRLs than hydrophilic pesticides, primarily due to the relatively high toxicity and biotransfer factors of lipophilic pesticides. In addition, we observe that, primarily for lipophilic pesticides, upstream and downstream regulations are not aligned in terms of defining MRLs in feed using current MRLs in crops with relevance to feed and foods of animal origin.

CONCLUSION

Some of the current pesticide regulations in the livestock-product supply chain need to be re-evaluated to ensure that MRLs in the upstream sector (i.e., crops) do not result in unacceptable residues in the downstream sector (i.e., MRLs in livestock products affecting animal and human health). Finally, we provide recommendations for optimizing the derivation of MRLs in feed, including the evaluation of residue fate during feed and food manufacturing processes. © 2022 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Toxic Metals and Metalloids in Infant Formulas Marketed in Brazil, and Child Health Risks According to the Target Hazard Quotients and Target Cancer Risk

Children are highly vulnerable to chemical exposure. Thus, metal and metalloid in infant formulas are a concern, although studies in this regard are still relatively scarce. Thus, the presence of aluminum, arsenic, cadmium, tin, mercury, lead, and uranium was investigated in infant formulas marketed in Brazil by inductively coupled plasma mass spectrometry, and the Target Hazard Quotients (THQ) and Target Cancer Risk (TCR) were calculated in to assess the potential risk of toxicity for children who consume these products continuously. Aluminum ranging from 0.432 ± 0.049 to 1.241 ± 0.113 mg·kg-1, arsenic from 0.012 ± 0.009 to 0.034 ± 0.006 mg·kg-1, and tin from 0.007 ± 0.003 to 0.095 ± 0.024 mg·kg-1 were the major elements, while cadmium and uranium were present at the lowest concentrations. According to the THQ, arsenic contents in infant formulas showed a THQ > 1, indicating potential health risk concerns for newborns or children. Minimal carcinogenic risks were observed for the elements considered carcinogenic. Metabolic and nutritional interactions are also discussed. This study indicates the need to improve infant formula surveillance concerning contamination by potentially toxic and carcinogenic elements.

New insights into the interaction between duodenal toxicity and microbiota disorder under copper exposure in chicken: Involving in endoplasmic reticulum stress and mitochondrial toxicity

Copper (Cu) has been widely used in industrial agricultural production, but excess use can lead to toxic effect on host physiology, which poses a threaten to public hygiene. However, the relationship between gut microbiota and Cu-induced intestinal toxicity is unclear. Here, we identified that intestinal flora disturbance was related to duodenal toxicity under Cu exposure. We found that excess Cu disturbed gut microbiota homeostasis, resulting in Cu accumulation and intestinal damage. In addition, Cu considerably increased intestinal permeability by reducing expression of tight junction proteins (Claudlin-1, Occludin, and ZO-1). Meanwhile, Cu could induce endoplasmic reticulum stress, mitophagy, and mitochondria-mediated apoptosis in the duodenum, with the evidence by the elevated levels of GRP78, GRP94, LC3Ⅱ/LC3Ⅰ and Caspase-3 protein expression. Correlation analysis showed that Melainabacteria was closely related to tight junction proteins and endoplasmic reticulum stress of duodenum, indicating that disturbance of intestinal flora may aggravate the toxic effect of Cu. Therefore, our results suggest that the destruction of intestinal flora induced by excessive Cu may further lead to intestinal barrier damage, ultimately leading to endoplasmic reticulum stress, mitophagy and apoptosis. This research provides a new insight into interpretation of the interrelationship between microbiota disorder and duodenal toxicity under Cu exposure.

Antibiotics in Raw Meat Samples: Estimation of Dietary Exposure and Risk Assessment

The extensive use of antibiotics in livestock farming poses increased concerns for human health as residues of these substances are present in edible tissues. The aim of this study was the determination of the levels of four groups of antibiotics (sulfonamides-SAs, tetracyclines-TCs, streptomycines-STr and quinolones-QNLs) in meat samples (muscles, livers and kidneys from beef, chicken and pork) and the estimation of the dietary exposure to antibiotics from meat consumption and the potential hazard for human health. Fifty-four samples of raw meat were randomly collected in 2018 from the Cretan market, Greece and analyzed both with an enzyme-linked immunosorbent assay (ELISA) and liquid chromatography-mass spectrometry (LC-MS). According to the results derived from the ELISA method, only 2% of the meat samples were free from antibiotics, 2% were detected with 4 antibiotics and the great majority of the samples (87%) were detected with 2 to 3 antibiotics. SAs presented the highest detection frequencies for all samples whereas TCs were not detected in any bovine sample. The highest median concentration was detected for STr in bovine muscles (182.10 μg/kg) followed by QNLs (93.36 μg/kg) in pork kidneys whereas the chicken samples had higher burdens of QNLs compared to the other meat samples. LC-MS analysis showed that oxytetracycline (OTC) was the most common antibiotic in all samples. The highest median concentration of all antibiotics was detected for doxycycline (DOX) (181.73 μg/kg in pork kidney) followed by OTC in bovine liver (74.46 μg/kg). Risk characterization was applied for each of the two methods; The hazard quotients (HQ) did not exceed 0.059 for the ELISA method and 0.113 for the LC-MS method for any group of antibiotics, whereas the total hazard indexes (HI) were 0.078 and 0.021, respectively. The results showed the presence of different groups of antibiotics in meat from the Cretan market and that the health risk to antibiotics is low. A risk assessment analysis conducted for meat consumption and corrected for the aggregated exposure revealed no risk for the consumers.

Concentrations of Essential Trace and Toxic Elements Associated with Production and Manufacturing Processes in Galician Cheese

The objective of this study was to determine the trace element composition and the toxic metal residues in Galician cow’s milk cheese produced in different systems (artisan, industrial, and organic). Fourteen elements (As, Cd, Co, Cr, Cu, Fe, Hg, I, Mn, Mo, Ni, Pb, Se, and Zn) were determined in 58 representative samples of Galician cheeses by inductively coupled plasma mass spectrometry. The toxic elements were present at low concentrations, similar to those reported for other unpolluted geographical areas. The essential elements were also within the normal range in cheeses. There were no statistically significant differences between smoked and unsmoked cheeses for any of the elements. Chemometric analyses (principal component analysis and cluster analysis) revealed that the industrial cheeses produced in Galicia using the milk from intensive dairy farms were different, in terms of elemental content, from artisan and organic cheeses, in which the elemental contents were similar.

Heavy Metals in Unprocessed or Minimally Processed Foods Consumed by Humans Worldwide: A Scoping Review

Heavy metals (HM) can be accumulated along the food chain; their presence in food is a global concern for human health because some of them are toxic even at low concentrations. Unprocessed or minimally processed foods are good sources of different nutrients, so their safety and quality composition should be guaranteed in the most natural form that is obtained for human consumption. The objective of this scoping review (ScR) is to summarize the existing evidence about the presence of HM content (arsenic (As), lead (Pb), cadmium (Cd), mercury (Hg), methylmercury (MeHg), and aluminum (Al)) in unprocessed or minimally processed foods for human consumption worldwide during the period of 2011–2020. As a second objective, we identified reported HM values in food with respect to Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) International Food Standards for Maximum Limits (MLs) for contaminants in food. This ScR was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and PRISMA Extension for Scoping Reviews (PRISMA-ScR); advance searches were performed in PubMed, ScienceDirect and FAO AGRIS (Agricultural Science and Technology Information) databases by two reviewers who independently performed literature searches with specific eligibility criteria. We classified individual foods in food groups and subgroups according to the Global Individual Information Food Consumption Data Tool (FAO/WHO GIFT). We homologated all the reported HM units to parts per million (ppm) to determine the weighted mean HM concentration per country and food group/subgroup of the articles included. Then, we compared HM concentration findings with FAO/WHO MLs. Finally, we used a Geographic Information System (GIS) to present our findings. Using our search strategy, we included 152 articles. Asia was the continent with the highest number of publications (n = 79, 51.3%), with China being the country with the largest number of studies (n = 34). Fish and shellfish (n = 58), followed by vegetables (n = 39) and cereals (n = 38), were the food groups studied the most. Fish (n = 42), rice (n = 33), and leafy (n = 28) and fruiting vegetables (n = 29) were the most studied food subgroups. With respect to the HM of interest, Cd was the most analyzed, followed by Pb, As, Hg and Al. Finally, we found that many of the HM concentrations reported exceeded the FAO/OMS MLs established for Cd, Pb and As globally in all food groups, mainly in vegetables, followed by the roots and tubers, and cereals food groups. Our study highlights the presence of HM in the most natural forms of food around the world, in concentrations that, in fact, exceed the MLs, which affects food safety and could represent a human health risk. In countries with regulations on these topics, a monitoring system is recommended to evaluate and monitor compliance with national standards. For countries without a regulation system, it is recommended to adopt international guidelines, such as those of FAO, and implement a monitoring system that supervises national compliance. In both cases, the information must be disseminated to the population to create social awareness. This is especially important to protect the population from the consumption of internal production and for the international markets of the globalized world.

Lead and Cadmium Bioaccumulation in Fresh Cow's Milk in an Intermediate Area of the Central Andes of Peru and Risk to Human Health

The dairy basin of the Mantaro River located in the centre of Peru faces serious anthropogenic disturbances as it receives emissions and discharges from the metallurgical mining activity located in the headwaters of the basin and milk contaminated with lead (Pb) and cadmium (Cd) endangers the environmental and human health, especially children. To measure the concentrations of Pb and Cd in milk and the dangers of their consumption in the Peruvian population, 40 milk samples were collected and quantified by atomic absorption spectrometry. The mean concentration of Pb in milk was 15 ± 2.6 µg/kg, which represented 75% of the Maximum Limit (ML), and that of Cd was 505 ± 123 µg/kg, which exceeded the ML by more than 194 times. The estimated weekly intake of Pb for people aged 2−85 years was below the Provisional Tolerable Weekly Intake (PTWI) references, determining risk coefficients (CRD) < 1. Weekly Cd intake was much higher than the PTWIs and CRDs were between 14 and 34, indicating that consumers would experience carcinogenic health effects, with children being at higher risk than adults, therefore, milk from the area is not safe for consumption. Cd would be transferred mainly through the soil (water)-grass-milk pathway, due to its presence in irrigation water and in fertilizers that contain Cd. The main pathway for Pb entry would be air-soil (water)-milk grass, from the fine particles emitted into the air by the mining-metallurgical activity, developed approximately 90 km from the study area.

Integrated approaches to mitigate threats from emerging potentially toxic elements: A way forward for sustainable environmental management

Potentially toxic elements (PTEs) such as toxic metal (loid)s and other emerging hazardous contaminants, exist in the environment and poses a serious threat. A large amount of wastewater containing PTEs such as cadmium, chromium, copper, nickel, arsenic, lead, zinc, etc. Release from industries during production process. Besides these, chemical-based fertilizers used in soils during crop production have become one of the crucial sources of PTEs. Various techniques are being employed for the mitigation of PTEs like chemical precipitation, ion exchange, coagulation, activated carbon, adsorption, membrane filtration, and bioremediation. Among these mitigation strategies, biological processes such as bioremediation, phytoremediation etc. Are extensively used, as they are economic have high-efficiency rate and are eco-friendly. This review intends to provide information on PTEs contamination through various sources; along with the toxicity of metal (loid)s with respect to their patterns of transmission and risks in the changing environment. Various remediation methods for the management of these pollutants along with their techno-economic perspective are also summarized in this review.

Development of a High-Throughput Screening Analysis for 195 Pesticides in Raw Milk by Modified QuEChERS Sample Preparation and Liquid Chromatography Quadrupole Time-of-Flight Mass Spectrometry

This study aimed to develop a simple, high-throughput method based on modified QuEChERS (quick, easy, cheap, effective, rugged, and safe) followed by liquid chromatography quadrupole time-of-flight mass spectrometry (LC-Q-TOF/MS) for the rapid determination of multi-class pesticide residues in raw milk. With acidified acetonitrile as the extraction solvent, the raw milk samples were pretreated with the modified QuEChERS method, including extraction, salting-out, freezing, and clean-up processes. The target pesticides were acquired in a positive ion electrospray ionization mode and an All ions MS/MS mode. The developed method was validated, and good performing characteristics were achieved. The screening detection limits (SDL) and limits of quantitation (LOQ) for all the pesticides ranged within 0.1–20 and 0.1–50 μg/kg, respectively. The recoveries of all analytes ranged from 70.0% to 120.0% at three spiked levels (1 × LOQ, 2 × LOQ, and 10 × LOQ), with relative standard deviations less than 20.0%. The coefficient of determination was greater than 0.99 within the calibration linearity range for the detected 195 pesticides. The method proved the simple, rapid, high throughput screening and quantitative analysis of pesticide residues in raw milk.

Advances on the Antioxidant Activity of a Phytocomplex Product Containing Berry Extracts from Romanian Spontaneous Flora

The present study aimed to evaluate the antioxidant properties of a phytocomplex product obtained using 10% hydroalcoholic extractive solutions, in equal proportions, from Ribes nigrum, Rubus idaeus, Rubus fruticosus and Fragaria moschata fresh fruits harvested from the spontaneous flora of Romania. These plant products were recognized for their rich antioxidant content. The phytochemical profile was assessed using HPLC chromatography and UV-Vis spectrometry. The obtained results highlighted the presence of complex bioactive compounds with antioxidant actions, namely anthocyanins, proanthocyanins and vitamin C. The antioxidant actions of the hydroalcoholic extractive solutions and the phytocomplex product were evaluated using chemiluminescence, electrochemical and superoxide dismutase (SOD) methods. The experimental results showed evident antioxidant activity in both the hydroalcoholic extracts and the phytocomplex product.

Human Health Risk Assessment of Arsenic, Cadmium, Lead, and Mercury Ingestion from Baby Foods

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As, Cd and Pb detected in baby foods containing fruit, grain, and root vegetables.

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Select product HIs exceeded 1 for As and Pb using conservative assumptions.

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Cancer risks exceeded 10⁻⁶ and were driven by As from grain products.

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Analysis revealed minimal risk under most scenarios using conservative assumptions.

Recently, the U.S. House of Representatives reported on the presence of heavy metals in raw ingredients used in baby foods and in finished baby food products themselves. In light of these concerns, this study aimed to evaluate potential risks associated with the presence of heavy metals in baby food products. We analyzed 36 baby food samples representing four ingredient categories (fruit; leguminous vegetable; root vegetable; or grain) for arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb). We assessed the potential lifetime cancer and non-cancer health risks posed to infants and toddlers following daily consumption of these chemicals in each food type, based on established daily food-specific ingestion rates. Daily doses were compared against selected reference values and oral slope factors to determine non-cancer hazard indices (HIs) and lifetime cancer risks. Hazard indices indicated a potential for non-cancer risk (e.g., HIs > 1.0) under only a few exposure scenarios, including for As and Pb under selected product type and age/concentration assumptions. Increases in lifetime cancer risks for all analytes across the ingredient categories evaluated ranged from 3.75 × 10⁻⁵ to 5.54 × 10⁻⁵; cancer risks were primarily driven by As from grain products. Though a limited set of exposure scenarios indicated a potential for health risk, the exposure assumptions in this assessment were conservative, and the heavy metal concentrations we found in baby foods are similar to those observed in similar whole foods. Based on these findings and the limited scenarios under which risks were identified, this study indicates that an infant’s typical intake of baby food is unlikely to pose health risks from heavy metals above accepted tolerable risk levels under most exposure scenarios.

Food Habits and Lifestyle of Romanians in the Context of the COVID-19 Pandemic

The pandemic caused by the SARS-CoV-2 virus has produced significant changes in socio-cultural life, diet, and interpersonal relationships across the world’s population. The present study aims to identify changes in lifestyle and diet among the Romanian population one year after the onset of the COVID-19 pandemic. An online questionnaire with 58 items (addressing the following aspects: socio-demographic and anthropometric data, current eating habits, and lifestyle changes) was distributed using institutional mailing lists and social media. A total number of 2040 respondents participated in the study, of whom 1464 were women, and 576 men. Among the respondents, 1598 came from urban areas and 442 from rural areas. The processing of the collected data showed significant changes in the behavior of the respondents caused by the pandemic situation with psycho-affective changes in some cases. The number of people who had anxiety, depression and nervousness increased by up to 20%. The majority of respondents (over 57%) were up to 30 years old, either students (43.50%) or employees going to workplaces (33.20%). Analyzing eating habits, we found that diet modification was needed to increase the daily consumption of fruits, vegetables, fish, and seafood. Regarding weight status during the pandemic, we noticed that 34.7% of normal-weight respondents said that they gained weight while 49.7% of overweight people and 52.5% of obese people said that they gained weight (p < 0.0001). Regarding psycho-emotional behavior, 11.81% of the surveyed women stated that they frequently had depressive states during the pandemic period and 11.63% of the men stated that they frequently presented depressive states during the pandemic (p = 0.005).

Quality Control of Different Types of Honey and Propolis Collected from Romanian Accredited Beekeepers and Consumer’s Risk Assessment

Honey is a natural product recognized and appreciated for its nutritional value and therapeutic potential. However, the quality of bee honey is essential because various contaminants can seriously affect consumers’ health. In the experimental part of the work, we analyzed different types of honey (linden, black locust, rapeseed and multifloral honey) and propolis, which were collected from Romanian accredited beekeepers who placed beehives in two areas characterized by different industrial activity: area 1 (A1) is an area with intense industrial activity, with other industries existing nearby, including a refinery, while area 2 (A2) is entirely devoid of industrial activity, but with moderate agricultural activity. A total of 144 samples were collected, twelve samples for each variety of honey, propolis and soil, corresponding to each area analyzed. In addition, seven heavy metals and three pesticides were tested for in the samples collected. Finally, the correlation between the degree of contamination with soil pollutants and the contamination of the bee products harvested from the analyzed areas was studied. Cadmium, lead, copper, zinc and the sum of DDT metabolites exceeded the maximum allowable levels in honey samples, with differences between different types of honey.

Determination of Lead Level in Pasteurized Milk and Dairy Products Consumed In Tehran and Evaluation of Associated Health Risk

Background: Milk and dairy products are the main sources of essential nutrients particularly for children. However, milk and dairy products can be contaminated with chemical hazards and contaminants which pose serious health risks for consumers. These toxic compounds are entered into the food chain through contaminated soil, water, and air and their presence even at low levels would result in metabolic disorders. Objectives: The aim of this study was to determine the level of lead in pasteurized milk and different dairy products in high-consumed brands in Tehran. Methods: A total of 38 samples (18 pasteurized milk and 20 dairy products from the most-consumed brands) were analyzed using graphite furnace atomic absorption spectroscopy for quantification of lead level. Hazard quotient (HQ) and carcinogenic risk (CR) were used to assess health risk and carcinogenic risk. Results: The results showed that the levels of lead in all pasteurized milk samples and dairy products were below the allowable limit. HQ was less than 1 in all samples and CR was in the range of 10-8 to 10-7 and both were at acceptable levels. Conclusions: It can be concluded that there was no risk of carcinogenicity in pasteurized milk samples and dairy products for children and adults. However, due to the higher consumption of milk by children and their greater susceptibility, the level of heavy metals should be monitored by health agencies.

Disorders of the Reproductive Health of Cattle as a Response to Exposure to Toxic Metals

The aim of this review is to comprehensively present disorders of the reproductive system in cattle exposed to contact with toxic metals. Toxic metals are a common environmental pollutant and can come from mines, smelters, fossil fuel combustion, or volcanic eruptions. Metals have the ability to bioaccumulate in living organisms, thus contaminating the food chain and may pose a threat to humans. They accumulate mainly in the liver and kidneys, but also in muscles and fat tissue. Toxic metals such as lead (Pb), arsenic (As), mercury (Hg), and cadmium (Cd) have a negative impact on the fertility of animals; they can lead to abortions, premature calving, or oocyte dysfunction. Moreover, in the male reproductive system, they disrupt spermatogenesis, and cause apoptosis of sperm and oxidative damage. The main source of exposure of livestock to toxic metals is through the consumption of feed or contaminated water. It is important to monitor the level of heavy metals in animal products to prevent human poisoning. Toxic metal biomonitoring can be performed by testing urine, blood, milk, plasma, or hair. Chromium (Cr), arsenic (As), and cadmium (Cd) are excreted in the urine, while lead can be detected by examining the blood of animals, while in milk, arsenic (As), cadmium (Cd), nickel (Ni), and lead (Pb) can be detected. Moreover, toxic metals do not biodegrade in the environment. To purify soil and waters, remediation methods, e.g., biological or chemical, should be used.

Detrimental effects of 6 months exposure to very low doses of a mixture of six pesticides associated with chronic vitamin deficiency on rats

This study aimed to evaluate the long-term low-dose effects of exposure to a mixture of 6 pesticide active substances (diquat, imazamox, imazethapyr, tepraloxydin, bentazone, acifluorfen) and to elucidate if chronic vitamin deficiency can influence their toxicity. Two hundred Wistar rats were divided in 4 groups: a vitamin-sufficiency control group, a vitamin-deficiency control group, a vitamin sufficiency test group and a vitamin-deficiency test group. The test groups were treated with the aforementioned pesticides at doses 100 times lower than the corresponding NOAEL. After 6 months, ten rats from each group were sacrificed and a complete evaluation of blood and urine biochemistry, biomarkers of oxidative stress, xenobiotic detoxification enzymes and lysosomal enzymes and organ histopathology was performed. The pesticides mixture and vitamin deficiency determined an increase in alkaline phosphatase levels and urinary calcium levels, abnormal serum lipid profile, and a decrease of total blood proteins levels, red blood cells, haematocrit and haemoglobin. The combination of the two stressors up-regulated CYP1A1, CYP1A2, CYP2B1 and GST levels. This study provides a new proof for the need to move forward from single chemical testing to a more complex approach to account for the multitude of stressors that can challenge the setting of real safety levels.

Environmental toxicants, oxidative stress and health adversities: interventions of phytochemicals

OBJECTIVES

Oxidative stress is the most common factor mediating environmental chemical-induced health adversities. Recently, an exponential rise in the use of phytochemicals as an alternative therapeutics against oxidative stress-mediated diseases has been documented. Due to their free radical quenching property, plant-derived natural products have gained substantial attention as a therapeutic agent in environmental toxicology. The present review aimed to describe the therapeutic role of phytochemicals in mitigating environmental toxicant-mediated sub-cellular and organ toxicities via controlling cellular antioxidant response.

METHODS

The present review has covered the recently related studies, mainly focussing on the free radical scavenging role of phytochemicals in environmental toxicology.

KEY FINDINGS

In vitro and in vivo studies have reported that supplementation of antioxidant-rich compounds can ameliorate the toxicant-induced oxidative stress, thereby improving the health conditions. Improving the cellular antioxidant pool has been considered as a mode of action of phytochemicals. However, the other cellular targets of phytochemicals remain uncertain.

CONCLUSIONS

Knowing the therapeutic value of phytochemicals to mitigate the chemical-induced toxicity is an initial stage; mechanistic understanding needs to decipher for development as therapeutics. Moreover, examining the efficacy of phytochemicals against mixer toxicity and identifying the bioactive molecule are major challenges in the field.

Exposure to lead and cadmium of the Belgian consumers from ceramic food contact articles

This study was aimed at estimating the intake of lead and cadmium by the Belgian consumers due to the use of ceramic ware. We adopted refined exposure scenarios with respect to migrant concentration, ceramic ware usage, and metal release characteristics. A deterministic estimation was initially performed, followed by probabilistic estimation, if the deterministic estimate exceeds toxicological reference values. Based on the reference doses established by the European Food Safety Authority (EFSA), the risk of lead and cadmium exposure was characterized by the margin of exposure (MOE) and the tolerable weekly intake (TWI), respectively. The probabilistic median and 95th percentile intake of lead were 0.02 and 5.77 μg/kg b.w. per day for adults, and 0.07 and 17.3 μg/kg b.w. per day for children. The MOEs for neurotoxicity, nephrotoxicity and cardiovascular effects were 7.1, 27 and 64 for average consumers, and 0.02, 0.1 and 0.3 for high consumers. The deterministic mean and 95th percentile intake of cadmium were 0.026 (7% TWI) and 0.03 (8% TWI) μg/kg b.w. per day for adults, and 0.08 (22 % TWI) and 0.09 (25 % TWI) μg/kg b.w. per day for children. Considering the exposure of the Belgian population from foodstuffs resulted in the exceedance of the TWI by as much as 20-fold. The risk of exposure to lead and cadmium of the Belgian consumers suggests measures, such as lowering the migration limits for ceramic ware, should be taken to minimize the risk.

Endocrine Disruptors Acting on Estrogen and Androgen Pathways Cause Reproductive Disorders through Multiple Mechanisms: A Review

Increasing contamination of the environment by toxic compounds such as endocrine disrupting chemicals (EDCs) is one of the major causes of reproductive defects in both sexes. Estrogen/androgen pathways are of utmost importance in gonadal development, determination of secondary sex characteristics and gametogenesis. Most of the EDCs mediate their action through respective receptors and/or downstream signaling. The purpose of this review is to highlight the mechanism by which EDCs can trigger antagonistic or agonistic response, acting through estrogen/androgen receptors causing reproductive defects that lead to infertility. In vitro, in vivo and in silico studies focusing on the impact of EDCs on estrogen/androgen pathways and related proteins published in the last decade were considered for the review. PUBMED and PUBCHEM were used for literature search. EDCs can bind to estrogen receptors (ERα and ERβ) and androgen receptors or activate alternative receptors such as G protein-coupled receptors (GPCR), GPR30, estrogen-related receptor (ERRγ) to activate estrogen signaling via downstream kinases. Bisphenol A, dichlorodiphenyltrichloroethane, dichlorodiphenyldichloroethylene, polychlorinated biphenyls and phthalates are major toxicants that interfere with the normal estrogen/androgen pathways leading to infertility in both sexes through many ways, including DNA damage in spermatozoids, altered methylation pattern, histone modifications and miRNA expression.

Assessment of Dietary Exposure and Risk of DDT Concerning Freshwater Fish Aquaculture

Pesticides may accumulate in freshwater fish due to contamination from the environment. This paper reports on a risk assessment of DDT and DDT metabolites in carp. A survey was conducted about dietary habits among fish consumers. Cluster analysis was accomplished based on the frequency and amount of carp consumption. Classical and carcinogenic risk assessments were performed for the clusters. While DDT contamination was present, it was not found to be risky concerning the complete diet of the clusters (carcinogenic risk was also negligible), moreover, carp consumption did not contribute significantly to the risk level even in the case of the extreme consumers.