Occurrence and estimation of aflatoxin M1 exposure in milk in Serbia

Determination of aflatoxin M1 and ochratoxin A in breast milk in rural centers of Yazd, Iran: Exposure assessment and risk characterization

Breast milk (BM) is considered as the best source of nutrition which could have prevention effects on various diseases in the first years of a child. Along with nutritive compounds, presence of contaminants such as mycotoxins in BM could be transmitted into neonate. The aim of this study was to determine the occurrence, levels, and factors associated with the presence of aflatoxin M1 (AFM1) and ocratoxin a (OTA) in BM samples of nursing mothers in rural centers of Yazd, Iran. The presence and average AFM1 and OTA concentration in 72 BM samples was measured by competitive ELISA. The demographic and diet parameters of nursing mothers were collected by a questionnaire and were analyzed using SPSS 18 software. AFM1 and OTA were detected in 63 (87.5%) and 47 (65.2%) samples with the mean concentration levels of 19.46 ± 13.26 ng/L (ranges from 5.1 to 53.9) and 200 ± 160 ng/L (ranges from 100 to 2460), respectively. Of these, 32 samples (50.7%) for AFM1 and 23 samples (48.9%) for OTA had values exceeding the limit set by the European Union regulation for infant foods (25 ng/L for AFM1 and 500 ng/L for OTA). It was also found that the risk of AFM1 and OTA occurrence in BM increased significantly with the consumption of beans, bread, cereals, fruit juice and crackers, and cream, respectively. This study showed that the estimated daily intake for AFM1 and OTA by 1 month of age infants was 2.7 and 28.5 ng/kg bw/day, respectively, while, as the age of the infant increased, the values were lower and close to 0.9 and 9.9 ng/kg bw/day for AFM1 and OTA in 12 months of age infants, respectively. The high occurrence and noticeable levels of AFM1 and OTA detected in this study indicated that some infants receive undesirable exposures to AFM1 and OTA with breast milk. Therefore, it is recommended that mothers are advised to avoid certain foods during pregnancy and breastfeeding that are likely sources of mycotoxins.

Climate Change and Mycotoxins Trends in Serbia and Croatia: A 15-Year Review

This review examines the 15-year presence of mycotoxins in food from Serbia and Croatia to provide a comprehensive overview of trends. Encompassing the timeframe from 2009 to 2023, this study integrates data from both countries and investigates climate change patterns. The results from Serbia focus primarily on maize and milk and show a strong dependence of contamination on weather conditions. However, there is limited data on mycotoxins in cereals other than maize, as well as in other food categories. Conversely, Croatia has a broader spectrum of studies, with significant attention given to milk and maize, along with more research on other cereals, meat, and meat products compared to Serbia. Over the investigated 15-year period, both Serbia and Croatia have experienced notable shifts in climate, including fluctuations in temperature, precipitation, and humidity levels. These changes have significantly influenced agriculture, consequently affecting the occurrence of mycotoxins in various food products. The results summarized in this 15-year review indicate the urgent need for further research and action to address mycotoxins contamination in Serbian and Croatian food supply chains. This urgency is further emphasized by the changing climatic conditions and their potential to exacerbate public health and food safety risks associated with mycotoxins.

Aflatoxins in maize, milk and dairy products from Serbia

This study presents data on the occurrence of aflatoxins B1, B2, G1 and G2 in maize and aflatoxin M1 (AFM1) in milk and dairy products from Serbia in 2022. A total of 100 maize samples were analysed using liquid chromatography tandem mass spectrometry, while 107 cow and goat milk, besides dairy products were tested with an ELISA method. Aflatoxins contaminated 78% of the maize samples, with aflatoxin B1 as the most prevalent aflatoxin, also at the highest determined level. All milk samples tested positive for AFM1, while contamination in dairy products ranged from 14% to 100%. The hot and dry weather during the 2022 maize growing season, characterised by moderate to extreme drought conditions, significantly increased maize contamination with aflatoxins, impacting subsequent milk and dairy products contamination. The findings of this study confirm the continuous trend and persistent challenge in Serbia concerning the prevalence of aflatoxins in maize and milk, closely linked to climate change.

Aflatoxins Contamination in Feed Commodities: From Occurrence and Toxicity to Recent Advances in Analytical Methods and Detoxification

Synthesized by the secondary metabolic pathway in Aspergilli, aflatoxins (AFs) cause economic and health issues and are culpable for serious harmful health and economic matters affecting consumers and global farmers. Consequently, the detection and quantification of AFs in foods/feeds are paramount from food safety and security angles. Nowadays, incessant attempts to develop sensitive and rapid approaches for AFs identification and quantification have been investigated, worldwide regulations have been established, and the safety of degrading enzymes and reaction products formed in the AF degradation process has been explored. Here, occurrences in feed commodities, innovative methods advanced for AFs detection, regulations, preventive strategies, biological detoxification, removal, and degradation methods were deeply reviewed and presented. This paper showed a state-of-the-art and comprehensive review of the recent progress on AF contamination in feed matrices with the intention of inspiring interests in both academia and industry.

Climate Change-A Global Threat Resulting in Increasing Mycotoxin Occurrence

During the last decade, scientists have given increasingly frequent warnings about global warming, linking it to mycotoxin-producing moulds in various geographical regions across the world. In the future, more pronounced climate change could alter host resilience and host-pathogen interaction and have a significant impact on the development of toxicogenic moulds and the production of their secondary metabolites, known as mycotoxins. The current climate attracts attention and calls for novel diagnostic tools and notions about the biological features of agricultural cultivars and toxicogenic moulds. Since European climate environments offer steadily rising opportunities for Aspergillus flavus growth, an increased risk of cereal contamination with highly toxic aflatoxins shall be witnessed in the future. On top of that, the profile (representation) of certain mycotoxigenic Fusarium species is changing ever more substantially, while the rise in frequency of Fusarium graminearum contamination, as a species which is able to produce several toxic mycotoxins, seen in northern and central Europe, is becoming a major concern. In the following paper, a high-quality approach to a preventative strategy is tailored to put a stop to the toxicogenic mould- and mycotoxin-induced contamination of foods and feeds in the foreseeable future.

Second order probabilistic assessment of chronic dietary exposure to aflatoxin M1 in Serbia

Considering the genotoxic and cancerogenic nature of aflatoxin M1 (AFM1), its presence in milk and dairy products may pose health risks for consumers. The chronic exposure was calculated using a two-dimensional (second order) Monte Carlo model. Results of 13 722 milk and dairy product samples analysed in the 2015-2022 period were used. Milk and dairy products intake information was collected with a Food Frequency Questionnaire (FFQ) validated by a 24-h recall-based method. Risk characterization was done by calculation of the Margin of Exposure (MOE) and by calculation of AFM1 induced number of hepatocellular carcinoma (HCC) cases. Mean AFM1 Estimated Daily Intake (EDI) was highest in children at 0.336 (CI: 0.294-0.385) ng kg^-1 bw day^-1, followed by adolescents with 0.183 (CI: 0.164-0.204), then adult females with 0.161 (CI: 0.146-0.179) and finally adult males with lowest EDI of 0.126 (CI: 0.115-0.139) ng kg^-1 bw day^-1. MOE values based on mean EDI for all population groups were above risk associated threshold and the number of possible HCC cases was in the range of 0.0002-0.0021 cases per year for 10⁵ individuals. The results suggest low health risks due to AFM1 exposure for the whole population. Still, this risk is not non-existent, especially for children as they have a higher ratio of the population exposed to risk associated AFM1 levels, with MOE values below risk indicating threshold starting at 77.5th percentile.

Aflatoxins in Maize from Serbia and Croatia: Implications of Climate Change

Aflatoxins (AFs) represent the most important mycotoxin group, whose presence in food and feed poses significant global health and economic issues. The occurrence of AFs in maize is a burning problem worldwide, mainly attributed to droughts. In recent years, Serbia and Croatia faced climate changes followed by a warming trend. Therefore, the main aim of this study was to estimate the influence of weather on AFs occurrence in maize from Serbia and Croatia in the 2018-2021 period. The results indicate that hot and dry weather witnessed in the year 2021 resulted in the highest prevalence of AFs in maize samples in both Serbia (84%) and Croatia (40%). In maize harvested in 2018-2020, AFs occurred in less than, or around, 10% of Serbian and 20% of Croatian samples. In order to conduct a comprehensive study on the implications of climate change for the occurrence of AFs in maize grown in these two countries, the results of available studies performed in the last thirteen years were searched for and discussed.

Human Breast Milk Contamination with Aflatoxins, Impact on Children's Health, and Possible Control Means: A Review

Aflatoxins are natural toxicants produced mainly by species of the Aspergillus genus, which contaminate virtually all feeds and foods. Apart from their deleterious health effects on humans and animals, they can be secreted unmodified or carried over into the milk of lactating females, thereby posing health risks to suckling babies. Aflatoxin M1 (AFM1) is the major and most toxic aflatoxin type after aflatoxin B1 (AFB1). It contaminates human breast milk upon direct ingestion from dairy products or by carry-over from the parent molecule (AFB1), which is hydroxylated in the liver and possibly in the mammary glands by cytochrome oxidase enzymes and then excreted into breast milk as AFM1 during lactation via the mammary alveolar epithelial cells. This puts suckling infants and children fed on this milk at a high risk, especially that their detoxifying activities are still weak at this age essentially due to immature liver as the main organ responsible for the detoxification of xenobiotics. The occurrence of AFM1 at toxic levels in human breast milk and associated health conditions in nursing children is well documented, with developing countries being the most affected. Different studies have demonstrated that contamination of human breast milk with AFM1 represents a real public health issue, which should be promptly and properly addressed to reduce its incidence. To this end, different actions have been suggested, including a wider and proper implementation of regulatory measures, not only for breast milk but also for foods and feeds as the upstream sources for breast milk contamination with AFM1. The promotion of awareness of lactating mothers through the organization of training sessions and mass media disclosures before and after parturition is of a paramount importance for the success of any action. This is especially relevant that there are no possible control measures to ensure compliance of lactating mothers to specific regulatory measures, which can yet be appropriate for the expansion of breast milk banks in industrialized countries and emergence of breast milk sellers. This review attempted to revisit the public health issues raised by mother milk contamination with AFM1, which remains undermined despite the numerous relevant publications highlighting the needs to tackle its incidence as a protective measure for the children physical and mental health.

Occurrence of Aflatoxin M1 in Cow, Goat, Buffalo, Camel, and Yak Milk in China in 2016

In this present study, 195 cow milk, 100 goat milk, 50 buffalo milk, 50 camel milk, and 50 yak milk samples were collected in China in May and October 2016. The presence of aflatoxin M1 (AFM1) was determined using enzyme-linked immunosorbent assay method. For all cow milk samples, 128 samples (65.7%) contained AFM1 in concentrations ranging from 0.005 to 0.191 µg/L, and 6 samples (3.1%) from Sichuan province in October were contaminated with AFM1 above 0.05 µg/L (EU limit). For all goat milk samples, 76.0% of samples contained AFM1 in concentrations ranging from 0.005 to 0.135 µg/L, and 9 samples (9.0%) from Shanxi province in October were contaminated with AFM1 above 0.05 µg/L. For all buffalo milk samples, 24 samples (48.0%) contained AFM1 in concentrations ranging from 0.005 to 0.089 µg/L, and 2 samples collected in October were contaminated with AFM1 above 0.05 µg/L. Furthermore, 28.0% of samples contained AFM1 in concentrations ranging from 0.005 to 0.007 µg/L in camel milk samples, and 18.0% of samples contained AFM1 in concentrations ranging from 0.005 to 0.007 µg/L in yak milk samples. Our survey study has expanded the current knowledge of the occurrence of AFM1 in milk from five dairy species in China, in particular the minor dairy species.

Mycotoxins occurrence in milk and cereals in North African countries - a review

North African countries; Algeria, Egypt, Libya, Morocco and Tunisia suffer from mycotoxin contamination. Various studies have indicated the presence of mycotoxins in raw milk and cereals (i.e. wheat, barley, maize and cereal-based products). Aflatoxins (AFs), Aflatoxin M1 (AFM1), Ochratoxin A (OTA), Fumonisin (FB1) and Zearalenone (ZEN)-mycotoxin are the most detected due to climatic change in the region. In this review, we will present the kind of foods and feeds cereals and milk based products contaminated and the level of their contaminated mycotoxin. On the other hand, researchers try to find biologic methods to remove/mitigate mycotoxins in food and feed using bio-products. But the research works concerning legislations and mycotoxin risk assessment still rare. Therefore, it appears necessary to make review on the current status of mycotoxins in North African countries in order to explore data related to contamination of basic food in this region and to highlight the problem to the policy-makers to establish a serious legislation on this matter. On the other hand, to give more information to the worldwide readers about the impact of climate change on the food and feed pollution on mycotoxins in the Mediterranean Sea region.

Incidence of Aflatoxin M1 in Milk and Milk Products from Punjab, Pakistan, and Estimation of Dietary Intake

In the present study, 124 samples of milk and milk products were analyzed for the presence of aflatoxin M1 (AFM1), which were purchased from the central cities of Punjab, Pakistan. The analysis was carried out using reverse-phase liquid chromatography, which was equipped with a fluorescence detector. The results showed that 66 samples (53.8%) of raw milk and milk products were found to be contaminated with detectable levels of AFM1 above ≤50 ng/L, and 24.2% of the samples had levels of AFM1 higher than the permissible limit of the European Union (EU; 50 ng/kg). In total, 53.6% of the raw milk, 57.8% of the UHT (ultra-heat-temperature) milk, 45% of the powdered milk, 57.1% of the yogurt, 55.5% of the cheese, and 50% of the buttermilk samples had levels higher than the LOD, i.e., 4 ng/L. The highest mean of 82.4 ± 7.8 ng/kg of AFM1 was present in the positive samples of raw milk. The highest dietary intake of AFM1 was found in infants’ milk (5.35 ng/kg/day), UHT milk (1.80 ng/kg/day), powdered milk (5.25 ng/kg/day), and yogurt (1.11 ng/kg/day). However, no dietary intake was detected in the cheese and butter milk samples used for infants. The results from the undertaken work are beneficial for establishing rigorous limits for AFB1 in animal feed, especially considering the high prevalence rate of hepatitis cases in the central cities of Punjab, Pakistan.

Aflatoxin M1 exposure in a fermented millet-based milk beverage 'brukina' and its cancer risk characterization in Greater Accra, Ghana

Brukina is a millet based fermented milk product which is consumed as a beverage in Ghana. It is however prone to aflatoxin M1 (AFM1) contamination, which is a serious health challenge for low and middle-income countries in subtropical regions. This study aimed at evaluating AFM1 levels and cancer risks associated with brukina (n = 150) sampled from different locations of the Greater Accra Region of Ghana. AFM1 were measured with High-Performance Liquid Chromatography (HPLC) connected to a Fluorescence Detector (FLD).Cancer risk assessments were also conducted using models prescribed by the Joint FAO/WHO Expert Committee on Additives (JECFA). Out of the 150 samples analyzed for AFM1, 80/150 (53%) tested positive between the range 0.00 ± 0.001-3.14 ± 0.77 µg/kg. Cancer risk assessments of AFM1 produced outcomes which ranged between 0.64 and 1.88 ng/kg bw/day, 0.31-9.40, 0.0323, and 1.94 × 10-3-0.06 for cases/100,000 person/yr for Estimated Daily Intake (EDI), Hazard Index (H.I), Average Potency, and Cancer Risks respectively for all age categories investigated. It was concluded that the consumption of brukina posed adverse health effects on the majority of the age categories in the different locations of Greater Accra Region since the calculated H.Is were greater than one (> 1). Therefore, contamination of brukina with AFM1 should be considered a high priority in public health and Ghana's cancer risk management actions.

Seasonal Occurrence of Aflatoxin M1 in Raw Milk during a Five-Year Period in Croatia: Dietary Exposure and Risk Assessment

This study’s objective was to estimate the seasonal occurrence of aflatoxin M₁ (AFM₁) in cow’s milk between winter 2016 and winter 2022 and to assess dietary exposure and risk assessment for the adult Croatian population. In total, 5817 cow milk samples were screened for AFM₁ concentrations using the enzyme immunoassay assay (ELISA). For confirmation purposes of AFM₁ concentration above the European Union maximum permitted level (MRL), ultra high-performance liquid chromatography with tandem mass spectrometry was performed. In 94.7% of milk samples, AFM₁ levels were below the detection limit (LOD) of the ELISA test. For 3.47% of samples, the AFM₁ was between the LOD and MRL values. Only 1.87% of all samples exceeded the MRL. The mean value of elevated AFM₁ in different seasons ranged between 59.2 ng/kg (autumn 2017) and 387.8 ng/kg (autumn 2021). The highest incidences of positive AFM₁ were determined in autumn and winter and the maximum (6.4%) was in winter 2019/2020. The largest percentage of positive samples (69.7%) was found in central Croatia. The estimated daily intakes for positive samples ranged between 0.17 and 2.82 ng/kg body weight/day. Risk assessment indicated a high level of concern during autumn and winter, especially for consumers of large amounts of milk.

Decrease in Aflatoxin M1 Concentration in Milk during Cholesterol Removal by Application of β-Cyclodextrin

Approximately one-third of humankind is chronically exposed to the carcinogenic aflatoxin M1 contained in milk. As β-cyclodextrin is frequently used in the food industry, its effect on aflatoxin M1 concentration was investigated during cholesterol removal from milk due to the similarity among the physicochemical properties of aflatoxin M1 and cholesterol. Moreover, the elimination of cholesterol using β-cyclodextrin has been successfully applied in many studies without any substantial effect on the quality of the treated milk. Therefore, milk samples were spiked with aflatoxin M1 within the range from 0.20 to 2.00 µg/kg, and cholesterol removal was carried out by 2.0% (w/w) β-cyclodextrin addition, as this concentration is enough for the sufficient removal of cholesterol. It was found that the mean cholesterol concentration decreased by 92.3%, while the aflatoxin M1 concentration decreased to 0.53 ± 0.04 µg/kg, i.e., by 39.1% after treatment (n = 2). This mitigation procedure itself is easy and inexpensive and thus is fully applicable with a high potential for complete decontamination of aflatoxin M1 milk. This method will therefore considerably improve the food safety issues associated with aflatoxin M1 presence in milk and dairy products.

Aflatoxin M1 in Raw Milk, Pasteurized Milk and Cottage Cheese Collected along Value Chain Actors from Three Regions of Ethiopia

Milk is a highly nutritious and perfect natural food for humans. However, when lactating animals feed on Aflatoxin B1 (AFB1)-containing feed, the hydroxyl metabolite aflatoxin M1 (AFM1) contaminates the milk and dairy products. The objective of the current study was to assess the level of AFM1 in raw milk, normally pasteurized milk and Ethiopian cottage cheese collected from value chain actors (producers, collectors, processors and retailers). Cross-sectional study and simple random techniques were used to collect primary samples. A total of 160 composite samples was collected; raw milk (n = 64), pasteurized milk (n = 64) and cheese (n = 32) was analyzed. Quantitative analysis of AFM1 was conducted using enzyme-linked immunosorbent assay (ELISA). The results indicate that AFM1 was detected in all milk products. Results along value chains show that the concentration of AFM1 in raw milk from collectors was significantly higher than from producers, and in pasteurized milk from processors and retailers (p < 0.05). However, no significant (p > 0.05) difference was observed in cottage cheese value-chain actors in all regions. Comparison of AFM1 mean values among all dairy products shows that raw milk had a significantly higher concentration of AFM1 followed by pasteurized milk and cottage cheese. However, there was no significant difference between raw and pasteurized milk (p > 0.05). The mean AFM1 contamination in milk products ranged from 0.137 to 0.319 µg/L (mean value 0.285 µg/L). The contamination percentages of AFM1 in raw milk (62.50%), pasteurized milk (67.20%) and cottage cheese (25%) were above the regulatory limit set by the European Union (EU) (0.05 µg/L). According to USA/Ethiopian Standard (US/ES) (0.50 µg/L), 21.87%, 25% and 1% exceeded the regulatory limit for the above products, respectively. The overall prevalence (56.88%) was above the EU regulatory limit and 19.38% over US/ES regulations. Therefore, to provide accurate information about the health risk to consumers, there is a need to conduct risk assessment studies in consumers of milk and dairy products at different age groups.

Fate of aflatoxins M1 and B1 within the period of production and storage of Tarkhineh: A traditional Persian fermented food

The objective of the study was to assess the amount of aflatoxin M1 (AFM1) and aflatoxin B1 (AFB1) during fermentation, drying, and storage of Tarkhineh-a traditional Persian fermented food-over four months. Tarkhineh samples were produced based on a traditional method. Various concentrations of AFB1 (2.5, 5, 7.5, and 10 µg/kg) and AFM1, stood at 0.25, 0.5, 0.75, and 1 µg/kg, were added to Iranian yogurt drink, called doogh, samples. Tarkhineh samples were evaluated for AFB1 and AFM1 on days 0, 2, 6, and 8 and also after drying and four months of storage. In cases of repeatability, recovery, and reproducibility, the high-performance liquid chromatography through fluorescence detector (HPLC-FD) method was successfully done to demonstrate aflatoxins (AFs) in Tarkhineh samples. The fermentation process had a considerable consequence on the reduction in AFM1 and AFB1 as compared to the control group, evidenced by 65.10%-81.20% and 55.80%-74.10%, respectively, after eight days of fermentation (p < .05). The highest reduction in AFB1 existed in samples containing 2.5 µg/kg toxin, followed by 5, 7.5, and 10 µg/kg, respectively. A similar trend was found for AFM1, as the highest concentration was found in samples containing 0.25 µg/kg toxin, followed by 0.5, 0.75, and 1 µg/kg, respectively.

S. M. Montenegro MC, Rodríguez-Díaz JM. Contaminants in the cow's milk we consume? Pasteurization and other technologies in the elimination of contaminants

Cow's milk is currently the most consumed product worldwide. However, due to various direct and indirect contamination sources, different chemical and microbiological contaminants have been found in cow's milk. This review details the main contaminants found in cow's milk, referring to the sources of contamination and their impact on human health. A comparative approach highlights the poor efficacy and effects of the pasteurization process with other methods used in the treatment of cow's milk. Despite pasteurization and related techniques being the most widely applied to date, they have not demonstrated efficacy in eliminating contaminants. New technologies have appeared as alternative treatments to pasteurization. However, in addition to causing physicochemical changes in the raw material, their efficacy is not total in eliminating chemical contaminants, suggesting the need for new research to find a solution that contributes to improving food safety.

Review of occurrence of mycotoxins in Serbian food items in the period from 2005 to 2022

This paper aimed to review the publications on mycotoxins' presence in cereals and foodstuffs originated from the Serbian market covering the period from 2005 to 2022. The review covers all the important steps in mycotoxins analysis including sampling, sample preparation, instrumental analysis, and concentration ranges in which the mycotoxins were found. Also, the results were interpreted from the European Union regulation point of view. The review emphasizes the importance of multi-mycotoxins analysis for determining the simultaneous presence of mycotoxins that can negatively affect the Serbian human population. The most frequently used instrumental technique in the mycotoxin analysis of Serbian products was the Enzyme-Linked Immunosorbent Assay followed by the Ultra-High Performance Liquid Chromatography coupled with triple quadrupole mass spectrometry. Most of the studies undertaken in Serbia until now investigated a few groups of matrices such as wheat, maize, milk, and dairy products. Only a few studies involved specific matrices such as nuts, dried fruits, biscuits, cookies, and spices. The review showed that contamination of milk and dairy products with aflatoxin M1 (AFM1), occurred at the very beginning of 2013, was the major health issue related to the population health. The contamination of milk and dairy products with the AFM1 was a consequence of maize contamination with aflatoxins which occurred in the year 2012, characterized by drought conditions. The studies dealing with the analysis of masked and emerging mycotoxins are rare and more attention should be paid to monitoring the presence of these types of mycotoxins in foodstuffs from Serbia.

Review of occurrence of mycotoxins in Serbian food items in the period from 2005 to 2022

This paper aimed to review the publications on mycotoxins' presence in cereals and foodstuffs originated from the Serbian market covering the period from 2005 to 2022. The review covers all the important steps in mycotoxins analysis including sampling, sample preparation, instrumental analysis, and concentration ranges in which the mycotoxins were found. Also, the results were interpreted from the European Union regulation point of view. The review emphasizes the importance of multi-mycotoxins analysis for determining the simultaneous presence of mycotoxins that can negatively affect the Serbian human population. The most frequently used instrumental technique in the mycotoxin analysis of Serbian products was the Enzyme-Linked Immunosorbent Assay followed by the Ultra-High Performance Liquid Chromatography coupled with triple quadrupole mass spectrometry. Most of the studies undertaken in Serbia until now investigated a few groups of matrices such as wheat, maize, milk, and dairy products. Only a few studies involved specific matrices such as nuts, dried fruits, biscuits, cookies, and spices. The review showed that contamination of milk and dairy products with aflatoxin M1 (AFM1), occurred at the very beginning of 2013, was the major health issue related to the population health. The contamination of milk and dairy products with the AFM1 was a consequence of maize contamination with aflatoxins which occurred in the year 2012, characterized by drought conditions. The studies dealing with the analysis of masked and emerging mycotoxins are rare and more attention should be paid to monitoring the presence of these types of mycotoxins in foodstuffs from Serbia.

Dietary Exposure and Risk Assessment of Aflatoxin M1 for Children Aged 1 to 9 Years Old in Serbia

The present study was conducted to estimate the exposure and characterize the risk for the child population of Serbia to Aflatoxin M1 (AFM1) from milk and milk-based food. A total of 3404 samples comprising milk and different milk-based food samples were collected from various regions of Serbia from 2017 to 2019. Evaluation of AFM1 exposure was carried out using the deterministic method, whereas risk characterization was evaluated using the margin of exposure (MOE) and the risk of hepatocellular carcinoma (HCC). Detection rates for AFM1 in milk and milk-based food samples ranged between 2% and 79%, with the highest incidence (79%) and mean level (22.34 ± 0.018 ng kg^-1) of AFM1 being detected in pasteurized and UHT milk. According to the three consumption estimates, the values of estimated daily intake (EDI) were higher for toddlers as compared with children aged 3-9 years. Children aged 1-3 years had the highest risk of exposure to AFM1 in milk, with an estimated daily intake of 0.164 and 0.193 ng kg^-1 bw day^-1 using lower bound (LB) and upper bound (UB) exposure scenarios, respectively. Such difference could result from the higher consumption to weight in younger children. Based on the estimated daily intake (EDI) found in this study, the risk of AFM1 exposure due to consumption of milk and milk-based food was low since the MOE values obtained were >10,000. In addition, the risk of HCC cases/year/10⁵ individuals of different age groups showed that the value of HCC, using potency estimates of 0.0017 (mean), was maximum (0.00034) in the age group 1-3 years, which indicates no health risk for the evaluated groups. The present study revealed the importance of controlling and preventing AFM1 contamination in milk through continuous monitoring and regular inspection to reduce the risk of AFM1 exposure, especially in children.

Multi-mycotoxin occurrence in feed, metabolism and carry-over to animal-derived food products: A review

The world requests for raw materials used in animal feed has been steadily rising in the last years driven by higher demands for livestock production. Mycotoxins are frequent toxic metabolites present in these raw materials. The exposure of farm animals to mycotoxins could result in undesirable residues in animal-derived food products. Thus, the potential ingestion of edible animal products (milk, meat and fish) contaminated with mycotoxins constitutes a public health concern, since they enter the food chain and may cause adverse effects upon human health. The present review summarizes the state-of-the-art on the occurrence of mycotoxins in feed, their metabolism and carry-over into animal source foodstuffs, focusing particularly on the last decade. Maximum levels (MLs) for various mycotoxins have been established for a number of raw feed materials and animal food products. Such values are sometimes exceeded, however. Aflatoxins (AFs), fumonisins (FBs), ochratoxin A (OTA), trichothecenes (TCs) and zearalenone (ZEN) are the most prevalent mycotoxins in animal feed, with aflatoxin M₁ (AFM1) predominating in milk and dairy products, and OTA in meat by-products. The co-occurrence of mycotoxins in feed raw materials tends to be the rule rather than the exception, and the carry-over of mycotoxins from feed to animal source foods is more than proven.

Quantitative risk assessment for aflatoxin M1 associated with the consumption of milk and traditional dairy products in Argentina

A quantitative risk assessment for exposure to aflatoxin M1 (AFM₁) related to the consumption of milk and traditional dairy products of Argentina was developed. The frequency and concentration of AFM₁ was modelled at various stages through the milk processes, considering Argentinean practices. Concentration of AFM₁ (0.046 μg/l, 95%CI = 0.002-0.264 μg/l) in raw milk was estimated. The AFM₁ concentration in milk was sensitive to the carry-over rate (r = 0.80), and milk yield in the first third of lactation during the spring-summer season (r = 0.11). AFB₁ levels in silage (r = 0.22), pasture during the spring-summer season (r = 0.11), concentrate (r = 0.08), and cotton seed (r = 0.05) were the factors most correlated with AFM₁ concentrations. Although the results showed that MoE values for the mean and median exposure to AFM₁ were < 10,000 in infants, toddlers, and other children, the additional cancer risk due to exposure to AFM₁ in infants, toddlers, and other children was 0.007, 0.005, and 0.0009 additional cases per year per 100,000 individuals, respectively, which indicates no health concern. In addition, the percentages of the population exceeding HI values (HI > 1) for exposure to AFM₁ for infants, toddlers, and other children were 45%, 49.1%, and 40.6%, respectively. Under this scenario, the most susceptible population at risk was children < 10 years old; therefore, it is necessary to establish measures to prevent contamination of AFM₁ in milk and milk products.

Organic versus Conventional Raw Cow Milk as Material for Processing

Milk, as one of the basic raw materials of animal origin, must be of adequate hygienic and physicochemical quality for processing. The aim of the article was to compare the quality of raw milk from three production systems, intensive, traditional (together referred to as conventional), and organic, as material for processing, as well as the quality of products made from it. Particular attention was focused on hygienic quality (somatic cell count and total bacterial count), physical characteristics (acidity), basic nutritional value (content of dry matter, total protein, casein, fat, and lactose), content of health-promoting substances (whey proteins, fatty acids, vitamins, and minerals), and technological parameters (rennet clotting time, heat stability, and protein-to-fat ratio). Research assessing the quality of organic milk and dairy products is significantly less extensive (if available at all) than for milk from conventional production (intensive and traditional). The available reports indicate that raw milk from organic farms is more valuable, especially in terms of the content of health-promoting compounds, including vitamins, fatty acids, whey proteins, and minerals. This applies to organic dairy products as well, mainly cheese and yoghurt. This is explained by the fact that organic farming requires that animals are kept in the pasture. However, the hygienic quality of the raw milk, and often the products as well, raises some concerns; for this reason, organic milk producers should be supported in this regard, e.g., through consultancy and training in Good Hygienic Practices. Importantly, milk production in the traditional and organic systems is in line with the concept of the European Green Deal.

Aflatoxin M1 in Brazilian goat milk and health risk assessment

Contamination of goat milk with aflatoxin M₁ (AFM₁) is a public health concern. This study investigated filamentous fungi in goat feed and quantified AFM₁ in milk samples (n = 108) from goat fed forage and concentrate. Based on the detected AFM₁ concentration, risk assessment analyses were performed concerning the Estimated Daily Intake (EDI) for one-year-old children and adults. Filamentous fungi were found in goat feed samples in a range of 3.1 ± 1.9 to 4.2 ± 0.2 log CFU/g. Five genera were identified, to cite Aspergillus, Penicillium, Fusarium, Rhizopus and Acremonium. Aspergillus species comprised A. flavus, A. niger, and A. ochraceus. All goat milk samples were contaminated with AFM₁ (5.60-48.20 ng/L; mean 21.90 ± 10.28 ng/L) in amounts below the limits imposed by regulatory agencies. However, EDI values for AFM₁ through goat milk estimated for one-year-old children were above the Tolerable Daily Intake. The calculated Hazard Index for one-year-old children indicated potential risk of liver cancer due to goat milk consumption. The Margin of Exposure values to AFM₁ in one-year-old children and adults consuming goat milk as the unique milk source indicated increased health risk. Therefore, contamination of goat milk with AFM₁ should be considered a high priority for Brazil's risk management actions.

An overview of aflatoxin B1 biotransformation and aflatoxin M1 secretion in lactating dairy cows

Milk is considered a perfect natural food for humans and animals. However, aflatoxin B1 (AFB1) contaminating the feeds fed to lactating dairy cows can introduce aflatoxin M1 (AFM1), the main toxic metabolite of aflatoxins into the milk, consequently posing a risk to human health. As a result of AFM1 monitoring in raw milk worldwide, it is evident that high AFM1 concentrations exist in raw milk in many countries. Thus, the incidence of AFM1 in milk from dairy cows should not be underestimated. To further optimize the intervention strategies, it is necessary to better understand the metabolism of AFB1 and its biotransformation into AFM1 and the specific secretion pathways in lactating dairy cows. The metabolism of AFB1 and its biotransformation into AFM1 in lactating dairy cows are drawn in this review. Furthermore, recent data provide evidence that in the mammary tissue of lactating dairy cows, aflatoxins significantly increase the activity of a protein, ATP-binding cassette super-family G member 2 (ABCG2), an efflux transporter known to facilitate the excretion of various xenobiotics and veterinary drugs into milk. Further research should focus on identifying and understanding the factors that affect the expression of ABCG2 in the mammary gland of cows.

Occurrence of Aflatoxin M1 (AFM1) in Donkey Milk Collected in Northern Italy

Aflatoxin M1 (AFM1) is a well-known mycotoxin that can be found in the milk of animals that have ingested feed contaminated with aflatoxin B1 (AFB1). In Italy, the development of donkey farms is mainly due to growing request of donkey milk, which is considered an incomparable substitute for human mother's milk for its chemical composition and organoleptic characteristics. The aim of this study was to assess the occurrence of AFM1 in donkey milk produced in a farm in Northern Italy, also in view of the few data available about the presence of this mycotoxin in this type of milk. Therefore, 63 milk samples were collected and analyzed using a fast and sensitive HPLC and fluorescence detection (FLD) method previously optimized and validated. None of the milk samples collected were found to be contaminated at a level above the limit of quantification (LOQ) (0.0125 ng/mL), while only one sample showed traces of the mycotoxin at a concentration between the limit of detection (LOD) and LOQ (0.0044 ng/mL), well below the legal limit established for infant milk and follow-on milk (0.025 ng/mL). These results are in line with those of the few similar surveys carried out on donkey milk and seem to indicate a low risk of AFM1 contamination for this food.

Aflatoxins in Milk and Dairy Products: Occurrence and Exposure Assessment for the Serbian Population

The main objective of this study was to assess the exposure associated with aflatoxin M1 (AFM1) of the adult population in Serbia from consumption of milk and dairy products. This assessment was performed using concentration values of AFM1 in raw milk (385 samples) and dairy products (556 samples) based on the analyses conducted in the period between 2015 and 2018. In parallel, a dairy products consumption survey was completed during 2018 based on ‘one-day’ and ‘seven-day’ recall methods. In order to estimate the intake of AFM1 from the consumption of dairy products for both recall methods, a Monte Carlo simulation was conducted. The study revealed that pasteurized milk and yogurt are dairy products mostly consumed by the Serbian adult population. Estimated daily intake of AFM1 was in the range of 62–74 × 10−3 ng/kg bw/day, depending on the recall methods and scenarios employed. Although the results show moderate exposure risks compared to similar studies worldwide, climatic conditions and weather extremes that have occurred recently may have negatively influenced the contamination of feed and, consequently, AFM1 contamination of milk. As a result, it is justifiable to promote continuous monitoring in feed and dairy supply chains in Serbia and provide an update of exposure assessment.

Aflatoxin M1 in Milk Worldwide from 1988 to 2020: A Systematic Review and Meta-Analysis

Background. Aflatoxins are found in various types of food and animal feed. Food contamination with aflatoxin toxin is of particular importance today. Various studies have reported different prevalence of aflatoxin M1 in animal milk. Therefore, due to the importance of this toxin, its role in health, and lack of general statistics about it worldwide, the present study aimed to determine the prevalence of aflatoxin M1 in milk worldwide with a systematic review and meta-analysis study. Methods. In this review study, national and international databases were extracted from SID, MagIran, IranMedex, IranDoc, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (ISI) between January 1988 and February 2020. A random effects model was used for analysis, and heterogeneity of studies with an I2 index was investigated. Data were analyzed using Comprehensive Meta-Analysis (version 2). Results. The prevalence of aflatoxin M1 in milk worldwide from January 1988 to February 2020 in 122 articles with a sample size of 18921 was 79.1% (95% CI: 75.5–82.3%). Regarding the heterogeneity based on metaregression, there was a significant difference between the effect of the year of study (p≤0.001) and sample size (p≤0.001) with the prevalence of aflatoxin M1 in animal milk. Conclusion. The results of this study show that the prevalence of aflatoxin M1 in milk is high worldwide. Therefore, considering the importance of the milk group and its products, special measures should be taken to protect the ration from aflatoxin molds and milk quality.

Occurrence of and Factors Associated With the Presence of Aflatoxin M1 in Breast Milk of Mothers in Fethiye, Turkey

Aflatoxins comprise a group of mycotoxins that are found in the environment. Exposure to aflatoxins has been reported to cause serious health problems in humans. Since aflatoxin M₁ (AFM₁) is secreted in breast milk, the exposure of infants to this toxin is an important concern. The aim of this study was to determine the prevalence, levels of, and factors associated with the presence of AFM₁ in breast milk of mothers in Fethiye, Turkey. Breast milk samples were taken from 100 mothers who had given birth over the period of October-November 2017. The AFM₁ content of the samples was determined via enzyme-linked immunosorbent assay. The lowest limit for milk samples in the Ridascreen® AFM₁ commercial test kit is 5 ng/L. Because of this, AFM₁ levels below 5 ng/L in the breast milk samples were assessed as negative. Of the breast milk samples tested, 53 were positive. The average AFM₁ amount in the positive samples was 6.36 ng/L (ppt; range 5.10-8.31 ng/L). Mothers who were housewives, lived in damp, humid houses, or ate spices or dried fruits and vegetables had significantly greater prevalence of AFM₁ in their breast milk than those who were employed, did not report dampness or mold in the home, or did not eat spices or dried fruits and vegetables. AFM₁ in breast milk could be an important risk factor for infant health. Informing the public about food safety could reduce the amount of AFM₁ being transferred into breast milk via food channels.

Risk assessment of aflatoxins in food

EFSA was asked to deliver a scientific opinion on the risks to public health related to the presence of aflatoxins in food. The risk assessment was confined to aflatoxin B1 (AFB1), AFB2, AFG1, AFG2 and AFM1. More than 200,000 analytical results on the occurrence of aflatoxins were used in the evaluation. Grains and grain-based products made the largest contribution to the mean chronic dietary exposure to AFB1 in all age classes, while 'liquid milk' and 'fermented milk products' were the main contributors to the AFM1 mean exposure. Aflatoxins are genotoxic and AFB1 can cause hepatocellular carcinomas (HCCs) in humans. The CONTAM Panel selected a benchmark dose lower confidence limit (BMDL) for a benchmark response of 10% of 0.4 μg/kg body weight (bw) per day for the incidence of HCC in male rats following AFB1 exposure to be used in a margin of exposure (MOE) approach. The calculation of a BMDL from the human data was not appropriate; instead, the cancer potencies estimated by the Joint FAO/WHO Expert Committee on Food Additives in 2016 were used. For AFM1, a potency factor of 0.1 relative to AFB1 was used. For AFG1, AFB2 and AFG2, the in vivo data are not sufficient to derive potency factors and equal potency to AFB1 was assumed as in previous assessments. MOE values for AFB1 exposure ranged from 5,000 to 29 and for AFM1 from 100,000 to 508. The calculated MOEs are below 10,000 for AFB1 and also for AFM1 where some surveys, particularly for the younger age groups, have an MOE below 10,000. This raises a health concern. The estimated cancer risks in humans following exposure to AFB1 and AFM1 are in-line with the conclusion drawn from the MOEs. The conclusions also apply to the combined exposure to all five aflatoxins.

Mycotoxins in maize harvested in Republic of Serbia in the period 2012-2015. Part 1: Regulated mycotoxins and its derivatives

The main objective of this study was to apply a liquid chromatography-tandem mass spectrometric method to investigate the presence of 20 mycotoxins in 204 maize samples harvested in Northern Serbia in the period 2012-2015, including seasons with extreme drought (2012), hot and dry conditions (2013 and 2015) and extreme precipitation (2014). Between 2 and 20 mycotoxins contaminated examined samples. In samples collected from each year, all of six examined fumonisins were detected with very high prevalence (from 76% to 100%). Aflatoxin B₁ was detected in 94% and 90% maize samples from 2012 and 2015, respectively. In samples from year 2014, deoxynivalenol, zearalenone and its derivatives were detected in 100% of samples. Furthermore, ochratoxin A (25%) was the most predominant in samples from 2012. The obtained results indicate that changes in weather conditions, recorded in the period of four years, had significant influence on the occurrence of examined mycotoxins in maize.

The overall and variations of Aflatoxin M1 contamination of milk in Iran: A systematic review and meta-analysis study

Major databases were searched until January 2019 and 77 eligible studies were included in the meta-analysis to estimate the overall mean of AFM1 in milk in Iran. The mean of AFM1 levels was obtained 55.97 ng/kg (95% CI: 50.09-61.84). However, the pooled estimated mean of AFM1 levels in milk were 94.58 (95% CI: 70.24-118.92), 59.19 (95% CI: 51.84-66.54) and 35.23 ng/kg (95% CI: 31.53-38.92), considering 4, 55 and 18 TLC, ELISA and HPLC-based studies (including 354, 9224 and 2606 samples), respectively. Also, there is a wide variation of AFM1 levels among different geographical regions which were the highest in northern (88.77 ng/kg). The AFM1 contamination of milk taken from the areas with humid climate was higher than the arid climate. AFM1 Levels were the highest in winter (48.70 ng/Kg). The level of AFM1 in pasteurized, raw, and UHT milk were 49.76, 55.08 and 94.81 ng/kg, respectively.

Occurrence and Seasonal Variations of Aflatoxin M1 in Milk from Punjab, Pakistan

The manifestation of aflatoxins in feed and food is a major issue in the world as its presence leads to some health problems. This study investigates the incidence of aflatoxin M₁ (AFM₁) contamination in raw milk samples which were collected from Punjab, Pakistan. The Cluster Random Sampling technique was used to collect 960 milk samples from five different regions, and samples were collected every month. The AFM₁ level in raw milk was analyzed by the ELISA technique. The findings demonstrate that 70% of samples exceeded the United States permissible maximum residue limits (MRL 0.50 µg/L), with an overall AFM₁ level that ranged from 0.3 to 1.0 µg/L. AFM₁ contamination varied with the season: The highest average contamination was detected in winter (0.875 µg/L), followed by autumn (0.751 µg/L), spring (0.654 µg/L), and summer (0.455 µg/L). The Eastern region exhibited the highest average AFM₁ contamination (0.705 µg/L). Milk samples from the Northern region were found to be widely contaminated, as 86.9% samples exceeded the US MRL, followed by the Eastern region, with 72.3% samples being contaminated with >0.5 µg/L AFM₁. The study indicated that the raw milk supply chain was heavily contaminated. Recommendations and remedial measures need to be developed by regulatory authorities to improve the raw milk quality.