Levels of aflatoxin M1 in different types of milk collected in Serbia: Assessment of human and animal exposure

Occurrence of Aflatoxin M1 and Estimate of Dietary Exposure in Cheeses from Organic and Conventional Production Systems

This study aimed to compare AFM1 occurrence in different cheese types produced by organic and conventional systems; and to evaluate the risk of food exposure to AFM1. A total of 176 commercial cheeses of 17 types were analyzed, 84 of organic and 92 of conventional production. Determination of AFM1 was performed by high- performance liquid chromatography (HPLC), being detected in 30.5% of samples, with 4.8% of organic cheese samples presenting quantifiable AFM1 values between 0.88 and 1.50 μg/kg. On the other hand, 4.3% of conventional cheese samples with values between 0.79 and 6.70 μg/kg. Two conventional cheese samples were above the limit of AFM1 allowed for cheeses by the Brazilian legislation. No statistical difference were found between organic and conventional cheeses regarding the occurrence (p = 0.1780) and concentration of AFM1 (p = 0.1810), according to the Chi-square and the T test, respectively. Estimated daily intake (EDI) and hazard index (HI) of dietary exposure to AFM1 were 0.26 ng/kg/day and 1.28 ng/kg/day, respectively, for conventional cheese samples, and 0.09 ng/kg/day and 0.47 ng/kg/day for organic samples, with no statistical difference for EDI (p = 0.1729) and HI (p = 0.1802) between the two production systems. Comparison between several cheese types from conventional and organic systems indicated that AFM1 is an obstacle to dairy production. Control and prevention of AFM1 contamination, as well as detoxification methods in the final products, are necessary. In the case of organic products, additional research is needed in order to determine which control and detoxification methods should be allowed in this production system.

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.

The impact of fullerenol nanoparticles on the growth of toxigenic Aspergillus flavus and aflatoxins production in vitro and in corn flour

Antifungal and antimycotoxigenic activity of fullerenol nanoparticles (FNPs) were investigated on Aspergillus flavus growth isolated from a real food sample and aflatoxins (AFs) (AFB1 and AFB2 ) production. The final FNPs concentrations in in vitro and in commercial corn flour after the stationary incubation period of 7 and 14 days were in the range 0.16-80 µg/mL and 0.16-80 µg/g, respectively. Nanocharacterization of FNPs revealed an average size of 5-20 nm and a zeta potential of -35 mV. The highest degree of A. flavus mycelium growth inhibition (28%) after 7 days was observed for applied FNP concentration of 8.0 µg/mL, while after 14 days FNP concentration of 0.32 µg/mL led to the maximal inhibition of A. flavus mycelium growth (36%). Spearman's correlations analysis revealed a strong positive correlation between AFB1 and AFB2 concentrations in YES broth after 7 (R = 0.994, p < 0.05) and 14 days (R = 0.976), as well as between AFs concentrations and A. flavus mycelium mass after 7 (R = 0.786 for AFB1 and R = 0.766 for AFB2 ) and 14 days (R = 0.810 for AFB1 and R = 0.833 for AFB2 ). Paired samples t-test showed the existence of a statistically significant difference (p < 0.05) between the produced AFs concentrations after the incubation of 7 and 14 days. Regarding the artificially inoculated corn flour the lower applied FNP concentrations (0.16-0.8 µg/g) achieved a reduction of AFB1 up to 42% and 60% after 7 and 14 days, respectively.

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.

Prevalence and concentration of Aflatoxin M1 in human breast milk in sub-Saharan Africa: a systematic review and meta-analysis, and cancer risk assessment

This study aimed to assess the prevalence, concentration of AFM1 in human breast milk, and to determine the risk of cancer for infants in sub-Saharan Africa. A systematic literature search was performed using PubMed, CINAHL, Web of science, global health, Cochrane, and Google Scholar electronic databases. A random-effects model was used to estimate the pooled prevalence and concentration of AFM1 in breast milk. The meta-analysis of 8 articles containing 9 studies showed the pooled prevalence of AFM1 in breast milk to be 56.18% (95% CI: 29.65-82.71) and the pooled concentration to be 31.12 ng/L (95% CI: 25.97-36.25). The cancer risk assessment indicated for both male and female 1-month infants in Sierra Leone (HI > 1) is high, and all the rest of the infants are free of risk (HI < 1). The pooled prevalence and mean concentration of AFM1 in breast milk is high. Monitoring of AFB1 concentration of commonly used foods will be of high value in reducing the burden of AFM1.

Prevalence and Concentration of Mycotoxins in Animal Feed in the Middle East and North Africa (MENA): A Systematic Review and Meta-Analysis

This study seeks a comprehensive meta-analysis of mycotoxin contaminants in animal feed consumed in the Middle East and North Africa (MENA) region. The obtained articles were reviewed, and 49 articles that investigated the contamination of mycotoxins including aflatoxins (AFs), deoxynivalenol (DON), zearalenone (ZEA), T-2 toxin, fumonisins (FUM), and ochratoxin A (OTA), in feed samples or components of animal feed in the MENA region were selected. The titles of the final articles included in the study were meta-analyzed. Necessary information was extracted and categorized from the articles, and a meta-analysis was performed using Stata software. The highest contamination was in dry bread (80%), and Algeria was the most contaminated country (87% of animal feed), with the most mycotoxins contaminating AFs (47%) and FUM (47%). The highest concentration of mycotoxins in animal feed is related to FUM (1240.01 μg/kg). Climate change, economic situation, agricultural and processing methods, the nature of the animal feed, and improper use of food waste in animal feed are among the most critical factors that are effective in the occurrence of mycotoxin contamination in animal feed in MENA. Control of influential factors in the occurrence of contaminations and rapid screening with accurate identification methods to prevent the occurrence and spread of mycotoxin contamination of animal feed seem important.

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.

Aflatoxin M1 in distributed milks in northwestern Iran: occurrence, seasonal variation, and risk assessment

Aflatoxin is one of the dangerous fungal toxins that is produced in the presence of humidity and heat and lack of proper storage conditions and is considered as a dangerous substance threatening human health. The work aimed to determination of aflatoxin M1 (AFM) level in raw, pasteurized, and sterilized milks offered in the study area and to evaluate the risk of its consumption. In this descriptive cross-sectional study, 60 samples of milk types supplied in the region were collected during two series of sampling (cold and hot seasons) and analyzed by ELISA method. LCR, MoE, and HI indices were used to assess the possible risk of consuming milk containing AFM. In all taken samples AFM was found, the toxin concentration range in the first and second series of sampling was 57.5-270.6 ng/L and 57-185.9 ng/L, respectively. The level of toxin in pasteurized and sterilized milks in both sampling series was higher than raw milks. Based on the obtained data and in order to assess the risk of milk consumption in the target population, associated values with EDI, LCR, MoE, and HI were also calculated and obtained in the range of 0.145-0.3 ng/k.d b.w, 0.0008-0.0017 additional case per one million population, 1892.9-3921.6 and 0.72-1.5 ng/kg b.w, respectively. According to the findings, all samples tested are contaminated and although it is within the range of the WHO recommendation, however, based on the calculated indicators, the risk of liver cancer threatens the consumers of these milks. Therefore, it is necessary to manage this issue through educational control and monitoring measures.

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.

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.

Exposure Assessment of Multiple Mycotoxins and Cumulative Health Risk Assessment: A Biomonitoring-Based Study in the Yangtze River Delta, China

The extensive exposure to multiple mycotoxins has been demonstrated in many countries; however, realistic assessments of the risks related to cumulative exposure are limited. This biomonitoring study was conducted to investigate exposure to 23 mycotoxins/metabolites and their determinants in 227 adults (aged 20-88 years) in the Yangtze River Delta, China. Eight mycotoxins were detected in 110 urine samples, and multiple mycotoxins co-occurred in 51/227 (22.47%) of urine samples, with deoxynivalenol (DON), fumonisin B1 (FB1), and zearalenone (ZEN) being the most frequently occurring. For single mycotoxin risk assessment, FB1, ZEN, aflatoxin B1 (AFB1), and ochratoxin A (OTA) all showed potential adverse effects. However, for the 12 samples containing DON and ZEN, in which none had a hazard risk, the combination of both mycotoxins in two samples was considered to pose potential endocrine disrupting risks to humans by hazard index (HI) method. The combined margin of exposure (MOET) for AFB1 and FB1 could constitute a potential health concern, and AFB1 was the main contributor. Our approach provides a blueprint for evaluating the cumulative risks related to different types of mycotoxins and opens a new horizon for the accurate interpretation of epidemiological health outcomes related to multi-mycotoxin exposure.

Accidental Use of Milk With an Increased Concentration of Aflatoxins Causes Significant DNA Damage in Hospital Workers Exposed to Ionizing Radiation

The occupational exposure to ionizing radiation (Irad) or associated with mycotoxin-contaminated food may lead to genome damage and contribute to health risk. DNA damage in 80 blood samples of hospital workers occupationally exposed to low-doses of Irad was compared with 80 healthy controls. Among them, 40 participants accidentally consumed milk with increased concentration of Aflatoxin. All participants underwent the testing for micronuclei from blood, and 40 of them 8-OHdG from urine. The frequency of micronuclei (MN) was analyzed by cytokinesis-block peripheral blood lymphocytes and the level of urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) by ELISA. The Irad led to increased frequency of MN (p < 0.05) and 8-OHdG level at exposed hospital workers. The consumption of milk with increased concentration of aflatoxin probably raised MN frequency and 8-OHdG value. Higher consumption of aflatoxin-contaminated milk (≥2 L/monthly) caused significantly increased MN frequency and 8-OHdG value in comparison to lower milk intake (≤0.5 L/monthly). Also, confounding factors, such as age, gender, and smoking status of all participants were included in the study. The obtained results revealed an increased incidence of MN and 8-OHdG level among hospital workers exposed to low-doses of IRad and milk with increased aflatoxin concentration.

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.

The Occurrence and Risk Assessment of Exposure to Aflatoxin M1 in Ultra-High Temperature and Pasteurized Milk in Hamadan Province of Iran

Objectives

Aflatoxins are a category of poisonous compounds found in most plants, milk and dairy products. The present research was carried out to detect the presence of aflatoxin M₁ (AFM₁) in samples of milk collected from Hamadan province, Iran.

Methods

Twenty five samples of ultra-high temperature (UHT) and 63 samples of pasteurized milk were collected and the amount of AFM₁ was measured by an Enzyme-Linked Immunosorbent Assay method. In addition, the estimated daily intake (EDI) and hazard index (HI) of AFM₁ was determined by the following equations:(EDI= mean concentration of AFM₁ × daily consumption of milk/body weight; HI= EDI/Tolerance Daily Intake).

Results

AFM₁ was detected in 21 (84%) UHT milk samples and in 55 (87.30%) pasteurized milk samples. Seven (28%) samples of UHT and 21 (33.33%) pasteurized milk samples had higher AFM₁ content than the limit allowed in the European Union and Iranian National Standard Limits (0.05 μg/kg). None of the samples exceeded the US Food and Drug Administration limit (0.5 μg/kg) for AFM₁. EDI and HI for AM₁ through milk were 0.107 ng/kg body weight/day, and 0.535, respectively.

Conclusion

A significant percentage of milk produced by different factories in Iran (84% of UHT and 87.3% of pasteurized milk) was contaminated with AFM₁. Therefore, more control and monitoring of livestock feeding in dairy companies may help reduce milk contamination with AFM₁. As the HI value was lower than 1, it can be assumed that there was no risk of developing liver cancer due to milk consumption.

Concentration and Prevalence of Aflatoxin M1 in Human Breast Milk in Iran: Systematic Review, Meta-Analysis, and Carcinogenic Risk Assessment: A Review

This meta-analysis was designed to review the published reports regarding the concentration and/or prevalence of aflatoxin M₁ (AFM₁) in human breast milk in Iran. The carcinogenic risk for Iranian infants consuming this milk was estimated with the hazard index. The PubMed and Scopus databases and the Scientific Information Database were screened for relevant studies between 1995 and 2017, and 11 of the 112 collected studies were included in the systematic review and meta-analysis. The mean (95% confidence interval) concentration of AFM₁ was 5.85 ng/L (4.54 to 7.15 ng/L), which was lower than the European Union standard (25 ng/L). The mean prevalence of AFM₁ in breast milk in Iran was 42% (11 to 77%). The estimated daily intakes for male and female infants were 0.02 to 5.57 ng/kg and 0.02 to 3.68 ng/kg of body weight per day, respectively. The rank order of estimated daily intake for both male and female infants according to age was 1 week > 1 month > 6 months > 12 months. The hazard index for all age groups of infants in all provinces in Iran was less than 1. Therefore, infants in Iran were not considered at carcinogenic risk from AFM₁ in human breast milk.

Exposure Assessment and Risk Characterization of Aflatoxin M1 Intake through Consumption of Milk and Yoghurt by Student Population in Serbia and Greece

The objective of this research was to perform an exposure assessment of aflatoxin M1 (AFM1) intake through the consumption of milk and yoghurt by the student population in Serbia and Greece. A food consumption survey of milk and yoghurt was performed during the first half of 2018 in the two countries with at least 500 interviewees (aged between 18 and 27 years) per country, covering their dietary habits and body weight based on one-day and seven-day recall methods. Values for the concentration of AFM1 were extracted from published research. Finally, a Monte Carlo analysis of 100,000 iterations was performed to estimate the intake of AFM1 from the consumption of the two dairy products. Results revealed that the estimated average exposure of students to AFM1 was in the range of 1.238⁻2.674 ng kg^-1 bw day^-1 for Serbia, and 0.350⁻0.499 ng kg^-1 bw day^-1 for Greece, depending on the dietary recall method employed. High estimations for hepatocellular carcinoma (HCC) cases/year/10⁵ individuals, depending on the prevalence of Hepatitis B virus surface antigen positive individuals (HBsAg+), were 0.0036⁻0.0047 and 0.0007⁻0.0009 for Serbia and Greece, respectively. Presented Margin of Exposure (MOE) and Hazard Index (HI) values indicate increased risk from exposure to AFM1, particularly in Serbia.

Occurrence of aflatoxin B1, ochratoxin A and zearalenone in maize silage in the region of Vojvodina, Serbia

Silage made from the whole-plant maize is one of the most popular forages in Serbia. Consumption of maize silage by cows can be up to 30-35 kg/day. In Serbia in the few last years in the focus of the public and agriculture community were two mycotoxins, aflatoxin B1 and its metabolite aflatoxin M1 due to the outbreak of contaminated maize which affected the Balkans in 2012. Maize is regularly checked on the occurrence of aflatoxin B1, however forages are often neglected as a potential source of mycotoxins in the nutrition of dairy cattle.

In this work, 48 samples of maize silage were analyzed for the occurrence of aflatoxin B1, ochratoxin A and zearalenone. Samples were collected from three regions (Bačka, Banat and Srem) in Vojvodina. In all samples, at least one mycotoxin above the limit of quantification was measured. Aflatoxin B1 was detected in 36 (75%) samples. In two samples from Banat, the concentration of aflatoxin B1 exceeded the maximum level (ML) set by Serbian regulation (30 µg/kg at moisture content of 12%). In seven samples, the concentration of aflatoxin B1 was above 20 µg/kg which is the EU regulated ML. Average concentration of ochratoxin A was 10.4 µg/kg, while the maximum measured value was 34.3 µg/kg. Maximum zearalenone content in all samples was 538 µg/kg while the average zearalenone concentration was 138 µg/kg.

The results from this research point out that mycotoxin contaminated silage in the region of Vojvodina, Serbia can significantly contribute to daily intake of aflatoxin B1 in dairy cattle.

A survey of AFM1 contamination in row cow milk produced in region of Kumanovo

Aflatoxins (AFs) are type of mycotoxins produced by certain Aspergillus species. In the livers of cows, the aflatoxin В1 (AFB1) ingested with contaminated food is metabolized in carcinogenic aflatoxin М1 (AFM1) which is then excreted in the milk and poses a serious risk to the health of the consumers. In January of 2019, twenty five (25) samples of milk were collected from local farms in the surrounding area of Kumanovo, Republic of North Macedonia. The samples were analysed in the Centre for Public Health, Kumanovo. A method MKC EN ISO 14501:2007 for analysis of AFM1 by HPLC with fluorescence detection was applied. This method is selective, precise and applicative. The final analytical result has shown AFM1 below the LOD in any of the analyzed samples. Due to the well-known fact that AFM1 is toxic, i.e. carcinogenic and the fact that milk is widely used as staple food, continuous development as well as introduction of new, more sensitive methods for detection of AFM1 are required. Keywords: Aflatoxin M1, HPLC-FLD, milk

Post-Harvest Contamination with Mycotoxins in the Context of the Geographic and Agroclimatic Conditions in Romania

This study aimed to assess post-harvest contamination with mycotoxins in the context of the geographic and agroclimatic conditions in Romania in 2012–2015, a period that was characterized by extreme meteorological events and the effects of climate change. The samples were randomly sampled from five agricultural regions of Romania and analyzed for mycotoxins by enzyme-linked immunosorbent assay. An SPSS analysis was done to explore correlations between mycotoxins (deoxynivalenol—DON, aflatoxins—AF, ochratoxin A—OTA, zearalenone—ZEA), product types (raw cereal, processed cereal, cereal-based food), geographic coordinates (latitude, longitude, agricultural region), and agroclimatic factors (air temperature, precipitation, soil moisture reserve, aridity index, soil type). In the southeast part of the Southern Plain and Dobrogea (Baragan Plain, located at 44–45° N, 26–27° E), contamination with AF and OTA was higher in raw and processed cereals (maize in silo, silo corn germs) in the dry years (2012 and 2013), and contamination with DON was high in processed cereals (wheat flour type 450) in the rainy year (2014). DON and OTA contamination were significantly correlated with cumulative precipitation in all years, while AF and ZEA contamination were non-significantly correlated with climatic factors and aridity indices. The distribution of mycotoxins by product type and the non-robust correlations between post-harvest mycotoxins and agrometeorological factors could be explained by the use of quality management systems that control cereal at warehouse receptions, performant processing technologies, and the quality of storage spaces of agri-food companies. The Baragan Plain is Romania’s most sensitive area to the predicted climate change in southeast Europe, which may be associated with its increased cereal contamination with AF and OTA.

Occurrence and Identification of Aspergillus Section Flavi in the Context of the Emergence of Aflatoxins in French Maize

Aflatoxins (AFs) are secondary metabolites produced by Aspergillus section Flavi during their development, particularly in maize. It is widely accepted that AFB1 is a major contaminant in regions where hot climate conditions favor the development of aflatoxigenic species. Global warming could lead to the appearance of AFs in maize produced in Europe. This was the case in 2015, in France, when the exceptionally hot and dry climatic conditions were favorable for AF production. Our survey revealed AF contamination of 6% (n = 114) of maize field samples and of 15% (n = 81) of maize silo samples analyzed. To understand the origin of the contamination, we characterized the mycoflora in contaminated samples and in samples produced in the same geographic and climatic conditions but with no AFs. A special focus was placed on Aspergillus section Flavi. A total of 67 strains of Aspergillus section Flavi were isolated from the samples. As expected, the strains were observed in all AF+ samples and, remarkably, also in almost 40% of AF- samples, demonstrating the presence of these potent toxin producers in fields in France. A. flavus was the most frequent species of the section Flavi (69% of the strains). But surprisingly, A. parasiticus was also a frequent contaminant (28% of the strains), mostly isolated from AF+ samples. This finding is in agreement with the presence of AFG in most of those samples.

Aflatoxin M1 in cow, sheep, and donkey milk produced in Sicily, Southern Italy

Samples (n = 485) of raw (n = 394) or heat-treated (n = 91) milk of three different species (cow, n = 170; sheep, n = 133; donkey, n = 84), collected 2013-2016 in Western Sicily (Southern Italy), were analyzed for aflatoxin M₁ (AFM₁) by enzyme-linked immunosorbent assay (ELISA). Positive ELISA results were further analyzed by HPLC with fluorescence detection. Both methods had a detection limit for AFM₁ in milk of 7 ng kg^-1. ELISA yielded 12.9 and 5% positives in cows and sheep milk, respectively, all samples of donkey milk were negative. Levels of AFM₁ were in most cases at 0.007-< 0.05 μg kg^-1, only two samples (sheep milk) slightly exceeded the European Union maximum level of 0.05 μg kg^-1. Only 6% of the samples were positive for AFM₁ in a concentration range of 0.008-0.15 μg kg^-1. Only milk samples collected directly from farms were positive. Overall, the levels were much lower than previously reported for Southern Italy cow and sheep milk samples purchased in retail stores. The results of this work indicate a continuous improvement of the feeding techniques on dairy farms of Southern Italy, which is essential to ensure consumers' protection.

Aflatoxins in maize harvested in the Republic of Serbia over the period 2012-2016

Aflatoxins (AFs) are one of the most frequent contaminants in maize. The Republic of Serbia represents a leader in terms of maize production and exports in Europe. In recent years, Serbia faced climate changes. Therefore, the main objective of this study was to examine AF occurrence in 3000 maize samples collected during 2012-2016. In maize samples from 2012, 2013, 2015, and 2016, AFs were detected in 72.3%, 24.7%, 36.7%, and 5.0% of the samples, in concentration ranges of 1.0-111.2, 1.2-65.2, 1.1-76.2, and 1.3-6.9 µg kg^-1, respectively. Contrary to this, in maize samples from 2014, no AFs were detected. Analysis of weather conditions indicates that 2012 was characterised by extreme drought conditions, 2013 and 2015 by lack of precipitation and high air temperatures, 2014 as the rainiest year in these years, while 2016 had moderate weather conditions.

Overview on the Mycotoxins Incidence in Serbia in the Period 2004⁻2016

With an average annual production of 6.9 M tonnes and 2.5 M tonnes of maize and wheat respectively, Serbia is one of the main grain producers and exporters in Europe. Cereals are also the major staple food in Serbian diet. In view of the high cereal consumption, for human and animal nutrition, the presence of mycotoxins entails a high public health risk of chronic exposure to mycotoxins. This study provides an overview of the incidence of predominant mycotoxins, mainly in cereal and dairy products, in Serbia, in the 2004⁻2016, using data reported in the scientific literature. The study demonstrated that the total prevalence of aflatoxins was 62.9% (n = 12,517) with 26.2% of the samples exceeding the EU limits during this period. Results obtained for T-2/HT-2 (n = 523), deoxynivalenol (n = 2907), fumonisins (n = 998), zearalenone (n = 689) and ochratoxin A (n = 740) indicated the prevalence of 45.5%, 42.9%, 63.3%, 39.3% and 28.1%, respectively. For these mycotoxins, the EU limits were less frequently exceeded. Comprehensive collection and analysis of all accessible information reviewed in this paper showed moderate incidence and prevalence of mycotoxins in Serbia, with an exception of the 2012 drought year and the 2014 flood year.

Occurrence of Aflatoxin M1 in Raw Milk from Manufacturers of Infant Milk Powder in China

This survey was performed to investigate the occurrence of aflatoxin M1 (AFM1) contamination of raw milk from manufacturers of infant milk powder in China. A total of 1207 raw milk samples were collected overall from four seasons of 2016 in Northeast China, Northwest China, Northern China, and Central China (11 provinces and one municipality). Results showed that 56 of the 1207 raw milk samples (4.64%) were positive for AFM1, which were obtained from Heilongjiang (two samples), Gansu (one sample), Shaanxi (46 samples), Beijing (one sample), and Hunan (six samples) provinces. None of the raw milk samples from manufacturers of infant milk powder exceeded the Chinese limit (62.5 ng/L) in 2016. Only a few raw milk samples were not suitable for use in infant milk according to EU (European Union) or U.S. infant milk limits. Furthermore, based on this survey and previous studies, it is particularly important to avoid AFM1 contamination in raw milk during the winter.

Aflatoxin M1 contamination of raw cow's milk in five regions of Kosovo during 2016

During February and August 2016 (winter and summer season), 192 samples of raw bulk tank milk have been collected from small dairy farms in five different regions of Kosova (Prishtina, Prizren, Peja, Mitrovica, and Gjilan). These samples were analyzed for aflatoxin M₁ (AFM₁) contamination level by ultra-high performance liquid chromatography coupled with electrospray ionization triple quadrupole tandem mass spectrometry (UHPLC-ESI-MS/MS). The limit of quantification for AFM1 was 0.02 μg/L and recovery at 0.1-0.5 μg/L was 90-95% (coefficient of variation 15-25%). A total of 74 milk samples (38%) were found to be contaminated with AFM₁ and 11 samples (5.7%) slightly exceeded the European Union maximum level of 0.05 μg/L. The maximum AFM₁ level was at 0.082 μg/L. There was no relevant difference between summer and winter with regard to AFM₁ frequency and levels. Although the frequency of AFM₁-positive samples varied between regions, from 7% (Prishtina) to 53% (Prizren), only minor regional differences were observed with regard to average and maximum toxin levels. The high percentage of milk samples which were non-compliant with AFM₁ maximum levels indicates that efforts to reduce the contamination levels of aflatoxin B₁ in cows feed in Kosovo are necessary.