Risk estimates of hepatocellular carcinoma in Vojvodina (Serbia) related to aflatoxin M1 contaminated cheese

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.

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

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

Health concerns associated to tropane alkaloids in maize food products in Serbia

Following the implementation of the European regulation limiting the presence of tropane alkaloids in certain foods, a survey was conducted in Serbia on 103 maize products (grits, polenta and semolina) to determine atropine and scopolamine content using liquid chromatography with tandem-mass spectrometry analysis (LC-MS/MS). The probability of exceeding the Acute Reference Dose (ARfD; 0.016 μg/kg bw/day) of the sum of atropine and scopolamine by consuming these products was tested. Overall, across age categories - children, younger and older adolescents, and adults, the group ARfD was exceeded by 21.4%, 17.5%, 11.7% and 11.7% of the samples, with maximum exposure reaching as much as 19-, 13-, 9- and 9-fold the group ARfD, respectively. Nevertheless, polenta could be the most favorable dietary option (17.9% of positive samples, 7.7% resulting in excessive exposure in children, reaching a maximum of 1.4-fold the group ARfD). According to the reported findings, adverse health effects of tropane alkaloids cannot be ruled out. The Margin of Exposure, founded on a clinically significant acute effects dose established by FAO/WHO, ranged from 1194 to 2381 (mean) and from 28 to 56 (95th percentile) across age categories. These estimates should certainly draw the attention of food authorities and nutritionist, particularly in the case of highly sensitive populations with contraindications and high consumers of corn products, such as coeliac patients.

Aflatoxin detection technologies: recent advances and future prospects

Aflatoxins have posed serious threat to food safety and human health. Therefore, it is important to detect aflatoxins in samples rapidly and accurately. In this review, various technologies to detect aflatoxins in food are discussed, including conventional ones such as thin-layer chromatography (TLC), high performance liquid chromatography (HPLC), enzyme linked immunosorbent assay (ELISA), colloidal gold immunochromatographic assay (GICA), radioimmunoassay (RIA), fluorescence spectroscopy (FS), as well as emerging ones (e.g., biosensors, molecular imprinting technology, surface plasmon resonance). Critical challenges of these technologies include high cost, complex processing procedures and long processing time, low stability, low repeatability, low accuracy, poor portability, and so on. Critical discussion is provided on the trade-off relationship between detection speed and detection accuracy, as well as the application scenario and sustainability of different technologies. Especially, the prospect of combining different technologies is discussed. Future research is necessary to develop more convenient, more accurate, faster, and cost-effective technologies to detect aflatoxins.

Incidence and Levels of Aflatoxin M1 in Artisanal and Manufactured Cheese in Pernambuco State, Brazil

Cheese is one of the most susceptible dairy foods to accumulating aflatoxins due to their high affinity to caseins. The consumption of cheese contaminated with high levels of aflatoxin M1 (AFM1) can be highly harmful to humans. The present work, based on high-performance liquid chromatography (HPLC), highlights the frequency and levels of AFM1 in coalho and mozzarella cheese samples (n = 28) from the main cheese-processing plants in Araripe Sertão and Agreste in the state of Pernambuco, Brazil. Of the evaluated cheeses, 14 samples were artisanal cheeses and the remaining 14 were industrial (manufactured) cheeses. All samples (100%) had detectable levels of AFM1, with concentrations ranging from 0.026 to 0.132 µg/kg. Higher levels (p < 0.05) of AFM1 were observed in artisanal mozzarella cheeses, but none of the cheese samples exceed the maximum permissible limits (MPLs) of 2.5 µg/kg established for AFM1 in cheese in Brazil and 0.25 µg/kg in the European countries by the European Union (EU). The high incidence of low levels of AFM1 found in the evaluated cheeses underscores the need for stringent control measures to prevent this mycotoxin in milk used for cheese production in the study area, with the aim of protecting public health and reducing significant economic losses for producers.

Aflatoxin M1 Contamination of Ghanaian Traditional Soft Cottage Cheese (Wagashie) and Health Risks Associated with Its Consumption

Wagashie is an unripened traditional cheese consumed in West Africa including Ghana. Being a milk product, it is unfortunately susceptible to aflatoxin M1 (AFM1) contamination, which is indeed a grave health challenge globally. This study evaluated AFM1 levels and health risk characterization associated with wagashie (n = 182) sampled from different locations in Ghana. AFM1 was measured with high-performance liquid chromatography with a fluorescence detector (HPLC-FLD). Risk assessments were also conducted using models prescribed by the Joint FAO/WHO Expert Committee on Food Additives (JECFA). Out of the 182 samples analyzed for AFM1, 93/182 (51.1%) tested positive between the range 0.00 ± 0.00–3.60 ± 0.99 µg/kg. Risk assessments of AFM1 using deterministic models produced outcomes that ranged between 0.11 and 3.60 ng/kg bw/day, 0.09–1.54, 0–0.0323 ng aflatoxins/kg bw/day, and 3.5 x 10−3 −0.06 cases/100,000 person/yr for estimated daily intake (EDI), margin of exposure (MOE), average potency, and cancer risks, respectively, for the age categories investigated. It was established that the consumption of wagashie posed adverse health effects on all age categories in the selected regions of the study because all calculated MOE values were less than 100,000. Therefore, contamination of wagashie with AFM1 should be a serious public health concern and as such considered a high precedence for Ghana’s risk management actions.

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.