Occurrence of total aflatoxins, ochratoxin A and deoxynivalenol in foodstuffs available on the Lebanese market and their impact on dietary exposure of children and teenagers in Beirut

Contaminant and residue profiles in Lebanese food: a comparative analysis with global standards

Lebanon's agricultural sector, known for its diverse crop and livestock production, faces challenges in the international market due to the presence of chemical residues and contaminants in its food exports. Recent rejections of these exports have raised global concerns about food safety, increasingly seen as vital for public health and economic prosperity. This review focuses on examining scientific studies about the levels of various chemical residues including pesticides, and veterinary drugs and contaminants like mycotoxins, and polycyclic aromatic hydrocarbons, and heavy metals in Lebanese food products. Findings indicate that these residues and contaminants often exceed both the maximum residue limits (MRLs) and maximum limits (MLs) set by the Codex Alimentarius and the European Union. The review concludes with recommendations for reducing these contaminants and residues to enhance Lebanon's food safety and quality, aligning with international standards, and mitigating the risk of export rejections.

Are Infants and Children at Risk of Adverse Health Effects from Dietary Deoxynivalenol Exposure? An Integrative Review

Deoxynivalenol (DON) is a foodborne mycotoxin produced by Fusarium molds that commonly infect cereal grains. It is a potent protein synthesis inhibitor that can significantly impact humans' gastrointestinal, immune, and nervous systems and can alter the microbiome landscape. Low-dose, chronic exposure to DON has been found to stimulate the immune system, inhibit protein synthesis, and cause appetite suppression, potentially leading to growth failure in children. At higher doses, DON has been shown to cause immune suppression, nausea, vomiting, abdominal pain, headache, diarrhea, gastroenteritis, the malabsorption of nutrients, intestinal hemorrhaging, dizziness, and fever. A provisional maximum tolerable daily intake (PMTDI) limit of 1 µg/kg/body weight has been established to protect humans, underscoring the potential health risks associated with DON intake. While the adverse effects of dietary DON exposure have been established, healthcare communities have not adequately investigated or addressed this threat to child health, possibly due to the assumption that current regulatory exposure limits protect the public appropriately. This integrative review investigated whether current dietary DON exposure rates in infants and children regularly exceed PMTDI limits, placing them at risk of negative health effects. On a global scale, the routine contamination of cereal grains, bakery products, pasta, and human milk with DON could lead to intake levels above PMTDI limits. Furthermore, evidence suggests that other food commodities, such as soy, coffee, tea, dried spices, nuts, certain seed oils, animal milk, and various water reservoirs, can be intermittently contaminated, further amplifying the scope of the issue. Better mitigation strategies and global measures are needed to safeguard vulnerable youth from this harmful toxicant.

Public health risk associated with the co-occurrence of aflatoxin B1 and ochratoxin A in spices, herbs, and nuts in Lebanon

Background

Aflatoxin B1 and ochratoxin A are mycotoxins produced by filamentous fungi that attack crops on field and storage. Both mycotoxins present a risk on public health since aflatoxin B1 is a hepatotoxic and hepatocarcinogenic agent while ochratoxin A can be nephrotoxic. Those mycotoxins can be found in several food items including spices, herbs, and nuts.

Objectives

In Lebanon, few studies address aflatoxin B1 and ochratoxin A contamination in spices, herbs, and nuts. So, the aim of this study is to investigate the concentrations of those two mycotoxins particularly in spices and herbs and the concentration of aflatoxin B1 in nuts, and to determine the dietary exposure of the Lebanese population and their possible attribution to liver cancer and renal damage.

Methods

In this work, a total of 198 samples of spices, herbs, and nuts were collected from different sites. Aflatoxin B1 and ochratoxin A were quantified using immune-affinity columns. A food frequency questionnaire was used to quantify the consumption of spices, herbs, and nuts in Lebanon. Exposure to aflatoxin B1 and ochratoxin A was calculated accordingly and liver and kidney cancer risks were evaluated.

Results

Aflatoxin B1 was respectively found in 100, 20.4, and 98.6% of the spices, herbs, and nuts samples, while ochratoxin A was found in 100 and 44.4% of spices and herbs, respectively. Aflatoxin B1 was found at mean concentration of 0.97, 0.27, and 0.40 μg/kg in spices, herbs, and nuts, respectively while ochratoxin A was found at mean concentrations of 38.8 and 1.81 μg/kg in spices and herbs, respectively. Aflatoxin B1 occurrence was shown to be associated in this study with 0.017 additional cancer cases per 100,000 persons per year, and ochratoxin A weekly exposure was shown to be 5.04 ng/kg bw less than the Provisional Tolerable Weekly Intake of 100 ng/kg bw which indicates low risk of renal damage from spices and herbs consumption.

Conclusion

The consumption of spices, herbs, and nuts in Lebanon could lead to an increase in health risks associated with aflatoxin B1 and ochratoxin A, specifically spices. The reported occurrence may be directly related to poor storage conditions.

Aflatoxin B1 in Rice: Effects of Storage Duration, Grain Type and Size, Production Site, and Season

ABSTRACT

Our study evaluated aflatoxin B1 (AFB1) levels in packed rice marketed in Lebanon and determined the exposure to this toxin from rice consumption. A total of 105 packed white, parboiled, and brown rice bags were collected. Enzyme-linked immunosorbent assay was used to measure AFB1. A comprehensive food frequency questionnaire was completed by 500 participants to determine patterns of rice consumption and, subsequently, the exposure levels to AFB1 from rice consumption in Lebanon. AFB1 was detected in all rice samples (100%). The average concentration ± standard deviation of AFB1 was 0.5 ± 0.3 μg/kg. Contamination ranged between 0.06 and 2.08 μg/kg. Moisture content in all rice samples was below the recommended percentage (14%). Only 1% of the samples had an AFB1 level above the European Union limit (2 μg/kg). Brown rice had a significantly higher AFB1 level than white and parboiled rice (P = 0.02), while a significant difference was found between both collections for the same brands (P = 0.016). Packing season, packing country, country of origin, presence of a food safety management certification, grain size, and time between packing and purchasing had no significant effect. Exposure to AFB1 from rice consumption in Lebanon was calculated as 0.1 to 2 ng/kg of body weight per day.

HIGHLIGHTS

Aflatoxin B1 Occurrence in Children under the Age of Five's Food Products and Aflatoxin M1 Exposure Assessment and Risk Characterization of Arab Infants through Consumption of Infant Powdered Formula: A Lebanese Experience

Aflatoxin M1 (AFM1) is a salient metabolite that can be used to assess Aflatoxin B₁ (AFB1) exposure in humans and animals. The carcinogenic potency of AFB1 and AFM1 was severely reported. The aims of this study were (1) to survey the contamination level of AFM1 in the most traded infant powdered formula brands (IPF) (n = 42) along with the AFB1 level in under 5's children food brands (biscuits, cornflakes, and cereals) (n = 42) and (2) to assess the estimated daily intake (EDI), the hazard quotient (HQ) and the margin of exposure (MOE) of AFM1 among infants (0-12 months) in Lebanon. All of the samples were analyzed using ELISA technique. AFB1 was below detection limit in all of the children's food brands samples. Out of 42 IPF samples 9.5% were AFM1-positive in the range of 29.54-140.16 ng/L and exceeded the maximum tolerable limit (MTL) set by the European commission (25 ng/kg). The overall average contamination level was 5.72 ± 0.014 ng/L. The EDI of AMF1 for male was in the range of 0.37-0.78 ng/kg/b.w./day and 0.40-0.87 ng/kg/b.w./day for females. Similarly, the HQ calculation resulted in an average of 3.05 for males and 3.28 for females. MOE calculations were far lower from 10,000 in both genders which indicates a high risk of genotoxicity and carcinogenicity. Our findings show that AFM1's EDI, HQ and MOE scored high among Lebanese infants. As infants consume more IPF relative to their body weight, the persistence of IPF with high AFM1 levels threatens their health. Thus, infant's exposure risk to AFM1 in IPF should be a continuous focus of attention.

Assessment of Dietary Exposure to Ochratoxin A in Lebanese Students and Its Urinary Biomarker Analysis

The present study investigated the dietary and urinary OTA occurrence among 44 Lebanese children. Relying on HPLC-FLD analysis, OTA was found in all the urine samples and in 46.5% and 25% of the 24 h duplicate diet and dinner samples, respectively. The means of OTA levels in positive samples were 0.32 ± 0.1 ng/g in 24 h diet, 0.32 ± 0.18 ng/g in dinner and 0.022 ± 0.012 ng/mL in urines. These values corresponded to margin of exposure (MOE) means of 7907 ± 5922 (neoplastic) and 2579 ± 1932 (non-neoplastic) calculated from positive 24 h diet, while 961 ± 599 (neoplastic) and 313 ± 195 (non-neoplastic) calculated from the urine. Since the MOE levels for the neoplastic effect were below the limit (10,000), a major health threat was detected and must be addressed as a health institutions' priority. Besides, the wide difference between PDIs and MOEs calculated from food and urine suggests conducting further OTA's toxicokinetics studies before using urine to measure OTA exposure.

Exposure to multiple mycotoxins in domestic and imported rice commercially traded in Tehran and possible risk to public health

Mycotoxins are secondary fungi metabolites that induce acute and chronic toxic effects in humans and animals. In the present study, nine mycotoxins including aflatoxins (AFB1, AFB2, AFG1 and AFG2), fumonisins (FB1 and FB2), Ochratoxin A (OTA), deoxynivalenol (DON), and zearalenone (ZEN) were determined in one hundred rice samples collected from Tehran using high performance liquid chromatography (HPLC) with fluorescence or photodiode array detector. In addition, possible risk to public health was investigated by assessing dietary exposure through rice consumption, the margin of exposure (MOE), respective risk of cancer and hazard index (HI) of the monitored mycotoxins in children and adults. The higher mean levels were determined for DON (102.22 μg.Kg-1), followed by FB1 (85.00 μg.Kg-1). For the rests of mycotoxins the levels did not exceed 20 μg.Kg-1. The estimated AFB1 intake for the adults and children through rice consumption exceeds the safe levels established for both carriers and non-carriers of hepatitis B virus. The mean and median determined exposure levels of OTA, DON ZEN and FB1, were found lower than the Provisional Maximum Tolerable Daily Intake (PMTDI) value for both adults and children of Tehran that consuming domestic and imported rice. The mean HI for adults and median HI for adults and children were below one, and mean HI for children was close to one. All the mean, median and maximum MoE values were <10,000 in adults and children, indicating a risk due to AFB1 exposure through rice consumption in Tehran. In addition, the calculated mean cancer risk in adult and child populations of Tehran were 0.27 and 0.64 cases per year per 105 individuals, respectively, that shows population in Tehran could be at risk of cancer due to AFB1 exposure through rice consumption as calculated. So further studies are necessary for the monitoring mycotoxins in rice and different food products as well as estimating average dietary exposure and cumulative exposure assessment of mycotoxins for main foods in IR Iran.

History of injury in a developing country: a scoping review of injury literature in Lebanon

BACKGROUND

Lebanon, an Eastern Mediterranean country, suffers a large burden of injury as a consequence of conflict and war, political instability, and the lack of policies and safety regulations. This article aims to systematically map and comprehensively describe the injury research literature in Lebanon and, to identify gaps for future research.

METHODS

MEDLINE, Embase, Eric and SafetyLit, and the grey literature, including conference proceedings, theses and dissertations, government and media reports, were searched without any date or language limits. Data were extracted from 467 documents using REDCap.

RESULTS

War-related injuries were the most prevalent type of injury in Lebanon, followed by homicide and other forms of violence. While existing literature targeted vulnerable and at-risk populations, the vast majority focused solely on reporting the prevalence of injuries and associated risk factors. There are considerable gaps in the literature dealing with the integration of preventive programs and interventions across all populations.

CONCLUSIONS

Lebanon, historically and currently, experiences a high number of injuries from many different external causes. To date, efforts have focused on reporting the prevalence of injuries and making recommendations, rather than implementing and evaluating interventions and programs to inform policies. Future injury related work should prioritize interventions and prevention programs.

Aflatoxin B1 and ochratoxin A in imported and Lebanese wheat and -products

AFB₁ and OTA are produced in food products due to climatic conditions like temperature and humidity. In Lebanon, few studies address AFB₁ and OTA contamination in wheat and wheat products. In this study, a total of 312 samples of wheat and wheat products were collected from different sites, including port, silos, mills, and supermarkets were analysed. Wheat and wheat products consumption in Lebanon was quantified using a food frequency questionnaire. Exposure to AFB₁ and OTA was calculated and liver and kidney cancer risk were evaluated. Results showed that AFB₁ and OTA were, respectively, found in 65.7% and 100% of the samples, with 0.6% and 17.6% exceeding the maximum limit set by the European Commission. AFB₁ was shown to be associated with 0.076 additional cancer cases per 100,000 persons per year and OTA weekly exposure was shown to be 53.2 ng/kg bw, which is less than the Provisional Tolerable Weekly Intake of 100 ng/kg bw.

Determination of Ochratoxin A (OTA), Ochratoxin B (OTB), T-2, and HT-2 Toxins in Wheat Grains, Wheat Flour, and Bread in Lebanon by LC-MS/MS

Cereals are prone to fungal infection during growth, harvesting, transportation, and/or storage. As a result, cereals such as wheat grains and wheat-derived products may be contaminated with mycotoxins leading to acute and chronic health exposure. The current study investigated the presence of the mycotoxins: ochratoxin A (OTA), ochratoxin B (OTB), T-2, and HT-2 toxins in samples of wheat grains (n = 50), wheat flour (n = 50), and bread (n = 37) from the main mills in Lebanon using LC-MS/MS. Accuracy ranged from 98-100%, recoveries from 93-105%, and intraday and interday precision were 5-7% and 9-12%, respectively. The tested wheat grains, wheat flour, and bread samples did not contain detectable levels of T-2 and HT-2 toxins and OTB. Four wheat flour samples (8% of flour samples) showed positive OTA levels ranging from 0.6-3.4 μg·kg-1 with an arithmetic mean of 1.9 ± 0.2 μg·kg-1. Only one sample contained an OTA concentration greater than the limit set by the European Union (3 μg·kg-1) for wheat-derived products. This study suggests that mycotoxin contamination of wheat grains, wheat flour, and bread in Lebanon is currently not a serious public health concern. However, surveillance strategies and monitoring programs must be routinely implemented to ensure minimal mycotoxin contamination of wheat-based products.

Determination of mycotoxins in biscuits, dried fruits and fruit jams: an assessment of human exposure

A reliable, fast and simple method using UHPLC-MS/MS was developed for the determination of aflatoxins B₁ (AFB1), G₁ (AFG1), B₂ (AFB2) and G₂ (AFG2), ochratoxin A (OTA), deoxynivalenol (DON), zearalenone (ZEA), HT-2 toxin and T-2 toxin in crude extracts of biscuits with fruit filling, cookies, dried fruits and fruit jams. The method was successfully demonstrated on 39 samples of biscuits with fruit filling, 34 cookies, 14 dried fruits and 10 fruit jams. The mycotoxins detected in biscuits samples were ZEA, OTA, T-2 and AFB1 with an average concentrations of positive samples of 2.64, 4.10, 8.13 and 1.32 µg kg^-1, respectively; while the mycotoxins detected in jam samples were AFB1, OTA, T-2 and AFB2 with an average concentrations of positive samples of 2.00, 17.7, 4.37 and 1.15 µg kg^-1, respectively. The results showed that the majority of samples were in compliance with relevant regulations. However in eight samples of biscuits and three samples of fig jam the contents of OTA were higher than the existing OTA limits. The combined dietary exposure of selected mycotoxins was estimated for the first time for children, adolescents and adults. The estimated combined dietary exposures were all lower than the proposed value assumed to predict a possible risk scenario.

The presence of aflatoxins and ochratoxin A in rice and rice products; and evaluation of dietary intake

In present study aflatoxins (AFs) and ochratoxin A (OTA) were analysed in 208 samples of rice and products collected from central areas of Punjab, Pakistan. The analysis was carried out using HPLC equipped with fluorescence detector. The results have shown that 35% of the samples were found contaminated with AFs, out of which 19% and 24% samples were found to be above the European Union (EU) maximum content for AFB1 and total AFs, respectively. About 19% samples were found contaminated with OTA and 14% samples were found to be above the EU maximum content. The highest mean level of AFB1 and total AFs were found in brown rice samples i.e. 8.91 and 12.4μg/kg, respectively. However, white rice samples have shown the highest mean level of OTA (8.50μg/kg) with highest level of 24.9μg/kg. The high mean dietary exposure 22.2 and 24.2ngkg(-1)bwday(-1) to AFB1 and OTA, respectively poses significant health hazard for local population.

Dietary exposure to aflatoxins, ochratoxin A and deoxynivalenol from a total diet study in an adult urban Lebanese population

Exposure to mycotoxins may be associated with carcinogenic, immunosuppressant and estrogenic effects. In the Middle-East, studies investigating food contamination and dietary exposure to mycotoxins are particularly scarce. This study aims at evaluating the dietary exposure of an adult Lebanese urban population to four mycotoxins (AFB1, AFM1, OTA, DON) classified as priority food contaminants by the WHO. Dietary exposure assessment was performed by means of the total diet study approach. Average and excessive consumer exposure estimates (p95) were calculated and compared with appropriate toxicological reference values (TRVs). Average dietary exposure levels to OTA and DON represented 29.9% and 156.8% of the respective TRVs, with the p95 exposure estimates approaching or exceeding the TRVs for these mycotoxins (95.1% and 355.8%, respectively). Based on the mean dietary exposure level to AFB1, cancer risk was estimated at 0.0527-0.0545cases/100,000persons/year, while mean exposure to AFM1 was associated with a population risk of 0.0018-0.0027cases/100,000persons/year. The study's findings place Lebanon among countries that are highly exposed to mycotoxins through the diet and call for larger-scale studies aiming at providing a comprehensive assessment of the dietary exposure of the Lebanese population to mycotoxins as well as to other food contaminants.

Ochratoxin A induces cytotoxicity, DNA damage and apoptosis in rat hepatocyte primary cell culture at nanomolar concentration

Ochratoxin A (OTA), a mycotoxin produced by several species of Aspergillus and Penicillum, is widely found as a contaminant of food. OTA exhibits a wide range of toxic activities, including nephro- and hepatotoxicity. Although the mechanisms of its genotoxicity and carcinogenicity have been studied before, many controversial results have been published. In addition, the studies were mostly conducted with kidney cells. Therefore, the present study used a primary culture of Wistar rat hepatocytes incubated with increasing concentrations of OTA (2.0-6.0 nanomolar). OTA treatment showed dose-dependent cytotoxicity and DNA damage. Further, flow cytometric analysis of hepatocytes showed dose-dependent apoptosis, suggesting that OTA-induced hepatotoxicity is, may be partly, mediated by apoptosis. Vascular endothelial growth factor gene, a potent pro-angiogenic in hepatocellular carcinoma and responsible for hepatocyte regeneration, did not show any change with OTA treatment, as analysed by reverse transcription polymerase chain reaction. Thus, the present data indicated OTA-induced rat hepatotoxicity in vitro at nanomolar concentration, which inferred a major possible target other than kidney cells.

Aflatoxin in raw and salt-roasted nuts (pistachios, peanuts and walnuts) sold in markets of tabriz, iran

Background:

Nuts are one of the main consumed snacks worldwide and also have an important role among Iranian's food habits. Natural contamination of nuts with aflatoxin is unavoidable and causes a special challenge for nuts safety and quality.

Objectives:

The purpose of this research was to study the aflatoxin contamination in commercially-available nuts (pistachio, walnut and peanut) in the markets of Tabriz, Iran.

Materials and Methods:

Sixty two samples of 50 g salt-roasted peanuts and pistachios and 109 samples of 50 g pure pistachios, walnuts and peanuts were collected from different areas of local markets. After the initial preparations, ELISA test was performed for Aflatoxin measurement.

Results:

Result showed that walnut (90%) and pure pistachio (2.3%) were the most and least contaminated samples, respectively. Mean aflatoxin contamination in the salt-roasted samples (19.88 ± 19.41 µg/kg) was significantly higher than the pure ones (6.51 ± 9.4 µg/kg) (P < 0.001). Respectively, 58.6%, 48.4% and 47.6% of salt-roasted pistachios, salt-roasted peanuts and walnut samples had aflatoxin contamination, which were more than the maximum tolerated level of Iran (MTL, 15 ppb).

Conclusions:

It was concluded that aflatoxin content of nuts should be monitored regularly to minimize the risk of aflatoxin hazard and ensure the food safety and quality.

Mold contamination of untreated and roasted with salt nuts (walnuts, peanuts and pistachios) sold at markets of tabriz, iran

BACKGROUND

Nuts are one of the main consumed snacks worldwide and a significant component of Iranian's diet. Natural contamination of nuts with fungus is unavoidable and is a major challenge to nuts safety and quality.

OBJECTIVES

The purpose of this research was to study fungal contamination in commercially available nuts (pistachios, walnuts and peanuts) in the markets of Tabriz, Iran.

MATERIALS AND METHODS

100 samples of 50 gr roasted with salt peanuts and pistachios and 300 samples of 50 gr pure pistachios, walnuts and peanuts were collected from different areas of the local markets. After initial preparation, the samples were cultured on Sabouraud's dextrose agar (SDA). 19 fungal isolates were identified.

RESULTS

The results show that Aspergillus niger was the predominant mold among pure (44%) and roasted with salt (14%) nuts (P < 0/001). In addition, percentage of mycotoxigenic fungal contamination was 18% for roasted with salt nuts and 11% for pure samples.

CONCLUSIONS

The overall results of the analysed samples showed that the rate of fungal contamination in pure samples was higher than roasted with salt ones (P < 0.005). Results of the current survey could be useful for minimizing fungal contamination and can educate people about the dangers of mold in nuts.

Dietary exposure and risk assessment for aflatoxins in New Zealand

Aflatoxin concentration data for a range of foods available in New Zealand (maize products, nuts and nut products, dried fruits and spices) were combined with dietary recall food consumption information from New Zealand national nutrition surveys to derive exposure estimates for a range of age-gender groups. Mean exposure estimates for total aflatoxins ranged from 0.09-0.11 ng/kg body weight/day for adult females, to 0.32-0.39 ng/kg body weight/ day for 5-10 year old children. Spices were the major contributors to dietary exposure for all population subgroups, followed by nuts and nut products. However, the contribution of spices to total dietary exposure could be traced to a single sample with a very high concentration. A life-time weighted average aflatoxin exposure was derived for New Zealand males and females and was combined with cancer potency estimates to give an assessment of risk. The mean risk equates to a potential for less than one excess cancer every 10 years.

Determinants of ochratoxin A exposure--a one year follow-up study of urine levels

Dietary exposure to the ochratoxin A (OTA) occurring in Portugal is characterized by a high frequency of contamination of the consumed foodstuffs, although at low levels. The exposure bears significance for the total food consumed, and not for a particular one. Biomonitoring studies are thus fundamental in simplifying the evaluation of exposure, with no need to examine the entire range of consumed foodstuffs. Biomonitoring studies further allow the identification of host factors as predictors of OTA exposure in epidemiologic studies, the results of which are merited for targeting intervention strategies by public health authorities and advising official regulatory decisions. Using a longitudinal approach, this study examined factors related to OTA exposure in the adult population over a one-year period. Anthropometric measures, season of the year and region were the selected factors correlated with OTA exposure biomarker. Urine samples from 95 inhabitants from six Portuguese main geographical areas were assayed through spectrofluorimetric detection. Exposure to OTA proved to markedly increase in winter, and gender differences were observed only in summer, which might be related to different dietary patterns not only between seasons, but also between genders. The same rationale may also serve the observed statistically significant differences between some regions. No other strong association upon the remaining determinants under testing was observed. These observations reinforce the need for OTA exposure evaluation, possibly specifically targeting the staple foods or dietary habits that sustain potential predictors or determinants of exposure.

Developments in mycotoxin analysis: an update for 2008-2009

This review highlights developments in mycotoxin analysis and sampling over a period between mid-2008 and mid-2009. It covers the major mycotoxins: aflatoxins, alternaria toxins, cyclopiazonic acid, fumonisins, ochratoxin, patulin, trichothecenes and zearalenone. Developments in mycotoxin analysis continue, with emphasis on novel immunological methods and further description of LC-MS and LC-MS/MS, particularly as multimycotoxin applications for different ranges of mycotoxins. Although falling outside the main emphasis of the review, some aspects of natural occurrence have been mentioned, especially if linked to novel method developments.