Risk Assessment Of Dietary Exposure To Aflatoxin And Study On Reducing Burden Of Disease By Prevention And Control Measures In Shandong Province

ObjectiveAflatoxin(AF)is toxic secondary metabolites produced by some strains of Aspergillus flavus and Aspergillus parasiticus,which can contaminate a variety of agricultural products and threaten food safety.The toxicity of aflatoxin varies greatly with different structure or species.The toxicity of Aflatoxin B1(AFB1)is the most toxic and carcinogenic,followed by Aflatoxin M1(AFM1).Studies have found that long-term exposure to AF can increase the risk of liver cancer,especially for people with chronic hepatitis B,and seriously affect human health.Shandong Province is a big agricultural province,and the pollution level of AFB1 and AFM1 in agricultural products is very important to maintain population health.Therefore,this study analyzed the pollution status of AFB1 and AFM1 in major foods in Shandong Province,calculated the health risks caused by dietary exposure to AFB1 and AFM1 in combination with residents’ food consumption,and evaluated the effect of prevention and control measures for AFB1 and AFM1 to reduce the disease burden,providing a scientific basis for the risk management measures taken by relevant departments of food safety.MethodsA total of 3,384 samples including 270 corn and its products,1015 wheat and its products,103 rice,166 peanuts and its products,466 other cooked nuts,80 peanut oil,125 corn oil,209 other vegetable oils(excluding peanut oil and corn oil),216 condiments,89 infant cereal supplements and 645 milk and its products were collected from 16 cities in Shandong Province.The collected samples were detected by immunoaffinity chromatography-high performance liquid chromatography.Point evaluation method was used to assess the dietary exposure risk of AFB1 and AFM1 in food in Shandong Province.Liver cancer risk,Margin of exposure(MOE),and hazard index(HI)were used to evaluate the carcinogenic and non-carcinogenic risks of people in Shandong Province caused by dietary exposure to aflatoxin.The effects of AFM1 exposure on height-for-age z-score(HAZ)of children were investigated through risk assessment of developmental delay in children.Disability adjusted life year(DALY)was used to evaluate the effect of various aflatoxin prevention and control methods on reducing burden of disease.Results1.The total positive rate of AFB1 in foods in Shandong Province was 6.50%(178/2739),and the total unqualified rate was 0.95%(26/2739).The positive rate of AFB1 in peanut oil samples was 26.25%(21/80),the average content and maximum values of AFB1 were 9.33 μg/kg and 274.00 μg/kg,respectively.The pollution level of AFB1 in bulk peanut oil was much higher than that in pre-packaged peanut oil,and the difference was statistically significant(P<0.05).The total exposure of AFB1 in rural residents was higher than that in urban residents.The health risk of AFB1 exposure through consumption of peanut oil in children between 2 and 6 years old was the highest,and the MOE value was less than 10000.The risk of liver cancer in the whole-level and consumer-level population were 0.0846 cases and 0.3512 cases per 100,000 people,respectively.After implementation of the limit standard strictly,the burden of liver cancer caused by AFB1 exposure was reduced by 3928 and 18600 per year respectively in the whole-level and consumer-level population who consumed peanut oil.Different prevention and control measures for AFB1 can reduce DALYs by 232-20580 per year.2.The total positive rate of AFM1 in milk and its products in Shandong Province was 4.03%(26/645),and the total unqualified rate was 0.The positive rate of AFM1 in infant formula was 11.51%(16/139)and the maximum of AFM1 was 0.19 μg/kg.The cancer risk of AFM1 exposure was highest in children between 2 and 3 years old,which was 0.0025 cases per 100,000 people.The consumption of liquid milk and infant formula may lead to non-carcinogenic risks and the risk of developmental delay in 2-3-year-old consumers.Prevention and control measures of AFM1 contribute to reduction of 6.21-11.58 DALYs per year.Conclusions1.The pollution level of AFB1 in peanut oil in Shandong Province was the highest,and the pollution level of bulk peanut oil was higher than that of pre-packaged.The AFM1 pollution level of infant formula was the highest in milk and its products,and the concentration of AFM1 in milk products in winter was higher than that in other seasons.2.The total AFB1 exposure of rural residents was higher than that of urban residents.The health risk of AFB1 exposure was highest in children between 2 and 6 years old.Exposure to AFM1 through liquid milk and infant formula may lead to non-carcinogenic risks in children between 2 and 3 years old.Early childhood exposure to AFM1 may be associated with developmental delays.Special attention should be paid to children between 2 and 6 years old.3.The prevention and control measures of AFB1 and implementation of limit standards strictly can effectively reduce the burden of liver cancer in the population;Prevention and control measures of APM1 have little effect on reducing the burden of liver cancer in the population.