Aflatoxin M1 in human breast milk: A global systematic review, meta-analysis, and risk assessment study (Monte Carlo simulation). (June 2019)

• Record Type: Journal Article
• Authors: Fakhri, Yadolah; Rahmani, Jamal; Oliveira, Carlos Augusto Fernandes; Franco, Larissa Tuanny; Corassin, Carlos Humberto; Saba, Sumbal; Rafique, Jamal; Mousavi Khaneghah, Amin
• Is Part Of: Trends in food science & technology. Volume 88(2019)
• Page Start: 333
• Page End: 342
• Publication Date: 2019-06
• Subjects: Mycotoxin -- Human breast milk -- Risk assessment -- Meta-analysis -- A systematic review -- Socioeconomic indexes; Food industry and trade -- Periodicals; Food -- Biotechnology -- Periodicals; 664.005
• DOI: 10.1016/j.tifs.2019.03.013
• Languages: English
• ISSNs: 0924-2244

Abstract

Abstract: Background: In this current study, a systematic review and meta-analysis in a global scale regarding the prevalence and concentration of aflatoxin M1 (AFM1 ) in the human breast milk were conducted based on the socioeconomic indexes and amounts of precipitation. Scope and approach: All available studies published in PubMed, Scopus, Web of sciences and Embase databases were screened between 1 January 1983 and 25 December 2017. Also, the probabilistic carcinogenic risk by the hazard index (HI) in the Monte Carlo simulation (MCS) was calculated. Key findings and conclusions: The meta-analysis of 57 papers containing 196 studies showed that the minimum and maximum concentrations of AFM1 in human breast milk was noted in Sierra Leone (0.80 ng/L) and the United Arab Emirates (UAE) (465.76 ng/L), respectively. The lowest prevalence of AFM1 in human breast milk was reported in Brazil (2%) while the highest was observed in the Gambia ∼ Tanzania ∼ Jordan (100%). The minimum and maximum concentrations of AFM1 in human breast milk were observed in America (10.30 ng/L) and South-East Asia continents (358.99 ng/L), respectively. Also, the lowest and highest prevalence of AFM1 in human breast milk was observed in the West Pacific (7%) and Africa (52%) continents, respectively. According to findings, with increasing average rain annual and poverty (GDP ranking), the prevalence of AFM1 in human breast milk significantly (P-value<0.05) increased. Moreover, the prevalence of AFM1 in human breast milk significantly (P-value<0.05) decreased with over time (Among the selected period; 1983 and 2017) which can be correlated with improvements in hygienic conditions as well as public awareness regarding the contamination of food products by AFM1 . The health risk assessment indicated that except for one month's infant in the UAE and Thailand, all infants' consumer of human breast milk in the world is not at considerable risk (HI < 1). Graphical abstract: Image 1 Highlights: Concentration and prevalence AFM1 in human milk from 196 studies were meta-analyzed. . The highest and lowest of AFM1 concentration was in United Arab Emirates (UAE) and Sierra Leone, respectively. The lowest and highest of AFM1 prevalence was in the Brazil and in the Gambia ∼ Tanzania ∼ Jordan, respectively. With increasing annual rain and poverty, the prevalence of AFM1 was increased. Except for one month's infant in UAE and Thailand, all infants' are not at considerable risk (HI < 1).