Abstract
Aflatoxins (AFTs), as a group 1 carcinogen, could lead to hepatocellular carcinoma (HCC). Dietary intake is the primary way of AFT exposure in humans. However, the contribution of foodborne AFT intake to the HCC burden remains unknown in recent years in China. Hence, the present study was conducted to estimate the burden of HCC attributed to foodborne AFT exposure by using disability-adjusted life years (DALYs). The risk assessment was used to estimate the incidence of HCC related to AFT exposure. Concentrations of AFTs in peanuts, peanut oil, corn, and corn products were retrieved from literature published between 2010 and 2020 in China. Corresponding daily food consumption data were obtained from two nationwide Chinese surveys. A direct approach was used to calculate DALY and DALY rates to quantify the HCC burden attributed to dietary AFT exposure. The total amount of AFT intake through peanut, peanut oil, corn, and corn products was 4.018 ng/kg bw/day resulting in 0.125 extra HCC cases per year/100,000 persons, corresponding to a DALY number and DALY rate of 21,625.08 and 1.53 per 100,000 population, respectively. Regionally, DALYs were high in Guangxi and Guangdong provinces, corresponding to 5948 and 5595 DALYs. A total of 1.5 DALYs/100,000 were lost due to the AFT exposure. DALYs per 100,000 population were higher in several coastal areas. Though the disease burden of HCC caused by dietary AFTs was low in the Chinese population, a high health risk was found in the residents of some areas with high AFT exposure. AFTs are still a health challenge for the Chinese people.
Highlights
Aflatoxins (AFTs) are secondary metabolites produced by Aspergillus flavus and Aspergillus parasiticus [1]
A total of 5800 (34.93%) samples were positive for aflatoxins among the whole samples, and the positive rate of AFTs in peanut oil was the highest (49.14%), followed by that in corn (29.10%)
The positive rate of AFTs in peanut, peanut oil, and corn was positively correlated with the number of detected cases (p < 0.05), while there was non-correlation in the case of corn products (p > 0.05) (Supplementary Figure S4)
Summary
Aflatoxins (AFTs) are secondary metabolites produced by Aspergillus flavus and Aspergillus parasiticus [1]. The most prominent four types of AFTs are aflatoxins B1, B2, G1, and G2 [2]. AFB1 is the most common and toxic type. Peanut and corn are the most common daily foods that are susceptible to contamination by AFTs [7]. AFTs are harmful to humans, achieving zero exposure is difficult because they are often present in commonly consumed food. Due to the toxicity of AFTs, many countries have established standards for restricting aflatoxins. The European Commission has set the maximum levels (MLs) of AFB1 and AFTs to be 2.0 and 4.0 μg/kg in peanuts for direct consumption [9]. According to the current China National Food Safety Standard (GB 2761-2017), the ML of AFB1 is 20 μg/kg in peanut and its products, corn, and corn products [10]
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