AFM1 Levels Research Articles

Aflatoxin M1 levels of skim milk powders produced in Turkey

In this study AFM1 levels of skim milk powders produced in Turkey were determined by immunoaffinity column and HPLC and the results were compared with the values accepted by Turkish Aliment Codex. AFM1 levels of 21 skim milk powder samples collected from seven firms in four different seasons (March-April-May, June-July-August, September-October-November and December-January-February) ranged between 0 to 0.705 μg/kg. Two samples (0.535 and 0.705 μg/kg) had exceeded the tolerance limit accepted by Turkish Aliment Codex (0.5 μg/kg). It was also recorded that these two samples collected in the second season (June-July-August) had no M1 content. From the point of seasonal variation, it was realized that AFM1 contents of the samples collected in summer were lower than that of the samples collected in the winter. Seasonal variations with regard to AFM1 were statistically significant (p < 0.01). As a result, AFM1 levels in 90.5% of the samples provided throughout the year did not exceed the maximum tolerance limit established by Turkish Aliment Codex.

Presence of Mycotoxins in Feed and Dairy Products of Cattle in Paraná, Brazil

Milk contamination by mycotoxins is considered a public health problem. Therefore, the objective of this study was to identify these contaminants in concentrates and in the milk from 31 high-producing herds. Only two of the 55 concentrate samples analyzed showed the presence of aflatoxin G1 (AFG1, 3.2 and 3.6 μg·kg-1). AFM1 was detected in 93.5% of the 62 milk samples analyzed with a range from 0.045 to 0.442 μg·L-1. All of the AFM1 concentrations were below the maximum limit tolerated (0.5 μg·kg-1) by the Brazilian Agência Nacional de Vigilância Sanitária (ANVISA). There was no difference in AFM1 contamination levels for both sampling periods (summer and winter). In conclusion, the AFM1 contamination in animal feed and, consequently, in milk is within the limits tolerated by ANVISA for Brazil (≤ 0.5 μg·kg-1). Furthermore, no season effect on AFM1 levels was found.

Assessment of aflatoxin in milk and feed samples and impact of seasonal variations in the Punjab, Pakistan.

The present study was designed to assess the incidence of aflatoxin contamination in animal feed and raw milk samples (total 240 each) collected from dairy farms during the complete year of 2015. These samples were collected through a cluster random sampling technique by dividing the province of Punjab, Pakistan into five clusters (north, south, east, west and central). Factors (environmental & physical) affecting aflatoxin contamination in milk and animal feed at farms were also studied. The AFM1 levels in raw milk & AFB1 levels in feed samples were analyzed by using the ELISA technique. Results demonstrated that overall about 53% raw milk samples from dairy farms were contaminated beyond the US MRL (0.50 µg/L) for AFM1 with than average level of 0.59 µg/L, while the 95% farm feed samples were exceeding the FDA MRL (20 µg/kg) of AFB1 with average level of 43 µg/kg. During winter season, the concentration of AFM1 was higher in all clusters with avg 0.68 µg/L, while the AFB1 contamination was highest in the spring season with avg 54 µg/kg. Market feed prices had negative correlation with AFB1 contamilevels, which were further supported by the positive correlation between quantity of feed at farms with AFM1 and AFB1 contamination. Results exhibited significantly positive impact of environmental factors on milk and feed aflatoxin contamination levels, whereas temperature showed an inverse relationship with AFM1 and AFB1 levels. The study recommends need of synergistic extension work to support dairy farms and highlight the contamination levels for regulatory bodies to introduce strategic policies for control measures.

Levels of Aflatoxin M1 and selected heavy metals (Pb, Cd, Cr, Cu, Zn, Fe, As, and Hg) in the breast milk of lactating mothers in South Eastern, Nigeria

In this study, the level and frequency of breast milk AfM1 and selected heavy metals as biomarkers of maternal exposure was assessed. Selected heavy metals (Pb, Cd, Cr, Cu, Zn, Fe, As, and Hg) were analyzed using Atomic Absorption Spectrophotometry while AfM1 levels were assessed by HPLC with fluorescence detection after aflatoxin extraction. The mean (±standard deviation) concentration of AfM1 in the breast milk samples was 4.02 ± 1.12 ng/L and 100% of all the samples contained AfM1 at 2.33–7.08 ng/L. AfM1 concentration was positively and significantly (p < 0.01) associated with the daily consumption of cassava-based foods, groundnut oil, maize, tomatoes and dry fruit (p < 0.05). The mean (±standard deviation) values of these heavy metals were Cd: 0.029 ± 0.013 mg/L, Cr: 0.019 ± 0.011 mg/L, Cu: 0.035 ± 0.013 mg/L, Fe: 0.049 ± 0.039 mg/L, Pb: 0.038 ± 0.013 mg/L and Zn: 0.009 ± 0.008 mg/L. The result of the estimated daily intake of breast milk by the breastfed infant show that heavy metals such as Pb, Fe, and Cd are ingested more daily than other metals analyzed. There was a weak positive but non-significant correlation between heavy metal content and daily intake of maternal diet except for beans where a significant correlation (p < 0.01) was found with Cr, Cu, and Zn exposure. A weak positive but non-significant correlation was also observed between exposure to heavy metals such as Cu, Fe and Pb and maternal diets. None of the samples exceeded the national and international legal regulatory limits for AfM1 and the selected heavy metals in breast milk except chromium. Nevertheless, the presence of these contaminants still presents a health risk.

Aflatoxin M1 in Nicaraguan and locally made hard white cheeses marketed in El Salvador

Aflatoxin M1 is a carcinogenic and genotoxic metabolite of Aflatoxins present in food contaminated by fungi for lactating cattle, it is excreted through milk and when used to make cheese, the toxin will also be transferred to the dairy. The contamination of unripened hard white cheese with AFM1 seems to vary according to the season of the year, possibly due to the change of foodstuff, from fresh pasture in the rainy season to dried foods in the dry season and vice versa. This research determined both the prevalence and contents of AFM1 in cheeses of local and Nicaraguan origin marketed in El Salvador, as well as the changes occurred according to the season and the association between levels of AFM1 with meteorological parameters. The significantly higher prevalence of AFM1 contamination in both local cheeses and Nicaraguans, was found in the dry season and the lowest in the rainy season (41 % vs. 20 %; 31 % vs. 0%, respectively), the same trend was observed in AFM1 contents (0.076 vs. 0.036 μg/kg; 0.050 vs. 0.021 μg/kg, respectively). A significant association was demonstrated between levels of AFM1 with the averages of accumulated rainfall and relative humidity according to the sampled season. The prevalence of AFM1 in cheeses indicate that El Salvador and Nicaragua are endemic to dairy contamination by that mycotoxin. Seasonal variation may be due to a lack of rainfall, that promotes the growth of aflatoxigenic fungi in the crops of raw materials, which will be used for feedstuff intended for dairy cattle, thus, the consumption of contaminated food will cause the temporary increase of AFM1 in milk and their derivatives.

Occurrence of Aflatoxin M1 in Raw Milk Marketed in Italy: Exposure Assessment and Risk Characterization.

The current study is based on the AFM1 contamination of milk determined from April 2013 to December 2018 in the framework of a self-control plan of six milk processing plants in Italy. These data – together with the consumption data of milk consumers – were evaluated and used for the calculation of the Estimated Daily Intake (EDI), the Hazard Index (HI), and the fraction of hepatocarcinoma cases (HCC) due to AFM1 exposure in different population groups. Altogether a total of 31,702 milk samples were analyzed, representing 556,413 tons of milk, which is an outstanding amount compared to published studies. The results indicate the monthly fluctuation of AFM1 levels through a period of nearly 6 years. The EDI of AFM1 in different population groups was in the range of 0.025–0.328 ng kg−1 body weight (bw) per day, based on the average consumption levels and weighted mean contamination of the milk in the study period. Considering average consumptions, in the groups of infants and toddlers, the HI calculation resulted in 1.64 and 1.4, respectively, while for older age groups, it was <1. The estimated fractions of HCC incidences attributable to the AFM1 intakes were 0.005 and 0.004 cases per 100,000 individuals in the 0–0.9 and 1–2.9-year age groups, respectively, and below 0.004 cases in the other age categories. The monthly average AFM1 contamination of tested milk consignments ranged between 7.19 and 22.53 ng kg−1. Although the results of this extensive investigation showed a low risk of HCC, the variability of climatic conditions throughout years that influence AFB1 contamination of feed and consequently AFM1 contamination of milk justifies their continuous monitoring and update of the risk assessment.

Frequency and levels of aflatoxin M1 in urine of children in Bogota, Colombia.

A study was conducted to investigate the frequency and levels of AFM1 and AFM2 in urine from children who attended the emergency service of a pediatric referral hospital in Bogota, Colombia. A survey on the consumption of foods likely to be a source of aflatoxins and on sociodemographic variables was conducted as well. The frequency of AFM1 in urine was found to be 41.7% with an average concentration in positive samples of 16pgmL-1 ± 10.7pgmL-1 (range > LOD-48.5pgmL-1). The presence of AFM1 in the urine was related to the consumption of cereals likely to be contaminated with AFB1, especially corn and rice. No detectable levels of AFM2 were found in any sample. The results show that children's exposure to aflatoxins in Colombia is indeed a problem and should be one of the priorities of the health authorities. Continuous monitoring of aflatoxins in foods should be carried out, in compliance with Colombian regulations, using analytical methods that allow determination and quantification of aflatoxins in different biological and non-biological matrices at trace levels.

Occurrence of aflatoxin M1 in raw milk traded in peri-urban Nairobi, and the effect of boiling and fermentation

ABSTRACTBackground: Dairy production in Kenya is important and dominated by small-holder farmers who market their produce through small-scale traders in the informal sector.Method: This study aimed to determine the prevalence of aflatoxin (AFM1) in informally marketed milk in peri-urban Nairobi, Kenya, and to assess knowledge of milk traders on aflatoxins using questionnaires. A total of 96 samples were analyzed for AFM1 using enzyme-linked immunosorbent assay. In addition, boiling and fermentation experiments were carried out in the laboratory.Results: All samples had AFM1 above the limit of detection (5 ng/kg) (mean of 290.3 ± 663.4 ng/kg). Two-thirds of the samples had AFM1 levels above 50 ng/kg and 7.5% of the samples exceeded 500 ng/kg. Most of the traders had low (69.8%) or medium (30.2%) knowledge. Educated (p = 0.01) and female traders (p= 0.04) were more knowledgeable. Experimentally, fermenting milk to lala (a traditional fermented drink) and yogurt significantly reduced AFM1 levels (p< 0.01) (71.8% reduction in lala after incubation at room temperature for 15 h, and 73.6% reduction in yogurt after incubation at 45ºC for 4h). Boiling had no effect.Conclusion: The study concluded that the prevalence of raw milk with AFM1 was high, while knowledge was low. Fermentation reduced the AFM1 levels.

Immunotoxicity of aflatoxin M1 : as a potent suppressor of innate and acquired immune systems in a subacute study.

Although, to date, there have been several in vitro and in vivo studies of immunomodulatory effects of aflatoxin M1 (AFB1 ), little is known about the effect of AFM1 on various aspects of innate and acquired immunity. In the present study, AFM1 was administered intraperitoneally, at doses of 25 and 50 μg kg-1 , body mass for 28 days and various immunological parameters were measured. Several parameters related to immune function were suppressed: organ mass, cellularity of spleen, proliferation response to lipopolysaccaride and phytohemagglutinin-A, hemagglutination titer, delayed type of hypersensitivity response, spleen cell subtypes, serum hemolytic activity, serum immunoglobulin G level and cytokine production. AFM1 did not cause changes in body mass, hematological parameters or the concentration of immunoglobulin M in blood serum. Overall, the data suggested that AFM1 suppressed innate and acquired immunity. Therefore, with respect to consumer safety, it is extremely important to further control the level of AFM1 in milk, and this should be considered as a precedence for risk management actions. © 2018 Society of Chemical Industry.

Detection of Aflatoxin Contamination of Dairy Production Chain in the Northwest Region of Rio Grande do Sul, Brazil

The present study evaluates levels of aflatoxin contamination involving small dairy farms from the in the Northwest region of Rio Grande do Sul, Brazil. The objectives of this trial is: quantify lactating cow diet and raw for bulk milk Aflatoxin B1 (AFB1) contamination; evaluate the use of a mycotoxin adsorbent on cows submitted to semi-confinement raising; and verify the presence of AFM1 contamination on UHT and powdered milk commercialized locally. For this, 17 farms were selected. During the experimental period, every lactating cow on each herd received 50 g/day of a commercial mycotoxin adsorbent for dairy cows (100% bentonite). From each farm, bulk milk, corn silage and concentrate samples were collected for aflatoxin quantification. Aflatoxin M1 was detected in all milk samples examined from each farm, but the levels were within the allowed by the legislation. Aflatoxin B1 was also detected in all samples of corn silage and concentrate. The mycotoxin adsorbent used reduced (p &lt; 0.05) AFM1 contamination in milk. AFM1 milk contamination levels observed on commercialized milk also respected Brazilian requirements. It is possible to conclude that there is a high incidence of Aflatoxin B1 contamination on corn silage and dairy cows concentrates in family farms from South Brazil region. Based on the condition in which the present study was conducted, the use of a mycotoxin adsorbent reduced the levels of AFM in milk in production system. However, the locally produced milk and commercial milk were below the AFM levels accepted by the National Requirements for AFM1 contamination.

The Incidence of Aflatoxin M1 in Milk Produced in a Regional Surveillance System Between 2013 and 2017

Aflatoxins are toxic metabolites, generally produced by Aspergillus flavus, A. parasiticus and A. Nomius. They can have immunosuppressive, mutagenic, teratogenic and carcinogenic effects, especially on the liver. The purpose of this study was to evaluate the frequency of AFM1 contamination in milk in an established surveillance area of Romania, during 2013-2017 period. The material was represented by 150 raw milk samples obtained from milk collecting units and breeding units in Cluj county. The samples were analyzed by ELISA method. Measurable levels of AFM1 were present in 28% of the milk samples examined. The level of AFM1 in the positive samples ranged between 0,010 and 0,089 μg/kg. Of the total samples, only two were found non-compliant with the EU regulatory limit (0.05 μg/kg). All the positive samples were detected in 2013. In the 2014-2017 period, the level of aflatoxin M1 in milk was undetectable. The contamination risk of AFM1 in milk may increase with feeds being stored in improper conditions of humidity and temperature. This risk can be significantly reduced by using aflatoxin uncontaminated feeds.

A survey of aflatoxin M1 contamination in raw milk produced in urban and peri-urban areas of Kisumu County, Kenya

ABSTRACTBackground: Food safety is of increasing global concern, and a OneHealth issue requiring attention of many disciplines. Aflatoxins are toxins produced by fungi and found in foods and feeds, and exposure causes negative health effects in humans and animals. When lactating animals consume aflatoxin B1, the metabolite (AFM1) is transferred to milk.Methods: A cross-sectional study was designed to determine characteristics of smallholder dairy farming in urban and peri-urban areas of Kisumu and quantify AFM1 in milk. Data was collected from 97 randomly selected dairy farms on farming practices, milk production, and awareness about aflatoxins. Collected milk samples were analyzed using enzyme-linked immunosorbent assay for AFM1.Results: Average milk produced was 13 liters per day per household and mainly used for household consumption and sold to neighbours. Farmers mainly fed cows on forage and concentrates (62.9%). Levels of AFM1 ranged from below the detection limit to 151 ppt, with a mean of 29.67 ppt; 26.4% exceeding the EU limit. Concentrate feeding was associated with higher AFM1 levels (p = 0.002); with farms feeding concentrates more likely to have levels exceeding 50 ppt (OR = 10.1).Conclusion: In conclusion, milk produced by small holder dairy farmers in Kisumu County frequently is contaminated with AFM1, implying health risks for human and animals.

EFFECT OF MICROBIAL CONTAMINATION WITH FUNGI, AFLATOXIN M1 AND ENTERIC GRAM NEGATIVE BACTERIA ON MILK AND SOME DAIRY PRODUCTS

milk and milk products are excellent high quality foods, providing nutritional values through important elements in the healthy human diet. In this study, 75 samples of dried milk, raw milk, butter, cream and cooked (processed) cheese (15 of each) were collected randomly from various dairy shops and supermarkets in Giza Governorate, and tested microbiologically for fungal and enteric gram negative bacterial contamination; detection of AFM1 residues using ELISA technique as well as detection of lipolytic and proteolytic activities of the most isolated fungi and bacteria. Six genera of moulds were recovered from the examined samples and three genera of yeasts. The most isolated moulds were species of genera Penicillium followed by Aspergillus, Cladosporium, Geotrichum, Mucor and Scopulariopsis, while the most isolated yeasts were species of genera Candida followed by Rhodotorula and Saccharomyces. AFM1 levels were detected in all analyzed samples of raw milk and milk products. AFM1 levels exceed EU legal limits (50 ppt) (0.05 μg/L/kg) while the detected limits were below the international legal limits of USA (FDA) (500 ppt) (0.50 μg/L/kg) in raw milk and dairy products for human consumption. The highest lipolytic and proteolytic activities were detected in A. niger and Mucor spp. (100%) while Cladosporium spp. possessed the lowest activities (50%), Candida albicans had activities (80%) and Rhodotorula had activities (62.5% and 75%). Pseudomonas spp. isolates were examined for proteolytic and lipolytic activities; three isolates had lipolytic activity (27.27%), also three isolates had proteolytic activity (27.27%). On the other hand,the most isolated enteric gram negative bacteria from the examined samples were identified as E. coli followed by species of Psudomonas, Klebsiella, Shigella and Salmonella. Moreover, no any bacteria were isolated from butter and dry milk samples. The economic importance and public health significance to the present results as well as apply the proposed sanitary measures to reduce microbial contamination and food safety for human health were discussed.

Occurrence of aflatoxin M1 in milk samples from Italy analysed by online-SPE UHPLC-MS/MS

The occurrence of aflatoxin M1 in 69 milk samples collected in a south region of Italy in 2016 was evaluated. The samples were analysed using an automated method based on online SPE coupled with UHPLC tandem mass spectrometry. After a salt induced liquid–liquid extraction with acetonitrile to remove protein from milk, the extract was diluted with water and analysed using an automated online SPE MS/MS method. Among the analysed samples no one had AFM1 higher than the legally allowable limits whereas 71.4% of the other analysed samples were above the LOD of the method. The highest contamination level of AFM1 was found in pasteurised milk (44.39 ng kg−1). The results show the worrying and widespread of AFM1 contamination, highlighting the necessity of monitoring studies in order to evaluate the reduction of the maximum legal limit.

Aflatoxin M1 Contamination Levels in Cheeses Sold in Isfahan Province, Iran.

ObjectivesAflatoxin M1 (AFM1)-contaminated dairy products pose serious human health risks, causing liver and renal failure if consumed. They are also related to decreased milk and egg production in infected animals. This study investigated the AFM1 contamination levels in cheeses sold in Isfahan province, Iran, by enzyme-linked immunosorbent assay (ELISA).MethodsA total of 100 white cheese samples were randomly collected from supermarkets in Isfahan province and after extraction using dichloromethane were prepared for the ELISA.ResultsOf the 100 samples, 52 (52%) were contaminated by AFM1, at levels ranging from 50.2 to 424.4 ng/kg. The remaining 48% of the samples had undetectable AFM1 levels (< 50 ng/kg). Based on the standard limit set by the European Commission and Iran, 8% (8/100) of the AFM1-positive samples (with concentrations between 250.2 and 424.4 ng/kg) had levels higher than the permissible value of 250 ng/kg.ConclusionAlthough the percentage of cheese samples in Isfahan province with AFM1 levels exceeding the national permissible limit was low, the examination of cheeses and the milk used for their production is nevertheless important for ensuring public health. Furthermore, optimum storage conditions of animal feed should be ensured, and livestock nutrition must be monitored for the presence of AFM1 and other aflatoxins.

Aflatoxin M1 in Dairy Products: Exposure and Health Risks

Aflatoxins are toxic secondary metabolites produced by Aspergillus flavus (Asp.flavus) and Aspergillus parasiticus (Asp. Parasiticus) molds. This mycotoxin group, which is particularly toxic to liver, is found in many cereal crops during growth, harvest, post-harvest and improper storage and in edible tissues of animals consuming contaminating cereal products. Dairy products containing the most aflatoxin residues in edible animal tissues are consumed large quantities by consumers particularly children who are more vulnerable than. Thus, the AFM1 found dairy product is one of the important problems threatening public health. Studies on the AFM1 levels of commercially milk in Turkey is indicated that the AFM1 levels of dairy products do not exceed the acceptable maximum legal limits in the Turkish Food Codex Contaminants Regulation but may pose a risk to health, especially during long term intakes in children. Studies have also shown that AFM1 levels of raw milk contain more AFM1 levels than those sold in the market. Because aflatoxins cannot be completely destroyed from foods and feeds, It is emphasized by the relevant experts that measures should be taken by countries to limit the intake of aflatoxins via diet to minimize potential risks to health and to limit the consumption of aflatoxin containing foods at levels that can not be reduced.

Novel Aflatoxin-Degrading Enzyme from Bacillus shackletonii L7.

Food and feed contamination by aflatoxin (AF)B1 has adverse economic and health consequences. AFB1 degradation by microorganisms or microbial enzymes provides a promising preventive measure. To this end, the present study tested 43 bacterial isolates collected from maize, rice, and soil samples for AFB1-reducing activity. The higher activity was detected in isolate L7, which was identified as Bacillus shackletonii. L7 reduced AFB1, AFB2, and AFM1 levels by 92.1%, 84.1%, and 90.4%, respectively, after 72 h at 37 °C. The L7 culture supernatant degraded more AFB1 than viable cells and cell extracts; and the degradation activity was reduced from 77.9% to 15.3% in the presence of proteinase K and sodium dodecyl sulphate. A thermostable enzyme purified from the boiled supernatant was designated as Bacillus aflatoxin-degrading enzyme (BADE). An overall 9.55-fold purification of BADE with a recovery of 39.92% and an activity of 3.85 × 103 U·mg−1 was obtained using chromatography on DEAE-Sepharose. BADE had an estimated molecular mass of 22 kDa and exhibited the highest activity at 70 °C and pH 8.0, which was enhanced by Cu2+ and inhibited by Zn2+, Mn2+, Mg2+, and Li+. BADE is the major protein involved in AFB1 detoxification. This is the first report of a BADE isolated from B. shackletonii, which has potential applications in the detoxification of aflatoxins during food and feed processing.

Seasonally Feed-Related Aflatoxins B1 and M1 Spread in Semiarid Industrial Dairy Herd and Its Deteriorating Impacts on Food and Immunity

To comparatively determine the levels of aflatoxin (AF) B1 in feedstuffs and of AFM1 in milk from semiarid industrial cattle farms in northeastern Iran during four seasons and to elucidate the effects of mixed AFB1 and AFM1 on bovine granulocytes, 72 feedstuffs (concentrate, silage, and totally mixed ration (TMR)) and 200 bulk milk samples were simultaneously collected for ELISA-based AFs detection. Isolated blood and milk neutrophils (n=8/treatment) were also preincubated with mix of 10 ng/ml AFB1 and 10 ng/ml AFM1 for 12 h; the impact was assessed on neutrophils functions. AFB1 levels in feedstuffs averaged 28 μg/kg (4–127 μg/kg), with TMR maximal (38±6.3 μg/kg), concentrate (32±6.5 μg/kg), and silage (16±1.5 μg/kg). The levels of AFB1 and AFM1 in feedstuffs and milk averaged 42±9.3, 27±2.8, 26±4.1, and 18.5±2.8 μg/kg and 85±7.3, 62±6.1, 46±6.2, and 41±6.5 ppb μg/kg in winter (maximal), autumn, spring, and summer, respectively. Mix of AFB1 and AFM1 weakened various functions of granulocytes. It adds new reason why during winter semiarid raised food-producing animals show more immune-incompetence.

Changes in body composition and Basic Metabolic Rate (BMR) following bariatric surgery

Changes in body composition and Basic Metabolic Rate (BMR) following bariatric surgery

Association between Aflatoxin M₁ and Liver Disease in HBV/HCV Infected Persons in Ghana.

Aflatoxins are produced by the fungi Aspergillus flavus and Aspergillus parasiticus and are common food contaminants in tropical developing countries. Extensive aflatoxin consumption has been shown to be highly associated with liver disease. A case-control study was conducted to determine the association between aflatoxin and liver disease in Kumasi, Ghana. A questionnaire was administered to examine socio-demographic characteristics and food storage and consumption practices, and urine samples were collected to measure levels of the aflatoxin metabolite (AFM1). Two hundred and seventy-six people participated in the study; 38 had liver disease (cases), 136 had neither hepatitis B/C nor liver disease (negative controls), and 102 were hepatitis B/C positive without liver cancer (positive controls). A much higher percent of participants in each group was male (76% of cases, 88% of negative controls and 65% of positive controls). Multivariate analysis showed that age was a significant predictor for being a case when cases were compared to negative controls. The odds of being a case was 70% less for participants aged 25–34 years (odds ratios (OR) 0.30; 95% confidence interval (CI) 0.10–0.88) compared to those ≥45 years. For cases; Akans were seven times more likely to have AFM1 levels below the median when compared to other ethnic groups (OR 7; CI 1.41–34.68). When cases were compared to positive controls, they were 2.29 times more likely to report awareness of aflatoxin contamination of groundnuts (95% CI 1.06–4.91). Cases were also two times more likely to report awareness of aflatoxin contamination of maize than all controls combined (95% CI 1.02–4.11). However, most cases reported that aflatoxin contamination does not cause sickness in humans. This shows that there is awareness of aflatoxin contamination without proper understanding of the serious potential adverse health impacts among these study participants. These findings indicate that educational interventions that stress the harmful health effects of aflatoxin in food, with an emphasis on the higher risk for males, are urgently needed. The reasons for lower aflatoxin levels among Akans need to be determined, and the findings used to design interventions that benefit other ethnic groups in the society.