Table 1.

A summary of AF impacts on human and animal health.

Type of Aflatoxins	Country	Host/Food Commodities	Detection Method	Study Subjects	Major Findings	References
AFB1	North Central Nigeria	Cereals, millet, rice, sorghum, nuts, and legumes	Liquid chromatography tandem mass spectrometry (LC-MS)	Average household population, which regularly consumes cereals and nuts	Liver cancer risk for AFB1 exposure in children was twice that of adolescents and four times that of adults.	[18]
AFB2	Iran	Sunflower oil, canola oil, refined olive oil, unrefined olive oil, frying oil, and blend oil	High-performance liquid chromatography (HPLC) with a fluorescence detector	Children and adult populations exposed to contaminated edible oils	There was no considerable difference in the margin of exposure between adults and children in the Zanjan Province, Iran despite both groups being at significant risk of liver cancer due to AFB2 from the consumption of unrefined olive oil. It is suggested that the reason may be linked to a lower daily intake of olive oil in children.	[22]
AFM1	Serbia	Milk, dairy products, and infant formula	ELISA and LC-MS/MS analysis	Toddlers (1–3 years) and children (3–9 years)	Pasteurized and UHT milk had the highest level of contamination (79%) and the greatest mean concentration of AFM1 (22.34 ± 0.02 ng kg−1), while cheese had the lowest mean concentration (1.36 ± 0.01 ng kg−1). The main contributor to the risk of HCC resulting from AFM1 exposure was the consumption of milk products, in the form of pasteurized and UHT milk, with estimated cases of 0.00038 and 0.00039 per 100,000 individuals per year for the lower bound and upper bound scenarios, respectively. The age group of 1–3 years was associated with the highest risk of HCC (0.00034), indicating no health risks for the groups assessed. Toddlers were estimated to have a higher daily intake of AFM1 in milk as compared to children aged 3–9 years, with an estimated daily intake of 0.164 and 0.193 ng kg−1 bw day−1 for the lower and upper bound exposure scenarios, respectively.	[20]
AFB1	Iran	Rice grains (contaminated rice grain powder, methanol extract of contaminated rice grains)	HPLC	Four-day-old Pekin ducklings	The consumption of raw rice grain powder and methanol extract containing AFs caused a significant increase in lactate dehydrogenase activity in experimental ducklings. Histopathological examinations revealed an accumulation of large fat droplets and hepatocyte cell swelling in the ducklings exposed to dietary AFs. The presence of AFB1, in combination with biomolecules, led to liver damage and impaired liver metabolic functions.	[23]
AFB	Brazil	Rice	LC-MS, equipped with a turbo ion spray electron spray ionization source at atmospheric pressure, and an Agilent chromatography system	Silver catfish (Rhamdia quelen)	Hepatocyte anisocytosis, moderate fat infiltration, apoptosis, and the multifocal necrosis of hepatocytes were observed in silver catfish at 5 days post-feeding with an AFB diet. The severity of toxic hepatitis significantly increased by day 10 post-feeding.	[24]
AFB1	Nigeria	Not stated	Not stated	Male and female Wistar rats	Both low and high levels of prenatal AFB1 exposure caused a significant reduction in weight and a decrease in cholesterol levels, accompanied by an increase in triglyceride levels. The weight of newborn mice was reduced, and weight gain was affected even after the withdrawal of exposure. Hormonal changes were observed in male and female mice, including decreased levels of testosterone, progesterone, and luteinizing hormone.	[25]
AFB1	Mexico	Popcorn (Zea mays everta)	HPLC equipped with an isocratic pump, a fluorescence detector, and an autosampler	Women and men in the city of Veracruz (food frequency questionnaires)	AFB1 was detected in at least 47% of the popcorn samples. The risk of liver cancer due to the consumption of AF-contaminated popcorn was found to be 0.993 cancers/year per 100,000 females, while for males, the average risk was 0.137 cancers/year per 100,000. Notably, males under the age of 18 carried the highest risk, at 0.137 cases per 100,000 persons.	[26]
AFB1	Turkey	Not stated	Not stated	Wister albino rats	AFB1 induced oxidative stress by generating ROS and causing lipid peroxidation. This leads to a significantly increased level of MDA and decreased activities of GSH and SOD. Additionally, AFB1 triggers the release of pro-inflammatory cytokines, including TNF-a, IL-1b, and IL-6. Abnormal liver function tests that included high levels of AST and ALT further explained the loss of hepatocyte structural integrity. AFB1 can disrupt the cell membrane permeability and the mitochondrial membrane in hepatocytes, leading to liver damage.	[28]
AFM1	Bangladesh	Human breast milk samples	Competitive ELISA	Nursing mothers and nursing babies	Maternal consumption of AFB1-contaminated food led to more than half of the 62 human breast milk samples from the Bangladesh cohort that was contaminated with AFM1. Using ELISA, the presence of AFM1 was detected in 51.6% of the samples, with an average daily intake of AFM1 in human newborns of 0.49 ng/kg b.w./day.	[29]
AFM1	Malawi	Raw milk samples	VICAM aflatest fluorometry	Adults and children from small-scale dairy farming households	A very low incidence of AFM1-induced HCC was observed in children, at 0.038 cases/100,000 individuals, and adults, at 0.023 cases/100,000 individuals, despite their high consumption of raw milk, at 300 mL/day and 541 mL/day, respectively.	[30]
AFM1	Brazil	Ultra-high temperature milk, powdered milk, and infant formula	HPLC with a fluorescence detector	Children from a child education center (food frequency questionnaires)	The risk of HCC in children was identified at 0.0015 to 0.0045 cases/100.000 individuals from the consumption of ultra-high temperature milk, powdered milk, and infant formula. The average number of HCC cases associated with AFM1 exposure was reported to be between 0.0027 and 0.0029 cases/100,000 individuals.	[32]