Occurrence of and Factors Associated With the Presence of Aflatoxin M₁ in Breast Milk of Mothers in Fethiye, Turkey

Abstract

Aflatoxins comprise a group of mycotoxins that are found in the environment. Exposure to aflatoxins has been reported to cause serious health problems in humans. Since aflatoxin M1 (AFM1) is secreted in breast milk, the exposure of infants to this toxin is an important concern. The aim of this study was to determine the prevalence, levels of, and factors associated with the presence of AFM1 in breast milk of mothers in Fethiye, Turkey. Breast milk samples were taken from 100 mothers who had given birth over the period of October–November 2017. The AFM1 content of the samples was determined via enzyme-linked immunosorbent assay. The lowest limit for milk samples in the Ridascreen® AFM1 commercial test kit is 5 ng/L. Because of this, AFM1 levels below 5 ng/L in the breast milk samples were assessed as negative. Of the breast milk samples tested, 53 were positive. The average AFM1 amount in the positive samples was 6.36 ng/L (ppt; range 5.10–8.31 ng/L). Mothers who were housewives, lived in damp, humid houses, or ate spices or dried fruits and vegetables had significantly greater prevalence of AFM1 in their breast milk than those who were employed, did not report dampness or mold in the home, or did not eat spices or dried fruits and vegetables. AFM1 in breast milk could be an important risk factor for infant health. Informing the public about food safety could reduce the amount of AFM1 being transferred into breast milk via food channels.

Determination of aflatoxin M1 in breast milk and related factors

“…In the study conducted in Fethiye, 53 of 100 breast milk samples were positive for AFM 1 , and the mean of positive cases was 6.36 ng/L AFM 1 . A significant difference (58.8%) was found in the breast milk samples of homemakers compared to the workers 3 . In the present study, while the educational status of women was associated with AFM 1 levels, their place of residence and age were not associated with AFM 1 levels.…”

“…Studies related to this case in Turkey cover the provinces of Afyonkarahisar 4 , Istanbul 28 , Ankara 2 , Erzurum 29 , Şanlıurfa 27 , Eskişehir 30 , and the district of Fethiye 3 . According to the results of these studies, the highest value in milk samples collected in these regions was determined in Ankara, with a range of 60.90–299.99 ng/L.…”

“…Thus, it is transferred to the baby in contaminants along with the beneficial components. One of these contaminants is mycotoxins, which occur naturally under appropriate heat and humidity and produce various toxic metabolites by fungi 2 , 3 .…”

Mycotoxins Exposure in Cabinda, Angola—A Pilot Biomonitoring Survey of Breastmilk

“…Infant development can be critically affected by artificial or natural contaminants, including mycotoxins [ 38 ]. Infants and children are at risk and are about three times more susceptible than adults to the adverse effects of mycotoxins due to high relationships between intake and body weight and between high metabolic rate and low detoxification capacity [ 29 , 40 ]. Therefore, they may be more sensitive to neurotoxic, endocrine, and immunological effects.…”

Ex Vivo and In Vitro Studies Revealed Underlying Mechanisms of Immature Intestinal Inflammatory Responses Caused by Aflatoxin M1 Together with Ochratoxin A

“…AFM1, the hydroxylated derivative of aflatoxin B1 (AFB1), has been frequently detected in human breast milk and processed infant food samples all over the world [ 16 , 17 , 18 , 19 , 20 ]. According to the latest research, the maximum AFM1 concentrations in breast milk samples from Morocco, Turkey, and southern Ethiopia are 13.33 ng/L, 8.31 ng/L, and 143.3 ng/L, respectively [ 17 , 21 , 22 ]. Moreover, available data from Mexico showed that 20% of the surveyed commercial infant formulae samples were contaminated with AFM1 in the range of 40–450 ng/L, exceeding the European Commission limit of 25 ng/L [ 23 ].…”