Aflatoxin: A hidden food contaminant adversely affecting the health of Pakistani population

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Dr. Waseela Ashraf and Dr. Abdul Rehman
Aflatoxins are poisonous matters produced by a fungus named Aspergillus. The fungus dwells in soil as well as in putrefying matter and, in this way, can attack several crops, especially during the storage under inappropriate conditions. Importantly, aflatoxins are colourless, tasteless, and odourless food contaminants that do not destroy during cooking and food processing. Several researchers have reported aflatoxin contamination in a variety of food and feed commodities in various parts of Pakistan. This includes staple foods like rice, wheat, maize, and many other food items such as noodles, chocolates, dry fruits, chilis, and different types of animal origin food products such as milk, sweets, cheese and butter. Longtime exposures to aflatoxins can cause liver cancer and weaken the body’s immune system.

While extremely higher levels of toxin consumption can lead to sudden death. These toxins have proven roles in child growth suppression (children failed to reach their growth potential) manifested as stunting, wasting and underweight both before and after the birth. These adverse effects on child growth are irreversible and remain for life. After ingestion of aflatoxins contaminated food, aflatoxins are converted into various metabolites in liver. These metabolites are also as lethal as their primary chemicals for health. Importantly, mothers can transmit these metabolites to their children through breastfeeding. Similarly, when food producing animals consume aflatoxin-contaminated feed, it not only reduces their production, but these aflatoxins and their metabolites are also transferred to humans through milk, meat, and eggs. Consequently, it is one of the biggest food safety challenges and becomes a severe threat to the health of humans and animals. The economic consequences are even worst because ideally aflatoxin-contaminated crops should not be consumed, sold or exported.

Nevertheless, due to economic instability in the country and limited access to food by the poor people, testing and destroying the contaminated food items is not commonly practiced. Hence, it increases the burden on the health system. According to the World Health Organization, Pakistan ranks at 29th in the world for higher number of deaths due to liver diseases. Similarly, National Nutrition Survey recorded a high prevalence of child stunting (4 in 10 children) and underweight (1 in 3 children) in Pakistan.In this perspective, the research was conducted to assess the aflatoxins’ exposure to children in Lahore and to determine their effects on child health. Two-hundred and thirty-eight children were enrolled in this study. Alarmingly, all the children had detectable levels of aflatoxins in their bodies. The median concentration of the toxin in participants was high compared to those reported in the neighboring countries. It was found that older children had higher levels of aflatoxins which indicates that they might had more exposure to toxin contaminated food than the younger children as the later had limited access to get food from outside. Both aflatoxins and their metabolites were higher in children living in the urban areas that might be attributed to the high demand for food and prolonged storage in urban areas. Similarly, the toxin metabolite was higher in male compared to female children, which can be due to the differences in biotransformation and excretion of toxin in male and female children as well as higher exposure of male children to food from outside sources. The children who were consuming formula and animal milk were more exposed to this poison compared to those who were breastfeeding.

This toxin had also adversely affected the liver and kidney functions of the participants which makes them more prone to get liver and kidney problems. Therefore, these findings highlight a dire need to establish a uniform mitigation strategy focusing on improving food quality through strict control measures and public awareness programs throughout the country. In addition, mothers should be encouraged to breastfeed their young ones instead of providing animal/formula milk to reduce toxins’ exposure. Eating a healthy and diversified diet is a way to reduce aflatoxin contamination. We should avoid eating food that is prone to aflatoxin contamination such as improper stored food items. Proteins and vegetables are also less prone to aflatoxin contamination. Sorting and washing before consuming the food items are also effective techniques in reducing toxins. Animals should be fed fungus free feed which would increase their production and reduce toxin effects. Farmers should follow good farming practices to reduce contamination and keep the crop safe. Good farming practices include using good and certified seeds, keeping the field clean of weeds, harvesting the crops when will dry, sorting the crops to reduce the damage done by birds and rodents before drying and storage, preventing grains from contact with soil while drying, storing the crops in a cool and dry place which is safe from rain, insects and pests.

Aflatoxin contamination is a neglected issue; therefore, extensive awareness campaigns should be launched among general public – producers as well as consumers – and health professionals about possible sources of aflatoxin contamination and its adverse effects on health. Aflatoxin Task Force should be made to develop a comprehensive integrated approach for the prevention and control of aflatoxin from field to table in One Health fashion involving the agriculture, livestock, health, trade, and environmental sectors.

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