Prevalence and Concentration of Aflatoxin M1 in Mother Milk: A Meta-analysis, Meta-regression, and Infants’ Health Risk Assessment

Abstract

Breast milk is a complete and nutritious food for newborns and infants, but it may be contaminated with Aflatoxin M₁ (AFM₁), which endangers consumers’ health. Several studies from various regions have determined the concentration and prevalence of AFM₁ in mother milk. In this study, an attempt was made to meta-analyze the concentration and prevalence of AFM₁ and estimate the health risk of infants. The concentration and prevalence of AFM₁ in the countries subgroup were meta-analyzed in the random effects model (REM), and also the effect over time on the prevalence of AFM₁ was determined by meta-regression. Finally, the human risk in infants was estimated via the margin of exposure (MOE_S) in different countries. The five countries with the highest prevalence of AFM₁ in mother milk were observed in Jordan (100.00), Tanzania (100.00), Mexico (97.00%), Lebanon (93.69%), and Colombia (90.00%). The pooled prevalence of AFM₁ in mother milk was 54.48%, 95% CI (42.99–65.73). The five countries with the highest concentration of AFM₁ in mother milk were observed: Egypt (570 µg/l), Sudan (413 µg/l), Cameroon (315.00 µg/l), Serbia (175 µg/l), and Tanzania (70 µg/l). The pooled prevalence of AFM₁ in mother milk was 6.00, 95% CI (5.80–6.90(. Except for Egypt, infants in other countries are at an acceptable health risk (MOEs > 10,000). Considering the unacceptable risk due to the consumption of milk containing AFM₁ in Egypt, it is suggested that programs be carried out to control the quality of mother milk.