IARC MONOGRAPHS ON THE EVALUATION OF CARCINOGENIC ...

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IARC MONOGRAPHS VOLUME 82
Figure 2. Level and prevalence of aflatoxin exposure
From Montesano et al. (1997)
Data are expressed as pg aflatoxin B 1–lysine equivalents/mg serum albumin and represent the mean levels
in samples with levels above the detection limit of the enzyme-linked immunosorbent assay used (5 pg/mg).
Shandong (China), Europe (France and Poland) and Egypt are represented at the detection limit, but no
samples were above this level of adduct (0% prevalence). The number of sera analysed varies per country.
Original data are from Wild et al. (1993a) and Yu (1995).
Leone, 25% of cord blood samples contained aflatoxins, primarily M 1 and M 2, as well as
others in variable amounts (range: 1 ng aflatoxin M 1/L to 64 973 ng aflatoxin B 1/L).
Of 35 cord serum samples from Thailand, 48% contained aflatoxins at concentrations
of 0.064–13.6 nmol/mL (mean, 3.1 nmol/mL). By comparison, only two of 35 maternal
sera obtained immediately after birth contained aflatoxin (mean, 0.62 nmol/mL). These
results show that transplacental transfer and concentration of aflatoxin by the fetoplacental
unit occur (Denning et al., 1990).
Analyses of breast milk in Ghana, Nigeria, Sierra Leone and Sudan showed primarily
aflatoxin M 1, aflatoxin M 2 and aflatoxicol. Aflatoxin exposure pre- or post-natally at
levels ≥ 100 ng/L was very often associated with illness in the child (Maxwell, 1998).
Exposure of infants to aflatoxin M 1 from mothers’ breast milk in the United Arab
Emirates has been measured by Saad et al. (1995). Among 445 donors of breast milk,
99.5% of samples contained aflatoxin M 1 at concentrations ranging from 2–3 μg/L. The
mothers were of a wide range of nationalities, ages and health status; no correlation was
observed between these factors and aflatoxin M 1 content of the milk.
El-Nazami et al. (1995) measured levels of aflatoxin M 1 in breast milk in 73 women
from Victoria, Australia and 11 women from Thailand. Aflatoxin M 1 was detected in
11 samples from Victoria (median concentration, 0.071 μg/L) and five samples from