Total Dietary Intake and Health Risks Associated with Exposure to Aflatoxin B1, Ochratoxin A and Fuminisins of Children in Lao Cai Province, Vietnam.

The health burden of foodborne mycotoxins is considerable, but particularly for children due to their lower detoxification capacity, rapid growth and high intake of food in proportion to their weight. Through a Total Dietary Study approach, the objective was to estimate the dietary exposure and health risk caused by mycotoxins for children under 5 years living in the Lao Cai province in northern Vietnam. A total of 40 composite food samples representing 1008 individual food samples were processed and analyzed by ELISA for aflatoxin B₁, ochratoxin A and fumonisins. Results showed that dietary exposure to aflatoxin B₁, ochratoxin A and total fumonisins were 118.7 ng/kgbw/day, 52.6 ng/kg bw/day and 1250.0 ng/kg bw/day, respectively. Using a prevalence of hepatitis of 1%, the risk of liver cancer related to exposure of aflatoxin B₁ was 12.1 cases/100,000 individual/year. Age-adjusted margin of exposure (MOE) of renal cancer associated with ochratoxin A was 127, while MOE of liver cancer associated with fumonisins was 542. Antropometric data show that 50.4% (60/119) of children were stunted, i.e. height/length for age z-scores (HAZ) below -2, and 3.4% (4/119) of children were classified as wasted, i.e. weight for height z-scores (WHZ) below -2. A significant negative relationship between dietary exposure to individual or mixture of mycotoxins and growth of children was observed indicating that the high mycotoxin intake contributed to stunning in the children studied.