Assessing the Risk and Consequences of Naturally Occurring Aflatoxins on Liver and Kidney Health in Children: A Cross-sectional Analysis in Lahore Pakistan.

Introduction Aflatoxins, potent carcinogenic and immunotoxin agents, are pervasive food contaminants. Aflatoxins pose significant health risks, impacting food safety, public health, and animal well-being. Methods This cross-sectional study evaluated exposure risk and toxic effects of naturally occurring aflatoxins on various hematobiochemical parameters in children. Blood and urine samples of children (n=238) were tested for aflatoxin B1 (AFB1) and M1 (AFM1). Viral hepatitis screening, complete blood count, liver, and kidney function tests, and anthropometry were also performed. Probable daily intake (PDI) and margin of exposure (MoE) for participants were also calculated. Results Urinary AFM1 was detected in 65.5% of participants with a median level of 1.9 ng/mg-creatinine (IQR: 0.23–1.4). All serum samples had AFB1-lysine adduct with a median level of 10.66 pg/mg-albumin (IQR: 6.25–20.32). Median PDI was 8.16 ng/kg bw/day suggests an individual’s estimated daily exposure to AFB1 (IQR: 3.18–26.82) indicates variability in exposure levels among participants. Median MoE was 49.0 (IQR: 93.65–159.77) suggesting higher liver cancer risk among participants. Results of regression analysis indicated that HCT (0.0011, p=0.048), monocytes (-0.027, p<0.001), ALP (-4.12×104, p=0.01), and TP (-0.0048, p=0.042) levels were influenced by AFM1. Whereas MCV (-9.88×106, p=0.018), ALT (-1.92×104, p=0.014) and ALP (6.66×106, p=0.028) were influenced by AFB1. Conclusions Our results indicate liver cancer risk from aflatoxin exposure in children and its adverse effects on hematobiochemical parameters warrant immediate mitigation strategies.