A Comprehensive Probabilistic Risk Assessment Strategy of Aflatoxin B1 Exposure from Medical Areca Nuts Consumption

Aflatoxin B₁ (AFB₁) is widely found and substantially impends public health. The current work aimed to assess AFB₁ in medical areca nuts in China. The average content of AFB₁ was 13.0 μg/kg, and the maximum content was 146.0 μg/kg. Furthermore, a comprehensive probabilistic risk assessment approach considering combined utilization of a Monte Carlo simulation with the margin of exposure (MOE) and quantitative liver cancer risk (HCC) strategies was developed for assessing the human health risk of AFB₁ from consuming medical areca nuts for the first time. The MOE values of AFB₁ in samples for no more than the 75th percentile were less than the threshold of 10,000 for both men and women. The estimated 90th percentile to the maximum of the HCC values for males and the estimated 75th percentile to the maximum of the HCC values for females were higher than one in a million upon exposure to medical areca nuts, indicating an unacceptable liver cancer risk. Sensitivity analysis demonstrated that for both MOE and HCC approaches, AFB₁ content was the parameter with the greatest effects on the results, followed by the exposure frequency (EF) and daily intake rate (IR). This study is the first of this kind, demonstrating the applicability of stochastic exposure evaluation techniques for the precise and scientific assessment of the health risk of AFB₁ in medical areca nuts, with the main purpose of minimizing human cancer risk.