Assessment of Potentially Toxic Trace Elements in commonly consumed fruits and vegetables from Supermarkets and Associated Health Risks in Thulamela Municipality, South Africa: a study protocol.

Potentially toxic trace elements (PTTEs) contamination is a major global food health burden, with lead exposure causing more than 33 million disability-adjusted life years lost in 2021, mainly from cardiovascular effects. Cadmium in food is strongly linked to kidney dysfunction and reproductive toxicity, while arsenic and zinc also pose serious health risks. Exposure occurs through industrial emissions, contaminated air and water. Despite global studies, local data on these elements in South African fruits and vegetables remain limited. The study aims to determine the levels of arsenic, lead, cadmium, and zinc in fruits and vegetables from Thulamela Municipality and assess potential health risks to consumers and compare the levels of the elements to legal requirements. A cross-sectional design will be adopted. Ten commonly consumed fruits and vegetables will be sampled purposively from three supermarkets in Thulamela and analysed for PTTEs using Inductively Coupled Plasma Spectrometry (ICP-MS) at University of Venda, and assessment of dietary exposure among adult consumers aged 18-65 years through 24-hour recall and Quantified Food Frequency Questionnaire (QFFQ). Differences in PTTEs with metal type and food type as factors will be determined using two-way ANOVA. Dietary data will be coded and analysed using Food Finder 3 software linked to SAFOODS to estimate intake. Health risks associated with intake of the PTTEs will be evaluated in terms of estimated daily intake (EDI), target hazard quotient (THQ), hazard index (HI) and Carcinogenic Risk (CR). Statistical analysis will be done using IBM SPSS version 29, and significance set at p<0.05. Measured elements levels will be compared to national legal limits to estimate daily intake and evaluate health risks. Ethical approval will be obtained and participants’ rights to consent, privacy, and confidentiality, will be protected. Expected outcomes include contamination levels of PTTEs in selected fruits and vegetables and associated health risk assessment.