Zearalenone-Contaminated Cereals in African Communities, Probabilistic Exposures and Adverse-Health Outcomes: A Meta-Analysis

Zearalenone, a mycotoxin produced by Fusarium spp., is one of the exposomes that elicits global public health concern. However, its exposure and health risks are least studied among cereal-growing communities in Africa. It has been well documented to possess estrogenic activities among female populations in humans and animals. Uncertainties are associated with using the permissible maximum tolerable daily intake as a health-based guidance value. This poses a challenge to quantifying reliable exposures and risks for age-related consumers globally and typically in Africa, where cereal consumption is predicted to increase in the next decade. This meta-analysis used probabilistic approaches to leverage uncertainties in zearalenone concentrations in various cereals reported in the scarce studies published across the continent. Using EFSA recommended guidelines, exposures to zearalenone and health risks, indexed as hazard quotient, were quantified among age-related consumer populations in Africa. Exposures were simulated at 100,000 iterations, benchmarked against the regulatory PMTDI (0.25 μg/kg) and quantified as hazard quotient (HQ) to describe risk of adverse health outcomes. The results presented zearalenone concentrations ranging from 0.90 to 1032 μg/kg and high prevalence in rice and rice-based products (75%). Simulated modal and 95th percentile zearalenone exposures ranged respectively from 5.33×10-3 to 9.70×10-2, and 1.91 to 31.60 μg/kg(bw)-day. Infants recorded the highest modal (9.70×10-2 μg/kg(bw)-day, 1). In older age groups, 95th percentile exposures ranked in descending order as: toddlers (13.11 μg/kg(bw)-day) > other children (6.84 μg/kg(bw)-day) > adolescent (3.65 μg/kg(bw)-day) > young adult (2.57 μg/kg(bw)-day) > adult females (2.33 μg/kg(bw)-day) > elderly group (2.09 μg/kg(bw)-day) > adult males (1.91 μg/kg(bw)-day) The results show a severe risk (HQ >1) among all consumer groups but especially for infants, which seems consistent with global observations in Europe, South America, and the Far East. Infants were more vulnerable to risks arising from zearalenone contaminations and exposures. They are very likely to be exposed to this mycotoxin that exhibits estrogenic traits throughout their lifetime and thus, concerted mitigation strategies for zearalenone must be encouraged to control