Risk of Exposure to and Mitigation of Effect of Aflatoxin on Human Health: A West African Example.

The purpose of this chapter is to examine the relative risk of exposure of different human populations to food-borne aflatoxins; the types of health impact that may be incurred by dietary exposure to aflatoxins; and possible strategies likely to mitigate risks to human health. Risk of exposure is examined in a global context comparing risk of toxin exposure by levels of national socioeconomic development. Then risk of exposure is reexamined in the context of agro-ecology, distribution of toxigenicity of Aspergillus flavus, and social factors that influence food management practices. The effects of aflatoxin exposure on human health are explored in three sections: human disease and nutritional status, carcinogenicity, and child growth and development. The section concerning mitigation of the effects of aflatoxin on human health contrasts efficacy of regulation, food basket modification, and production-side agriculture intervention. It is concluded that risk of hepatocellular carcinoma in developing countries, such as West Africa, may be addressed by vaccination for hepatitis B virus (HBV) and other public health options. Young children in West Africa who are chronically exposed to aflatoxin in foods and who consume nutritionally deficient diets have been shown to be stunted and underweight, as measured by World Health Organization (WHO) Z-scores.