Mycotoxins and human health.

Mycotoxins have been investigated in relation to a wide range of adverse human health effects, but the evidence for all but a small number of associations is limited. Thus, the full impact on human health of the widespread exposure to mycotoxins remains to be defined. The main exception is for aflatoxins; epidemiological, experimental, and mechanistic studies have contributed to establishing aflatoxins as a cause of human liver cancer, with a particularly elevated risk in people chronically infected with hepatitis B virus. In addition, acute aflatoxicosis after exposure to high dietary toxin levels has been demonstrated. The impairment of child growth by aflatoxin exposure early in life remains an important subject of study. More information is also required on the potential immune effects of aflatoxins, especially in vulnerable populations. For fumonisins, studies indicate a possible role in oesophageal cancer and in neural tube defects, although no definitive conclusions can be drawn at present. For deoxynivalenol and other trichothecenes, exposure has been linked to acute poisoning outbreaks in large numbers of subjects. For ochratoxin A and zearalenone, the human health effects remain undefined. The limited tools available to accurately assess human exposure to mycotoxins and the relative paucity of epidemiological studies need to be addressed if the full extent of the adverse effects of these common dietary contaminants is to be understood and adequate public health measures taken. In this respect, newly established biomarkers of exposure at the individual level are proving valuable in improving exposure assessment in epidemiological studies.