Author
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TORRES, OLGA - Molecular Diagnostic Laboratory |
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MATUTE, JORGE - National Institute Of Public Health (INSP) |
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Showker, Adele |
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Voss, Kenneth |
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MCCOTTER, ORION - Centers For Disease Control And Prevention (CDC) - United States |
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HUMPF, HANS-ULRICH - Westphalian University |
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EGNER, PATRICIA - Johns Hopkins University |
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GROOPMAN, JOHN - Johns Hopkins University |
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RILEY, RON - University Of Georgia |
Submitted to: Meeting Abstract
Publication Type: Abstract Only Publication Acceptance Date: 5/9/2017 Publication Date: 5/16/2017 Citation: Torres, O., Matute, J., Showker, A.J., Voss, K.A., Mccotter, O., Humpf, H., Egner, P., Groopman, J., Riley, R.T. 2017. Mycotoxin exposure among Guatemalans: Implications for public health. UJNR 12th International Symposium “Toxins, Pathogens, and Foods: Challenges and Opportunities for Public Health”, May 16-18, 2017, Laurel and College Park, MD, 2017 (meeting abstract). Interpretive Summary: Technical Abstract: Guatemala has the highest rate of stunting in the Pan American region and the fourth wordwide. It also has the highest liver cancer rate in this region, which is the same among male and females. Guatemalans of low socioeconomic status consume about 400g of corn/day as tortillas. Subsistence farmers in the highlands generally produce one harvest per year whereas in the lowlands farmers can have two or more harvests. During the remaining six months of the year, highland families purchase corn in local markets, most of which originates in the lowlands or is smuggled into Guatemala from Mexico. A 2012 survey revealed that 99% (n=633/640 corn samples from markets or local stores) of Guatemalan corn (from 280/336 municipios)was contaminated with fumonisins, and 36% (n=206/572) with aflatoxin B1. Additionally, 68 moldy corn samples had extremely high aflatoxin B1 levels. Futher studies conducted in departments where consumption of corn tortillas is high determined that women in Jutiapa, Chiquimula, and Santa Rosa has high exposures based on both the analysis of corn and of FB1 concentrations in urine (n=596). Exposure in women from Alta Verapaz (n=45) and other municipios, e.g. Chuarrancho (n=45), were also high, while less than 50% of the volunteers in other locations had exposures >2ug/kg/bw/day (n=687). Exposures were relatively low in Chimaltenango, Sacatepequez, and Escuintla (n=973) during 2012-2015. Our studies revealed that many Guatemalan women who are high corn-tortilla consumers are exposed to high amounts of FB1 (>2ug/kg/bw/day), as indicated by analysis of 2355 urine samples obtained with informed consent. A separate study was conducted by the Institute of Nutrition of Central America and Panama(INCAP) in 2016. Some level of aflatoxin-lysine adduct was found in the plasma of 100% of 443 male and female adults over 40 years living in one of five departments where liver cancer is prevalent. Additionally, blood samples from previously conducted studies were analyzed for ochratoxin A (OTA). A high percentage of samples were positive. In contrast, only 2/37 coffee samples collected from stores and homes in Guatemala were hightly contaminated with OTA. However, 88% of corn samples analyzed by the Ministery of Agriculture of Guatemala in 2016 were found to be contaminated with OTA. Although data on double or multiple mycotoxin exposures is not available, co-exposures are likely since corn purchased for local consumption is co-contaminated with several mycotoxins. It is urgent that good agricultural practices be implemented in Guatemala and that, given the high levels of consumption, this effort be accompanied with massive promotion of food diversity in Guatemalan diets, to improve Guatemalan public health. |