Aflatoxin, fumonisin, ochratoxin, zearalenone and deoxynivalenol biomarkers in human biological fluids: A systematic literature review, 2001-2018

Human exposure to mycotoxins occurs mostly through dietary intake, although exposure through dermal and inhalation routes has also been shown. Depending on the type of mycotoxins, the applied dose and duration of exposure, a particular toxin can cause either chronic or acute illnesses such as kidney failure and cancer. Thus, understanding the biotransformation of mycotoxins and identification of reliable biomarkers in the human body is important for accurate risk assessment of mycotoxin exposure. This review provides a comprehensive overview of worldwide aflatoxins, fumonisins, ochratoxin, zearalenone and deoxynivalenol mycotoxin biomonitoring studies reported in the last 18 years. The studies performed in Africa, Europe, Asia and America are based on the measurement of a limited number of mycotoxin biomarkers and do not provide a comprehensive risk assessment of the mycotoxin exposure. Although the findings represent a small segment of a much larger health risk of mycotoxins exposure, it is acknowledged that a multianalyte approach covering bioconjugated and other metabolites of most often occurring mycotoxins would better reflect the extent of the global exposure problems with these highly toxic compounds.