Occurrence, evaluation, and human health risk assessment of ochratoxin a in infant formula and cereal-based baby food: a global literature systematic review

Abstract

This study reviews global levels of ochratoxin A (OTA) in infant formula and cereal-based foods, using Monte Carlo simulation to assess risks. The review found 24 studies on global OTA levels in infant food and cereal-based products, using databases including PubMed, Scopus, Web of Science and Embase until March 2024. We estimated OTA exposure in infant food based on concentration, intake and body weight. The exposure and hazard quotient margin were calculated using BMDL10 and TDI values. Monte Carlo simulation evaluated human health risks from OTA in infant formula and cereal-based foods. A global study from 14 countries shows varying levels, surpassing EU limits in Tunisia, Ecuador, the USA, and generally in Africa, notably in infant cereals, which had higher levels than formula. Globally, OTA was present in 29.3% of the 3348 samples analyzed, with Lebanon at 95.2% and Brazil at 0%. Analysis indicates only non-carcinogenic risk for infants. While health risks for infants are mostly low, ongoing research and monitoring are vital to minimize OTA exposure in infant food.

Keywords:

• Ochratoxin A
• infant formula
• cereal-based food
• human health risk assessment
• Monte Carlo simulation
• mycotoxin

Acknowledgments

The authors extends the appreciation to the Deanship of Postgraduate Studies and Scientific Research at Majmaah University for funding this research work through the project number (R-2024-1195).

Author contribution

MSA: conceptualization, investigation, writing the original draft. YAA and YA: data curation, methodology, validation, writing—review and editing. RAS: investigation, formal analysis, validation, writing, and supervising the implementation of the study. SA, YAA: validation, software, investigation, writing, reviewing. YSA and RKA: data curation, writing reviewing and editing.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data analyzed during this study are available within the study.