First Total Diet Study of Aflatoxins in Singapore: Exposure Risk, High-Risk Foods, and Public Health Implications.

Dietary exposure of Singapore population to foodborne and natural toxins was estimated through Total Diet Study (TDS) approach. Among the common mycotoxins and plant toxins studied, such as aflatoxins, ochratoxin A, zearalenone, deoxynivalenol, and fumonisins, aflatoxins were identified with food safety concerns. Aflatoxin occurrence was determined in 642 commonly consumed foods, with a detection rate of 4%, and a mean concentration of 0.01-0.07 µg/kg. Dietary exposure and risk assessment of aflatoxins for the general population revealed a mean estimated daily intake (EDI) of 0.0002-0.002 ng/kg bw/day, a margin of exposure (MOE) of 2819-7101, cancer risk of 0.002-0.004 additional cases per 100,000 person per year, and a hazard quotient (HQ) of 0.19-0.20. Despite the low overall estimated exposure risk for the general population, elevated exposure was observed among the eaters-only group, with the highest upper-bound (UB) exposure reaching 3.4 ng/kg bw/day for high consumers (95th percentile) of satay sauce, a popular Asian delicacy. The corresponding cancer risk of 0.23 additional cases per 100,000 individuals, or 14 additional cases annually, contributes to an estimation of 1% of the 1442 liver cancer cases reported in Singapore in 2022. These findings highlight the importance of continuous monitoring and call for appropriate mitigation strategies for further reduction in aflatoxin exposure in the Singapore population.