Dietary exposure to mycotoxins and health risk assessment in the second

French total diet study

Vronique Sirot

, Jean-Marc Fremy, Jean-Charles Leblanc

French Agency for Food, Environmental and Occupational Health Safety (ANSES, Agence nationale de scurit sanitaire de lalimentation, de lenvironnement et du travail),
27 avenue du Gnral Leclerc, F-94701 Maisons-Alfort, France
a r t i c l e i n f o
Article history:
Received 29 August 2012
Accepted 25 October 2012
Available online 5 November 2012
Keywords:
Total diet study
Mycotoxins
Exposure
Food
a b s t r a c t
Mycotoxins are produced in plants by micro-fungi species, and naturally contaminated the food chain. In
the second French total diet study (TDS), mycotoxins were analyzed in 577 food samples collected in
mainland France to be representative of the population diet and prepared hhas consumedii. Highest mean
concentrations were found in wheat and cereal-based products (bread, breakfast cereals, pasta, pastries,
pizzas and savoury pastries. . .). Exposure of adult and child populations was assessed by combining
national consumption data with analytical results, using lowerbound (LB) and upperbound (UB) assump-
tions for left-censorship management. Individual exposures were compared with available health-based
guidance values (HBGV). Only the exposure to deoxynivalenol (DON) and its acetylated derivatives was
found to signicantly exceed the HBGV in LB in adults (0.5% [0.1; 0.8]) and children (5% [4; 6]). HBGV was
exceeded in UB only for T-2 and HT-2 toxins by, respectively, 0.2% [0.02; 0.05] and 4% [3; 5] of adults, and
11% [9; 12] and 35% [32; 37] of children. Although the exposures assessed were generally lower than the
previous French TDS, the results indicated a health concern for trichothecenes and a need to reduce die-
tary exposure as well as analytical limits.
2012 Elsevier Ltd. All rights reserved.
1. Introduction
Mycotoxins are secondary metabolites produced by lamentous
micro-fungi species belonging to various genera such as Aspergillus,
Penicillium, Fusarium and Byssochlamys, and that are capable of
causing disease and death in humans and animals (Bennett and
Klich, 2003; Richard, 2007). Mycotoxins are produced in plants
(wheat, maize, rice, beans, oily seeds, dried fruits, nuts, grape,
etc.), in the elds or during storage if the conditions are favorable
for the growth of fungi (Richard, 2007). The production of myco-
toxins depends on the strain of fungus, the substrate, and on the
temperature and humidity conditions (Bennett and Klich, 2003).
Infestation or growing of the fungi is more likely to occur on dam-
aged plants or with lesions. Mycotoxins are usually thermostable
during baking and other thermal processes (Deshpande, 2002;
Scudamore et al., 2003; Turner et al., 2009). They persist more or
less during the transformation of contaminated plants, depending
on the process, and are usually not eliminated during cooking
and sterilization. Due to their lipophilic properties and their ability
to bind with plasmatic proteins, mycotoxins can persist in organ-
isms when the exposure is chronic or repeated. Animals, which
may be fed with contaminated feed of vegetable origin, may be
chronically exposed to mycotoxins. Due to transfer and metabo-
lism, animal products such as milk or offal can be contaminated.
The toxicity of mycotoxins differs depending on the kind of tox-
in, and it was observed in animals that it was related to the species,
the dose ingested, the duration of the exposure, and their sex and
age. Aatoxins (AFs), in particular aatoxin B1 (AFB1), the major
form mostly occurring, are considered as the most strong natural
genotoxic carcinogen (Squire, 1981). Experimental data showed
that AFB1 carcinogenicity could be considered as 10 fold higher
than aatoxin M1 (AFM1) carcinogenicity. Of note, AFM1 is a
hydroxylated metabolite of AFB1 found in milk of animals that
have been exposed to AFB1, and then in dairy products (Allcroft
and Carnaghan, 1963). The International Agency for Research on
Cancer (IARC) classied AFB1 in group 1: carcinogenic to humans
0278-6915/$ - see front matter 2012 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.fct.2012.10.036
Abbreviations: 3-Ac-DON, 3-Acetyldeoxynivalenol; 15-Ac-DON, 15-Acety-
ldeoxynivalenol; a-ZAL, alpha-zearalanol; b-ZAL, beta-zearalanol; a-ZOL, alpha-
zearalenol; b-ZOL, beta-zearalenol; AF, aatoxin; AFB1, aatoxin B1; AFB2, aatoxin
B2; AFG1, aatoxin G1; AFG2, aatoxin G2; AFM1, aatoxin M1; BW, body weight;
DON, deoxynivalenol; EFSA, European Food Safety Authority; FB, fumonisin; HBGV,
health-based guidance value; IARC, International Agency for Research on Cancer;
INCA, French individual national consumption survey; JECFA, Joint FAO/WHO
Expert Committee on Food Additives; LOD, limit of detection; LOQ, limit of
quantication; NIV, nivalenol; NOAEL, no-observed-adverse-effect level; OTA,
ochratoxin A; OTB, ochratoxin B; PAT, patulin; PTMDI, provisional maximum
tolerable daily intake; PTWI, provisional tolerable weekly intake; SCF, Scientic
Committee on Food; TCT, trichothecene; TDI, tolerable daily intake; TDS, total diet
study; ZEA, zearalenone.

Corresponding author. Tel.: +33 1 49 77 38 07; fax: +33 1 49 77 38 92.

E-mail addresses: sirotv@gmail.com, veronique.sirot@anses.fr (V. Sirot).
Food and Chemical Toxicology 52 (2013) 111
Contents lists available at SciVerse ScienceDirect
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j our nal homepage: www. el sevi er . com/ l ocat e/ f oodchemt ox
(IARC, 1993). Based on epidemiological data in human, the Joint
FAO/WHO Expert Committee on Food Additives (JECFA) calculated
for European adults a risk per unit dose of 0.01310
5
(ng/kg bw/
day)
1
, i.e. an increase in the incidence of cancer in the general
population of 0.013 cancers per year per 100,000 subjects per ng
AFs per kg body weight per day during life-years, or 13 cancers
per 100 million people (JECFA, 1998). AFM1 was classied in group
2B by IARC: possibly carcinogenic to humans (IARC, 1993), as
well as ochratoxin A (OTA) and fumonisins B1 and B2 (FB1, FB2)
(IARC, 2002). Nevertheless, the JECFA proposed a provisional max-
imum tolerable daily intake (PMTDI) of 2 lg/kg bw/day for fumon-
isins alone or combined, based on the nephrotoxic effects observed
in rats (JECFA, 2001). In human, OTA has also been associated with
Balkan endemic nephropathy (Tatu et al., 1998), and could be asso-
ciated with immunotoxic and neurotoxic effects (EFSA, 2006). In
2007, the JECFA conrmed in 2007 the provisional tolerable weekly
intake (PTWI) of 100 ng/kg bw/week proposed in 1995 based on
early nephrotoxic effects in pigs (JECFA, 1996, 2007). However,
based on the same effects, the European Food Safety Authority
(EFSA) proposed in 2006 a PTWI of 120 ng/kg bw/week (EFSA,
2006), and conrmed it in 2010 based on new data (EFSA, 2010b).
Some other mycotoxins were considered by IARC as not classi-
able as to its carcinogenicity to humans (group 3); it is the case
for patulin (PAT) (IARC, 1986), some zearalenone (ZEA) metabolites
(IARC, 1993), some trichothecenes (TCTs), in particular T-2 toxin,
nivalenol (NIV), and deoxynivalenol (DON) (IARC, 1993). For those
mycotoxins, other chronic toxicological effects than carcinogenic-
ity have been reported. PAT has been shown to be cytotoxic and
genotoxic. In 1995, the JECFA proposed a PMTDI of 0.4 lg/kg bw/
day based on a study on rats (JECFA, 1995). This value was con-
rmed by the Scientic Committee on Food (SCF) in 1996 and
2000 (SCF, 1996, 2000a).
TCTs from type A, including T-2 and HT-2 toxins, induce hema-
tological modications in animal, immunotoxic and reprotoxic ef-
fects including, notably, inhibition of hormonal production,
malformations of newborns, and fetus mortality. In 2001, the JECFA
proposed a PMTDI of 60 ng/kg bw/day for T-2 toxin and HT-2 toxin,
alone or combined, based on immunotoxic and hematotoxic effects
in pigs (JECFA, 2001), and this value was conrmed by the SCF (SCF,
2002). Using a benchmark dose analysis the EFSA established a
group TDI of 100 ng/kg bw for the sum T-2 + HT-2 toxins (EFSA,
2011b). In animal, DON could be immunotoxic and hematotoxic.
In 2010, the JECFA considered the toxicity of the acetylated deriva-
tives (3-Acetyldeoxynivalenol (3-Ac-DON) and 15-Acetyldeoxyni-
valenol (15-Ac-DON)) equal to that of DON and extended the
previous PTMDI of 1 lg/kg bw/day (EFSA, 2007; JECFA, 2001; SCF,
2002) to a group PTMDI for the three compounds (JECFA, 2010).
For NIV, the SCF established a TDI of 0.7 lg/kg bw/day based on
immunotoxic and hematotoxic effects observed in mice (SCF, 2002).
ZEA may have an estrogenic activity and induce troubles of the
reproduction function: lower fertility, fetal wastage, and lower
hormone levels. The JECFA established a group PMTDI of 0.5 lg/
kg bw/day for ZEA, based on the hormonal effects on saws (JECFA,
2000) but the SCF proposed a lower provisional tolerable daily in-
take (TDI) of 0.2 lg ZEA/kg bw/day based on a study on pig (SCF,
2000b). In 2011, the EFSA proposed a new TDI of of 0.25 lg/
kg bw/day based on more recent data on pig, but also taking into
account comparisons between pigs and humans (EFSA, 2011c).
Performed in several countries using a standardized method rec-
ommended by international bodies (EFSA, 2011a; WHO, 2005,
2006), the total diet studies (TDS) aim at providing contamination
data on food prepared as consumed by the population and exposure
data, in order to help the risk manager in making public health deci-
sions. In 20012005, the National Institute of Agricultural Research
(INRA) implemented, in collaboration with the French Food Safety
Agency (AFSSA), the rst French TDS including mycotoxins (Leblanc
et al., 2005). In 20062010, the French Agency for Food, Environ-
mental and Occupational Health Safety (ANSES, formerly AFSSA)
conducted the second French TDS, also covering mycotoxins. This
article aims at presenting the results of the exposure to some myco-
toxins of the general French population, and evaluating the risk
with regards to the international health-based guidance values.
2. Material and method
2.1. Consumption data and food sampling
First, foods representative of the diet of the French population were selected
from the second national individual dietary consumption survey (INCA2), carried
out in 20062007 and implemented through a period of 11 months. The sample
of 1918 adults aged 1879 years and 1444 children aged 317 years was represen-
tative of the French population through stratication (Dubuisson et al., 2010; Du-
four et al., 2008). Subjects completed a 7-day food record diary (consecutive
days) as well as other questionnaires on anthropometrical and socio-economical
factors. Portion sizes were estimate through photographs compiled in a manual
adapted from the SuViMax picture booklet (Hercberg et al., 1994). Food records
were subsequently coded into 1280 food items.
Core foods were selected on the basis of two criteria: (i) the most consumed
foods in terms of quantity by adults and/or children with at least 5% of consumer
rate, and (ii) the main known or supposed contributors to the exposure, if they were
not selected by the rst criterion. The methodology was already described in the lit-
erature (Sirot et al., 2009). Two hundred and twelve core foods were selected from
the consumption survey, covering 8889% of the adult and child diet. The whole list
of foods included in the TDS can be found in Sirot et al. (2009).
The food sample collection (n = 1319) was performed in eight great metropoli-
tan regions corresponding to the INCA2 regions. In order to be as representative as
possible of the French food consumption habits, each food sample was composed of
up to 15 subsamples of equal weight of the same food, taking account of the market
shares, origin or species, conditioning and packaging, avoring if any, etc. (Sirot
et al., 2009). Samples were prepared as consumed by the population (i.e. peeled,
cooked, etc.) according to the cooking habits recorded in the INCA2 survey.
2.2. Analysis of food samples
Samples of foods which were known or supposed to contribute to the exposure
to mycotoxins (n = 577) were analyzed for 25 mycotoxins: AFB1, AFB2, AFG1, AFG2
and AFM1, OTA, OTB, PAT and some Fusarium toxins: TCTs from type A (T-2 toxin,
HT-2 toxin) and type B (NIV, DON, 3-Ac-DON, 15-Ac-DON), zearalenone and its
metabolites (a-ZAL, b-ZAL a-ZOL and b-ZOL), and fumonisins B1 and B2. Based on
available data from literature, on the expertise of analysts specialized in the routine
analysis of raw and processed food products and on monitoring program reports,
the above listed mycotoxins and their metabolites can occur only in certain types
of food products. For this reason, it was not necessary to consider all types of col-
lected food products on the list for all listed mycotoxin determination. The occur-
rence of some mycotoxin metabolites such as AFM1 was also considered in food
from animal origin. The analyses were carried out by the Laboratory of Develop-
ment and Analysis located in Ploufragan, F-22440 (LDA22), under accreditation
and quality assurance conditions according to the standard NF EN ISO/CEI 17025
v2005. Series of tests were performed during each analysis: concentrations of stock
solutions were checked using spectrophotometry, calibration curves were drawn
for each series of analyses, spiked samples were used to calculate the performance
parameters for each group of food products corresponding to the specic method
(Table 1). Recovery rates were calculated for each type of food products and each
assay series. Every analytical result was corrected according to the recovery rate.
However results with a recovery rate below 60 or above 120% were considered as
being outside of the acceptable analytical performance parameter range and conse-
quently were not used for exposure assessment calculation. LDA22 is accredited by
the French Accreditation Committee COFRAC for the program 99.1 Mycotoxins.
The standard NF EN 12 955 (AFNOR, 1999) was used for the detection and
determination of AFB and G. Briey this analytical technique consists of an extrac-
tion by using water + methanol solvent mixture (or methanol for fatty products), a
clean-up step by using an immuno-afnity column containing anti-AF antibodies).
The puried extract is injected to a reversed phase Liquid Chromatography followed
by a derivatization system and uorescence detector (IACLCFD). The standard NF
EN ISO 14 501 (AFNOR, 2007) was used for the detection and determination of
AFM1 in milk. Briey this analytical technique consists of a combined extraction
and clean-up step of defatted liquid milk sample by using an immuno-afnity col-
umn (containing anti-AF antibodies). The puried extract is injected to a reversed
phase Liquid Chromatography followed by a uorescence detector (IACLCFD).
An in-house validated method was performed for the detection and determination
of AFM1 in cheeses, butter, pork and poultry products. Briey this analytical tech-
nique consists of an extraction by using methyl chloride and clean-up step by using
an immuno-afnity column (containing anti-AF antibodies). The puried extract is
injected to a reversed phase Liquid Chromatography followed by a uorescence
detector (IACLCFD).
2 V. Sirot et al. / Food and Chemical Toxicology 52 (2013) 111
Detection and determination of the other considered mycotoxins were per-
formed by using an in-house validated multi-compound method. Briey, this tech-
nique involves an extraction by using actonitrile + water solvent mixture for dry
food products or acetonitrile for liquid food products, followed by a centrifugation;
then samples were evaporated until dryness. The dry residue was dissolved by ace-
tic acid + methanol mixture; and after a ltration, the sample residue was submit-
ted to Liquid Chromatography coupled with Mass Spectrometry (LC-MS/MS). This
technique was used for the following mycotoxins in the following food product
groups: (i) FB1 et FB2 in breakfast cereals; (ii) OTA in bread, breakfast cereals, pasta,
rice, semolina, other cereals, pastries, biscuits, pastries, pork and poultry products,
fruits, dry fruits, nuts, chocolate, alcoholic, beverages coffee, hot beverages, pizzas-
quiches, sandwiches; (iii) PAT in pastries, fruits, fruits puree, sodas; (iv) considered
and above listed TCTs A et B in bread, breakfast cereals, pasta, rice, semolina, other
cereals, pastries, biscuits, pastries, pork and poultry products, fruits, dry fruits, nuts,
pizzas, quiches, sandwiches; (v) ZEA in bread, breakfast cereals, pasta, rice, semo-
lina, other cereals, pastries, biscuits, pastries, pork and poultry products including
eggs and ovoproducts, fruits, sodas, pizzas, quiches, sandwiches.
Left-censored data (results reported below LOD and/or LOQ) management was
done by substitution (EFSA, 2010a; GEMS-Food Euro, 1995). Two scenarios were
considered: (i) the lowerbound (LB) approach by replacing the results below LOD
by zero and results below LOQ by LOD; (ii) the upperbound (UB) approach by
replacing the results below LOD by LOD and results below LOQ by LOQ.
2.3. Exposure assessment
The exposure of the population to mycotoxins was assessed by combining the
national consumption data (INCA2) with the contamination data from the analyses.
The exposure was assessed individually, using individual consumption data and
body weight (bw) of each consumer according to the following formula:
E
i;j

P
n
k1
C
i;k
L
k;j
BW
i
where E
i,j
is the exposure to the contaminant j for the subject i, C
i,k
is the consump-
tion level of the food k by the subject i (k = 1 to N), L
k,j
is the level of contaminant j in
the food k, BW
i
is the body weight of the subject i. Each food consumed by a subject
was assigned the mean contamination level calculated of the samples from its re-
gion, or, if the food was not sampled in the region, the average of the levels from
all regions sampled. Mean exposure as well as 95th percentile (P95) were then cal-
culated for adults (1879 years old) and children (317 years old).
The individual exposure to each mycotoxin was compared with the health-
based guidance value (TDI, PMTDI, or PTWI), and the population rate exceeding
the health-based guidance value was calculated for adults and children, with the
95% condence interval. The selection of health-based guidance values for risk char-
acterization of each substance has been validated by ANSES Expert Committee on
Contaminants in food. Interpretation and recommendations were proposed as well
as follow-up actions when needed.
Concerning AFs, it has been shown that hepatitis signicantly increases the risk
of liver cancer associated with aatoxin intake. The JECFA showed that the general
incidence could be calculated based on a combination of incidences observed in
people presenting or not the hepatitis B surface antigen, i.e. HBsAg + and HBsAg-
people: respectively, 0.3 and 0.01 cancer/year for 100,000 people per ng aatoxin/
kg bw/day (JECFA, 1998). In France, the rate of HBsAg
+
individuals has been as-
sessed to be around 1% (INVS, 2005). Then, the general incidence was assessed to
be 0.013 cancer/year (0.3 1% + 0.01 99%) for 100,000 people per ng aatoxin/
kg bw/day. The theoretical prevalence of liver cancer attributable to AFs was calcu-
lated based on those data and demographic data of the French population (i.e. based
on 47.3 millions of adults in 2010 (www.insee.fr), by multiplying this general prev-
alence by the exposure (in ng aatoxin/kg bw/day).
Indeed, as carcinogenic potency of aatoxins is enhanced in individuals with
simultaneous hepatitis B infection, carcinogenic potency of aatoxin B1 is esti-
mated in the presence and absence of hepatitis B surface antigen in the serum,
which is an indicator of infection with the virus (JECFA, 1998). As this kind of cancer
mainly occurs after 50 years old and as epidemiological studies were only per-
formed in adults, the calculation was done for adults only.
In the present article, the results focused only on mycotoxins for which a
health-based guidance value was available for the risk assessment, i.e. AFs from
groups B, G, and M1, OTA, PAT, T-2 toxin, HT-2 toxin, NIV, DON, ZEA, FB1 and FB2.
3. Results
Details on mean occurrence data on mycotoxins found in food
are presented in Table 2. The results showed a high proportion of
censored data (mycotoxin that has not been detected or quanti-
ed): from 55% (DON) to 100% (AFs B2, G1, G2 and M1, T-2 and
HT-2 toxins, 3-Ac-DON, PAT). More specically, patulin was de-
tected in samples containing apple only, and AFs have been de-
tected in dark chocolate samples only. Cereal-based products
appeared to be the most often contaminated products in LB; for
example biscuits for ZEA (3 lg/kg) and FBs (35 lg FB1/kg and
75 lg FB2/kg), bread and bread products for OTA (0.13 lg/kg)
and DON (132 lg/kg), pasta for OTA (0.10 lg/kg), pizza/savoury
pastries and hamburgers for DON (101 and 83 lg/kg, respectively).
Rice and wheat appeared to present highest levels for NIV (18.3 lg/
kg) and T-2 toxin (2 lg/kg). Chocolate also appeared to be a vector
of ZEA (1.55 lg/kg) and AFB1 (>0.03 lg/kg).
The exposures of the adult and child populations are presented
in the Tables 3 and 4. Only the foods contributing to the exposure
are presented in the tables. As a result from the contamination lev-
Table 1
Performance parameters according to mycotoxins and food products.
Toxins Food products Method LOD (lg/kg) LOQ (lg/kg) Uncertainty at LOQ (%)
Aatoxins Food products based on Cereals IACLCFD
B1 0.05 0.2 15
B2 0.05 0.2 15
G1 0.05 0.2 20
G2 0.05 0.2 30
M1 Liquid milk IACLCFD 0.001 0.005 20
Dairy products IACLCFD 0.01 0.05 25
Fumonisins Breakfast cereals LCMS/MS
B1 10 20 15
B2 10 20 30
Ochratoxin A Solid food products
a
LCMS/MS 0.02 0.5
Beverages
b
LCMS/MS 0.01 0.05 20
Patulin Solid food products
c
LCMS/MS 6 20 10
Beverages
d
LCMS/MS 3 10 10
Trichothecens Solid food products
e
LCMS/MS 3 10 20
Zearalenone Solid food products
f
LCMS/MS 1.5 5 10
Beverages
g
LCMS/MS 0.15 0.5 15
a
Bread, breakfast cereals, pasta, rice, semolina, other cereals, pastries, biscuits, pastries, pork and poultry products, fruits, dry fruits, nuts,chocolate, pizzas-quiches,
sandwiches.
b
Alcoholic, beverages coffee, hot beverages.
c
Pastries, fruits, fruits puree.
d
Fruit juices, sodas.
e
Bread, breakfast cereals, pasta, rice, semolina, other cereals, pastries, biscuits, pastries, pork and poultry products, fruits, dry fruits, nuts, pizzas, quiches, sandwiches.
f
Bread, breakfast cereals, pasta, rice, semolina, other cereals, pastries, biscuits, pastries, pork and poultry products including eggs and ovoproducts,fruits,pizzas, quiches,
sandwiches.
g
Sodas.
V. Sirot et al. / Food and Chemical Toxicology 52 (2013) 111 3
els, only the chocolate appeared to contribute to the mean LB expo-
sure to aatoxins, and especially AFB1 and AFG2 (2080%). In
adults, fruits appeared to be the main contributor to the mean
PAT exposure (4550%), followed by mashed and cooked fruit
(38% in LB). In children, non-alcoholic beverages were the main
contributor to PAT (about 40% whatever the hypothesis), followed
by mashed and cooked fruit (47% in LB). In adults as in children,
bread and bread products appeared to be the main contributor to
the mean exposure to OTA (20% and 80%, respectively), DON
(60% and 40%, respectively in LB), NIV (20% and 50%, respectively),
ZEA (41% and 20%, respectively), and FB1 for adults only (36%).
Mean exposure to the sum of AFs was estimated at 0.0019 ng/kg
bw/day in adults (P95 = 0.012) and 0.0013 ng/kg bw/day in chil-
dren (P95 = 0.008). In UB, mean exposure was 0.89 ng/kg bw/day
in adults (P95 = 1.54) and 1.56 in children (P95 = 2.96) (data not
shown). Considering that AFM1 is 10 times less toxic than the
other AFs and using the mean exposure to the AF sum, the number
of excess cancer cases in adults was assessed at 0.00002 per
100,000 persons/year under LB and at 0.011 per 100,000 persons/
year under UB, corresponding, in the whole adult population, to
0.01 and 5.2, respectively (data not shown).
Whatever the hypothesis (LB or UB), nobody exceeded the low-
est health-based guidance value dened for PAT, OTA, NIV, ZEA,
and FB1 and FB2, considered separately or combined (Table 5).
The P95 of exposure represented at the most less than 50% of the
health-based guidance value (50% in children for OTA and ZEA).
Health-based guidance values were exceeded for some TCTs only.
More precisely, in UB only, 0.2% of adults IC
95%
= [0.02; 0.5] and
Table 2
Estimation of the mean levels of mycotoxins (lg/kg fresh weight) in food groups.
N
*
AFB1 AFB1 AFB2 AFG1 AFG2 AFM1 OTA OTA PAT PAT FB1 FB1 FB2 FB2
LB UB UB UB UB UB LB UB LB UB LB UB LB UB
Bread and dried bread products 14 0 0.05 0.05 0.05 0.05 0.129 0.393 1.4 5.4 0.3 3.1
Breakfast cereals 6 0 0.05 0.05 0.05 0.05 0.033 0.25 8 13.3 1.7 8.7
Pasta 4 0 0.05 0.05 0.05 0.05 0.1 0.35
Rice and wheat products 6 0 0.05 0.05 0.05 0.05 0.067 0.3
Croissant-like pastries 6 0 0.05 0.05 0.05 0.05 0 0.2
Sweet or savoury biscuits and bars 8 0 0.05 0.05 0.05 0.05 0 0.2 35 36.5 75 75
Pastries and cakes 18 0 0.05 0.05 0.05 0.05 0 0.2 0 6
Milk 38 0.001
Ultra-fresh dairy products 14 0.01
Cheese 17 0.01
Eggs and egg products 31 0 0.05 0.05 0.05 0.05
Butter 3 0.01
Poultry and game 36 0 0.05 0.05 0.05 0.05 0.01 0 0.2
Offal 13 0 0.05 0.05 0.05 0.05 0.01 0 0.2
Delicatessen meats 80 0 0.05 0.05 0.05 0.05 0.01 0.047 0.253
Vegetables (excluding potatoes) 17 0 0.05 0.05 0.05 0.05 0 0.2
Fruit 39 0 0.2 0.042 6.097
Dried fruits, nuts and seeds 2 0 0.05 0.05 0.05 0.05 0 0.2
Chocolate 10 0.03 0.075 0.05 0.05 0.05 0.01 0 0.2
Non-alcoholic beverages 25 0.002 0.016 0.115 3.654 1.1 4.7 0.2 2.7
Alcoholic beverages 6 0.017 0.025 0.3 3.3 0 2
Coffee 30 0 0.01
Other hot beverages 23 0.001 0 0.01
Pizzas, quiches and savoury pastries 4 0 0.2
Sandwiches and snacks 28 0.013 0.219
Mixed dishes 65 0.018 0.227
Dairy-based desserts 28 0 0.2
Compotes and cooked fruit 6 1 8.333
DON DON Ac-3-DON Ac-3-DON Ac-15-DON Ac-15-DON Niv Niv T-2 T-2 HT-2 HT-2 ZEA ZEA
LB UB LB UB LB UB LB UB LB UB LB UB LB UB
Bread and dried bread products 132.1 132.1 0.2 3.5 0 3 2.6 6.4 0.4 4 2.1 8 1.5 5
Breakfast cereals 8.5 10.8 0 3 0.5 4.2 1.5 6.5 1 5.3 1 5.3 1.3 4.4
Pasta 56.3 56.3 0 3 0 3 6.5 10 0.8 4.75 3 10 1.1 4.1
Rice and wheat products 57.5 58.5 0 3 0 3 18.3 19.3 2 7.7 2 7.7 0.8 3.3
Croissant-like pastries 73.3 73.3 0 3 0 3 0 3 0 3 0.5 4.2 1.5 5
Sweet or savoury biscuits and bars 58.4 61.9 0 3 1.9 4.5 1.9 4.5 1.1 5.6 1.5 6.5 3 5.8
Pastries and cakes 54.2 55.0 0 3 0 3 0 3 0 3 0.5 4.2 1.3 4.6
Eggs and egg products 0 1.5
Poultry and game 0 1.5
Offal 0 3 0 3 0 3 0 3 0 3 0 3 0 1.5
Delicatessen meats 0.2 3.4 0 3 0 3 0 3 0 3 0 3 0 1.5
Vegetables (excluding potatoes) 1.5 6 0 3 0.1 3.3 0 3 0 3 0 3 0.4 2.4
Fruit 0 1.5
Dried fruits, nuts and seeds 0 3 0 3 0 3 1.5 6.5 0 3 3 10
Chocolate 1.55 4.1
Non-alcoholic beverages 0.0 0.2
Other hot beverages 0.1 0.4
Pizzas, quiches and savoury pastries 101.3 101.3 0 3 0 3 0 3 0.75 4.75 0 3 1.5 5
Sandwiches and snacks 83.0 83.0 0 3 0 3 5.1 7.6 0.2 3.4 0 3 0.6 3.0
Mixed dishes 20.7 23.4 0 3 0 3 7.7 10.6 0.1 3.2 0.2 3.4 0.3 2.3
Dairy-based desserts 4.4 7.7 0 3 0 3 0.0 3.1 0.1 3.1 0.2 3.4 0.7 3.1
Compotes and cooked fruit 0.75 3.25
*
Number of food composite samples (composed by 15 sub-samples).
4 V. Sirot et al. / Food and Chemical Toxicology 52 (2013) 111
Table 3
Estimation of the French adult exposure (mean and 95th percentile) to mycotoxins (ng/kg bw/day).
AFB1 AFB2 AFG1 AFG2 AFM1 OTA PAT
Mean P95 Mean P95 Mean P95 Mean P95 Mean P95 Mean P95 Mean P95
LB UB LB UB UB UB UB UB UB UB UB UB LB UB LB UB LB UB LB UB
Bread and dried bread products 0 0.080 0 0.188 0.080 0.188 0.080 0.188 0.080 0.188 0.172 0.580 0.395 1.325
Breakfast cereals 0 0.003 0 0.063 0.003 0.063 0.003 0.063 0.003 0.063 0.003 0.014 0.100 0.384
Pasta 0 0.028 0 0.088 0.028 0.088 0.028 0.088 0.028 0.088 0.006 0.120 0.067 0.410
Rice and wheat products 0 0.018 0 0.077 0.018 0.077 0.018 0.077 0.018 0.077 0.007 0.084 0.078 0.385
Croissant-like pastries 0 0.007 0 0.054 0.007 0.054 0.007 0.054 0.007 0.054 0 0.030 0 0.217
Sweet or savoury biscuits and bars 0 0.006 0 0.041 0.006 0.041 0.006 0.041 0.006 0.041 0 0.022 0 0.165 0 0.05 0 3.17
Pastries and cakes 0 0.022 0 0.083 0.022 0.083 0.022 0.083 0.022 0.083 0 0.087 0 0.332 0 2.62 0 9.96
Milk 0.001 0.007
Ultra-fresh dairy products 0.012 0.037
Cheese 0.004 0.011
Eggs and egg products 0 0.011 0 0.040 0.011 0.040 0.011 0.040 0.011 0.040
Butter 0.002 0.005
Poultry and game 0 0.020 0 0.076 0.020 0.076 0.020 0.076 0.020 0.076 0.004 0.015 0 0.079 0 0.305
Offal 0 0.001 0 0.025 0.001 0.025 0.001 0.025 0.001 0.025 0.000 0.005 0 0.004 0 0.102
Delicatessen meats 0 0.020 0 0.057 0.020 0.057 0.020 0.057 0.020 0.057 0.003 0.010 0.017 0.099 0.067 0.273
Vegetables (excluding potatoes) 0 0.001 0 0.029 0.001 0.029 0.001 0.029 0.001 0.029 0 0.024 0 0.204
Fruit 0 0.326 0 1.114 0.28 10.59 1.84 36.5
Dried fruits, nuts and seeds 0 0.001 0 0.022 0.001 0.022 0.001 0.022 0.001 0.022 0 0.003 0 0.088
Chocolate 0.0019 0.005 0.022 0.039 0.004 0.033 0.004 0.033 0.004 0.033 0.001 0.007 0 0.015 0 0.132
Non-alcoholic beverages 0.001 0.020 0.003 0.105 0.08 5.66 0.78 30.6
Alcoholic beverages 0.065 0.077 0.335 0.372
Coffee 0 0.033 0 0.120
Other hot beverages 0.000 0.003 0 0.020 0 0.135
Pizzas, quiches and savoury pastries 0 0.052 0 0.314
Sandwiches and snacks 0.003 0.043 0.066 0.447
Mixed dishes 0.006 0.120 0.069 0.531
Dairy-based desserts 0 0.063 0 0.375
Compotes and cooked fruit 0.24 1.58 3.36 15.7
Total 0.002 0.22 0.01 0.39 0.2 0.3 0.2 0.3 0.2 0.3 0.03 0.05 0.28 1.92 0.61 3.23 0.63 21.2 3.21 50.5
DON Ac-3-DON Ac-15-DON NIV T-2 toxin HT-2 toxin
Mean P95 Mean P95 Mean P95 Mean P95 Mean P95 Mean P95
LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB
Bread and dried bread products 226.3 226.3 529.9 529.9 0.27 5.45 1.66 14.14 0 4.82 0 11.31 10.11 13.29 25.71 31.92 0.31 5.55 1.69 14.20 4.33 14.93 10.35 35.16
Breakfast cereals 0.5 0.6 13.6 13.6 0 0.16 0 3.75 0.02 0.21 0.69 4.84 0.08 0.34 1.88 8.13 0.06 0.30 1.84 8.13 0.06 0.30 1.84 8.13
Pasta 30.6 30.6 96.6 96.6 0 1.67 0 5.27 0 1.67 0 5.27 3.61 5.55 11.42 17.57 0.79 3.50 2.56 11.14 1.67 5.55 5.27 17.57
Rice and wheat products 5.7 6.6 50.1 52.0 0 1.10 0 4.59 0 1.10 0 4.59 1.88 2.80 17.23 19.57 0.19 1.53 1.53 7.35 0.19 1.53 1.53 7.35
Croissant-like pastries 11.6 11.6 84.4 84.4 0 0.44 0 3.25 0 0.44 0 3.25 0 0.44 0 3.25 0.00 0.45 0 3.25 0.04 0.53 0.56 4.00
Sweet or savoury biscuits and
bars
6.7 7.1 47.5 50.1 0 0.33 0 2.47 0.14 0.44 1.36 2.95 0.14 0.44 1.36 2.96 0.15 0.68 1.15 4.99 0.16 0.69 1.23 5.33
Pastries and cakes 38.2 38.5 156.7 156.7 0 1.31 0 4.98 0 1.31 0 4.98 0 1.31 0 4.98 0 1.31 0 4.98 0.60 2.71 3.01 11.38
Offal 0 0.1 0 1.5 0 0.06 0 1.53 0 0.06 0 1.53 0 0.06 0 1.53 0 0.06 0 1.53 0 0.06 0 1.53
Delicatessen meats 0.1 1.5 0.6 4.3 0 1.21 0 3.39 0 1.21 0 3.39 0 1.21 0 3.39 0 1.21 0 3.39 0 1.21 0 3.39
Vegetables (excluding potatoes) 0.2 0.8 1.9 7.1 0 0.37 0 3.06 0.00 0.37 0.06 3.06 0 0.37 0 3.06 0 0.37 0 3.06 0 0.37 0 3.06
Dried fruits, nuts and seeds 0 0.0 0 1.3 0 0.04 0 1.32 0 0.04 0 1.32 0.02 0.09 0.66 2.86 0 0.04 0 1.32 0.04 0.14 1.32 4.40
Pizzas, quiches and savoury
pastries
23.8 23.8 140.9 140.9 0 0.77 0 4.71 0 0.77 0 4.71 0 0.77 0 4.71 0.07 0.93 0.84 5.95 0 0.77 0 4.71
Sandwiches and snacks 16.1 16.1 178.0 178.0 0 0.58 0 5.32 0 0.58 0 5.32 0.95 1.43 14.73 16.59 0.07 0.74 1.37 7.23 0 0.58 0 5.32
Mixed dishes 12.1 13.4 63.7 66.0 0 1.66 0 7.59 0 1.66 0 7.59 3.47 5.04 26.33 29.68 0.11 1.92 1.34 9.56 0.07 1.82 0.99 9.06
(continued on next page)
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Table 3 (continued)
DON Ac-3-DON Ac-15-DON NIV T-2 toxin HT-2 toxin
Mean P95 Mean P95 Mean P95 Mean P95 Mean P95 Mean P95
LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB
Dairy-based desserts 1.1 2.0 16.3 19.4 0 0.94 0 5.62 0 0.94 0 5.62 0.01 0.97 0.09 5.83 0.03 1.02 0.54 6.63 0.01 0.97 0 6.25
Compotes and cooked fruit
Total 373 379 715 722 0.27 16.1 1.61 28.5 0.17 15.6 0.87 26.9 20.3 34.1 45.3 66.6 1.78 19.6 4.83 36.5 7.16 32.2 14.5 58.9
FB1 FB2 ZEA
Mean P95 Mean P95 Mean P95
LB UB LB UB LB UB LB UB LB UB LB UB
Bread and dried bread products 2.70 13.49 7.04 34.29 0.06 3.47 0.39 8.52 2.41 8.03 5.65 18.85
Breakfast cereals 0.32 0.64 8.57 15.63 0.08 0.42 1.68 9.64 0.07 0.24 1.88 6.25
Pasta 0.81 2.72 2.57 8.70
Rice and wheat products 0.06 0.70 0.56 3.42
Croissant-like pastries 0 0.00 0 1.20 0.22 0.74 1.62 5.41
Sweet or savoury biscuits and bars 2.63 2.79 26.06 26.13 1.41 1.41 19.48 19.48 0.29 0.64 1.92 4.44
Pastries and cakes 0.60 2.05 2.26 7.58
Eggs and egg products 0 0.32 0 1.21
Poultry and game 0 0.59 0 2.28
Offal 0 0.03 0 0.76
Delicatessen meats 0 0.60 0 1.70
Vegetables (excluding potatoes) 0.08 0.36 0.83 3.48
Fruit 0 2.48 0 8.36
Chocolate 0.14 0.31 1.16 2.19
Non-alcoholic beverages 1.34 6.65 7.50 31.23 0.88 6.88 5.78 34.00 0.01 0.29 0.13 1.56
Alcoholic beverages 0.45 5.42 3.49 28.57 0 3.62 0 17.07
Other hot beverages 0.02 0.35 0.18 2.20
Pizzas, quiches and savoury pastries 0.39 1.29 2.36 7.86
Sandwiches and snacks 0.15 0.65 1.75 6.42
Mixed dishes 0.15 1.18 1.05 5.47
Dairy-based desserts 0.33 1.25 2.17 8.14
Compotes and cooked fruit 0.16 0.63 1.85 7.02
Total 7.45 29.1 22.9 65.6 2.44 15.89 10.1 42.2 5.90 25.5 10.8 42.5
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Table 4
Estimation of the French child exposure (mean and 95th percentile) to mycotoxins (ng/kg bw/day).
AFB1 AFB2 AFG1 AFG2 AFM1 OTA PAT
Mean P95 Mean P95 Mean P95 Mean P95 Mean P95 Mean P95 P95 Mean P95
LB UB LB UB UB UB UB UB UB UB UB UB LB UB LB UB LB UB LB UB
Bread and dried bread products 0 0.076 0 0.198 0.076 0.198 0.076 0.198 0.076 0.198 0.169 0.559 0.412 1.400
Breakfast cereals 0 0.020 0 0.099 0.020 0.099 0.020 0.099 0.020 0.099 0.002 0.085 0.029 0.426
Pasta 0 0.063 0 0.179 0.063 0.179 0.063 0.179 0.063 0.179 0.009 0.266 0.086 0.767
Rice and wheat products 0 0.035 0 0.146 0.035 0.146 0.035 0.146 0.035 0.146 0.019 0.170 0.156 0.667
Croissant-like pastries 0 0.025 0 0.112 0.025 0.112 0.025 0.112 0.025 0.112 0 0.101 0 0.449
Sweet or savoury biscuits and bars 0 0.023 0 0.100 0.023 0.100 0.023 0.100 0.023 0.100 0 0.093 0 0.400 0 0.28 0 7.50
Pastries and cakes 0 0.050 0 0.171 0.050 0.171 0.050 0.171 0.050 0.171 0 0.198 0 0.686 0 5.94 0 20.57
Milk 0.006 0.019
Ultra-fresh dairy products 0.026 0.083
Cheese 0.005 0.017
Eggs and egg products 0 0.015 0 0.080 0.015 0.080 0.015 0.080 0.015 0.080
Butter 0.003 0.008
Poultry and game 0 0.027 0 0.095 0.027 0.095 0.027 0.095 0.027 0.095 0.005 0.019 0 0.110 0 0.379
Offal 0 0.001 0 0.036 0.001 0.036 0.001 0.036 0.001 0.036 0.000 0.007 0 0.003 0 0.143
Delicatessen meats 0 0.033 0 0.104 0.033 0.104 0.033 0.104 0.033 0.104 0.006 0.019 0.012 0.144 0.065 0.458
Vegetables (excluding potatoes) 0 0.003 0 0.048 0.003 0.048 0.003 0.048 0.003 0.048 0 0.037 0 0.321
Fruit 0 0.340 0 1.239 0.14 10.74 1.03 39.13
Dried fruits, nuts and seeds 0 0.000 0 0.047 0.000 0.047 0.000 0.047 0.000 0.047 0 0.002 0 0.188
Chocolate 0.0013 0.017 0.013 0.072 0.016 0.065 0.016 0.065 0.016 0.065 0.003 0.013 0 0.065 0 0.260
Non-alcoholic beverages 0.001 0.054 0.009 0.164 0.49 17.20 3.27 59.35
Alcoholic beverages 0.001 0.001 0.060 0.074
Coffee 0 0.001 0 0.058
Other hot beverages 0.000 0.004 0 0.007 0 0.058
Pizzas, quiches and savoury pastries 0 0.091 0 0.479
Sandwiches and snacks 0.004 0.060 0.070 0.431
Mixed dishes 0.009 0.250 0.082 0.904
Dairy-based desserts 0 0.187 0 0.932
Compotes and cooked fruit 0.57 4.70 5.64 33.33
Total 0.001 0.39 0.008 0.74 0.39 0.74 0.39 0.74 0.39 0.74 0.054 0.130 0.23 2.82 0.58 5.25 1.21 39.3 6.9 96.5
DON Ac-3-DON Ac-15-DON NIV T-2 toxin HT-2 toxin
Mean P95 Mean P95 Mean P95 Mean P95 Mean P95 Mean P95
LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB LB UB
Bread and dried bread products 219 219 573 573 0.11 4.84 0.82 12.63 0 4.59 0 11.90 9.78 12.94 26.28 33.76 0.15 4.93 0.95 12.63 4.18 14.34 10.90 37.25
Breakfast cereals 4.0 4.8 20.8 23.2 0 1.22 0 5.97 0.41 2.18 2.40 10.83 0.61 2.65 2.98 12.93 0.45 2.26 2.48 11.14 0.45 2.26 2.48 11.14
Pasta 69.4 69.4 199.0 199.0 0 3.78 0 10.71 0 3.78 0 10.71 8.19 12.60 23.21 35.71 1.82 8.03 5.36 23.21 3.78 12.60 10.71 35.71
Rice and wheat products 14.3 16.0 98.7 99.3 0 2.12 0 8.78 0 2.12 0 8.78 4.76 6.43 33.73 35.71 0.45 3.18 3.06 13.51 0.45 3.18 3.06 13.51
Croissant-like pastries 40.4 40.4 190.9 190.9 0 1.51 0 6.73 0 1.51 0 6.73 0 1.51 0 6.74 0 1.51 0 6.73 0.09 1.73 0.79 8.12
Sweet or savoury biscuits and bars 24.2 25.7 97.9 105.4 0 1.39 0 6.00 0.29 1.62 2.13 6.59 0.29 1.62 2.13 6.59 0.58 2.73 2.67 12.22 0.64 2.89 2.84 12.41
Pastries and cakes 70.7 71.4 273.1 274.1 0 2.97 0 10.29 0 2.97 0 10.29 0 2.97 0 10.29 0 2.97 0 10.29 0.69 4.58 4.31 17.14
Offal 0.0 0.0 0.0 2.1 0 0.04 0 2.14 0 0.04 0 2.14 0 0.04 0 2.14 0 0.04 0 2.14 0 0.04 0 2.14
Delicatessen meats 0.1 2.2 0.7 6.7 0 1.96 0 6.22 0 1.96 0 6.22 0 1.96 0 6.22 0 1.96 0 6.22 0 1.96 0 6.22
Vegetables (excluding potatoes) 0.3 1.1 2.7 9.1 0 0.55 0 4.82 0.01 0.57 0.13 5.15 0 0.55 0 4.82 0 0.55 0 4.82 0 0.55 0 4.82
Fruit
Dried fruits, nuts and seeds 0.0 0.0 0.0 2.8 0 0.03 0 2.83 0 0.03 0 2.83 0.01 0.06 1.41 6.13 0 0.03 0 2.83 0.03 0.09 2.83 9.43
Pizzas, quiches and savoury pastries 42.1 42.1 223.2 223.2 0 1.37 0 7.18 0 1.37 0 7.18 0 1.37 0 7.18 0.12 1.65 1.13 8.38 0 1.37 0 7.18
Sandwiches and snacks 22.4 22.4 190.5 190.5 0 0.82 0 5.61 0 0.82 0 5.61 1.11 1.85 15.44 18.67 0.07 0.98 1.39 8.05 0 0.82 0 5.61
Mixed dishes 34.6 36.6 124.1 133.1 0 3.55 0 12.32 0 3.55 0 12.32 5.78 9.61 33.20 41.25 0.29 4.22 2.32 16.57 0.15 3.91 1.59 14.86
Dairy-based desserts 1.7 4.4 19.3 28.1 0 2.80 0 13.98 0 2.80 0 13.98 0.01 2.82 0 13.98 0.07 2.97 0.89 16.67 0.01 2.82 0 13.98
Total 544 556 1018 1029 0.11 28.9 0.8 54.0 0.71 29.9 2.78 57.3 30.5 59.0 71.9 119 4.00 38.0 9.0 72.8 10.5 53.1 22.3 104
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11% of children [9; 12] exceeded the PTMDI proposed by JECFA for
T-2 toxin, and 4% of adults [3; 5] and 35% of children [32; 37] ex-
ceeded the PTMDI proposed by JECFA for HT-2 toxin. In LB, not an
adult and an insignicant part of the children exceeded the group
PTMDI for T-2 and HT-2 toxins (0.1% [0.05: 0.3]), whereas in UB,
30% of adults [28; 32] and 74% of children [72; 77] exceeded the
PTMDI. In LB also, 0.5% of adults [0.2; 0.8] exceeded the group
PTMDI proposed by JECFA for DON, 3-Ac-DON, and 15-Ac-DON,
and 5% of children [4; 6]. In UB, 0.7% of adults [0.3; 1.1] and 10%
of children [8; 11] exceeded the PTMDI.
4. Discussion
Generally speaking, the total exposures to mycotoxins appeared
to be lower in the second TDS than in the rst one (Leblanc et al.,
2005). For DON only, exposure was slightly higher in the second
French TDS than in the rst one. Comparisons of results from both
TDS should be done cautiously in that the analytical limits (LOD
and LOQ) were higher in the rst study (until a factor 8), resulting
in a different impact of the censorship management. In the rst
French TDS, only the middlebound (MB) approach was used for
exposure calculations, i.e. substitution of censored data by ana-
lytical limits (LOD and LOQ). For OTA, PAT, NIV, and ZEA, the UB
exposures in the second TDS were lower than the MB assessments
in the rst one, by a factor 1.12. The exposure to FBs of adults also
decreased since the rst TDS. But, for children, the LB estimation of
the second TDS was equivalent to the MB estimation of the rst
one. The decrease in the exposures is probably related to the ef-
ciency of the European risk management measures entered in force
in 2006 concerning the maximal levels of some mycotoxins in
foods (Commission Regulation (EC), 2006). In the special case of
aatoxins, MB estimations of mean exposure and P95 of the rst
French TDS were comprised between LB and UB of the second
one, showing no signicant evolution of the exposure between
20012004 and 20072009 the respective periods of sampling.
Differences in occurrence and exposure data between both TDS
should not be interpreted as trends between 2005 and 2011, in
that mycotoxin levels highly depend on the humidity and temper-
ature conditions, and vary widely between and within regions, as
well as from a year to another (Bennett and Klich, 2003). Even if
the sampling plan of the second French TDS took account of the
variability of the contamination between years (sampling period
from 2007 to 2009) and between seasons (Sirot et al., 2009), one
should underline that this sampling period was particularly good
weather conditions in France and then was unfavorable to myco-
toxins development, as already shown (Gourdain, 2012). Neverthe-
less, one should bear in mind that this hypothesis is only valid for
TDS samples mainly of French origin.
Moreover, previous observations showed that the preparation
of the samples before analysis, such as typical cooking environ-
ments, can lead to reduction of concentrations for some mycotox-
ins (Lauren and Smith, 2001). Another factor that could explain the
differences between both French TDSs is the fact that the sampling
plans were different between both studies, and food groups were
composed by different foods. Then, comparisons of occurrence data
for mycotoxins between studies should be made cautiously.
In the case of DON and its derivatives, the levels observed ap-
peared generally lower than the concentrations reported at the
international level (JECFA, 2011), suggesting a reduction of levels
in food on cooking, which is concordant with reduction observed
during some cereal-based product transformation (Scudamore
et al., 2009). In its latest report, the JECFA noted that additional
data on the occurrence and the effects of processing on 3-Ac-
DON, 15-Ac-DON and DON-3-glucoside were needed, as well as
their co-occurrence with DON. However, in this study, the deriva-
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8 V. Sirot et al. / Food and Chemical Toxicology 52 (2013) 111
tives 3-Ac-DON and 15-Ac-DON represent only 0.1% of the mean LB
exposure to DON and about 10% in UB. Certainly due to consump-
tion levels, LB exposure in adults was close or a bit lower than the
results from other European countries, such as Catalonia (Cano-
Sancho et al., 2011), Lebanon or Germany (JECFA, 2011) and chil-
dren exposure was also close to the Netherlands ones based on a
duplicate diet study (Schothorst et al., 2005). Concerning NIV, an-
other trichothecene, LB results in children are also concordant with
the results from the same Dutch study (Schothorst et al., 2005).
Moreover, previous results have shown that infants and individu-
als with ethnic dietary patterns could be the most exposed popu-
lation groups to DON (Cano-Sancho et al., 2011), which is
concordant with the highest contribution of polished rice in the
Korean diet for instance (Ok et al., 2009) and the high concentra-
tions found in some ethnic foods (Cano-Sancho et al., 2012c). For
infants, relatively low levels of DON are generally reported in baby
foods, suggesting that high exposure is certainly transitional and
due to low body weight.
There is less studies on TCT A exposure assessment. Intake eval-
uations of T-2 + HT-2 based on Norway and UK consumption data
were summarized in the 2001 JECFA monograph (JECFA, 2001).
Moreover, the intakes of T-2 and HT-2 toxins were estimated by
multiplying the weighted average concentrations in each commod-
ity provided by European countries, by the respective consumption
level in the European-type diet. In LB, adult T-2 toxin exposure ap-
peared lower in this TDS, but HT-2 toxin exposure appeared equal
to the JECFA estimation. The JECFA concluded that the total was not
expected to exceed the group PMTDI for T-2 + HT-2 toxins. More
recently, the EFSA estimated total dietary intake of T-2 + HT-2 tox-
ins across 14 European countries (EFSA, 2011b). For adults the dai-
ly exposure ranged 3.4 ng/kg bw (LB) to 18 ng/kg bw (UB) for
average consumers, and 7.2 (LB) to 39 ng/kg bw (UB) for consum-
ers at P95. Toddlers (1236 months) was the subgroup with the
highest exposure (1243 ng/kg bw/day for average consumers,
and 2391 ng/kg bw at P95). Those estimates were lower than in
this study.
Patulin is usually found in fruits, in particular apple and apple-
based products like juice, masked and cooked apples, etc., and the
contamination mainly occurs on damaged fruits or during rotting.
The occurrence data of this study are concordant with this partic-
ular point, suggesting that human exposure can only be envisaged
from processed apple-based products, which has already been pro-
posed (Verger et al., 1999). LB exposure results of this TDS are con-
cordant with previous results based on fruit consumption
(Piemontese et al., 2005) or slightly higher than the exposure of
a Spanish study based on apple-based product consumption
(Gonzalez-Osnaya et al., 2007). This difference is probably linked
with higher analytical limits in the French TDS (factor 10 for LOD
and 30 for LOQ in liquid products). Due to high difference in ana-
lytical limits, and to the generally very high censorship rate in
mycotoxins analyses, it is usually preferable to compare LB data,
which are less biased by analytical limits than the UB data.
Concerning OTA, exposure in LB was generally concordant with
other results from Norwegian, Swedish, and Spanish consumers
(Coronel et al., 2012; Thuvander et al., 2001), based on the combi-
nation on consumption data from food frequency questionnaires
and contamination data or from the literature, or from analysis
on pooled samples. The estimation of exposure from a 2005 Dutch
duplicate diet survey (1.2 ng/kg bw/day) was also in the range of
our LB-UB results (Sizoo and van Egmond 2005). UB exposure
(mean and P95) were close or lower than a North American assess-
ment of usual exposure based on a probabilistic approach (Kuiper-
Goodman et al., 2010). Another study concluded that these expo-
sure levels were not associated with a signicant cancer risk, based
on the animal lowest observed adverse effect limit and the tumor-
igenic dose associated with a 5% increase in tumor incidence above
background (Haighton et al., 2012).
In bread and dried bread products and breakfast cereals, both
FB1 and FB2 were simultaneously present, with mean FB1/FB2 ra-
tios of 4.6 and 4.7. In sweet or savoury biscuits and bars, the ratio
was the opposite (0.5). FB1 and FB2 are usually mainly found in
cereals, particularly maize in temperate climate areas, but the
tropical and subtropical climates are particularly favorable to fun-
gal growth. That is certainly why European commodities are not so
contaminated than ethnical food such as Mexican corn-based foods
(Cano-Sancho et al., 2012b).Then, French TDS results are lower
than Brazilian exposure assessed for adults between 0.9 lg/
kg bw/day and 2.9 lg/kg bw/day for FB1, depending on the con-
sumer group, but mainly based on the consumption of maize prod-
ucts that is higher than in Europe (Caldas and Jardim, 2012). The
Table 5
Mean exposure and 95th percentile (P95) of exposure to mycotoxins (ng/kg bw/day) and percentage of subjects above the health-based guidance values (%).
Mycotoxins Health-based guidance value Adults Children
Mean P95 % [CI
95%
] Mean P95 % [CI
95%
]
OTA 120 ng/kg bw/wk = 17 ng/kg bw/d (EFSA, 2010b) LB 0.28 0.61 0 0.23 0.58 0
UB 1.91 3.23 0 2.82 5.26 0
PAT 0,4 lg/kg bw/d = 400 ng/kg bw/d (JECFA, 1995) LB 0.63 3.21 0 1.21 6.86 0
UB 21.2 50.5 0 39.3 96.5 0
DON + 3-Ac-DON + 15-Ac-DON 1 lg/kg bw/d = 1000 ng/kg bw/d (JECFA, 2010) LB 373 716 0.5 [0.1; 0.8] 544 1018 5 [4; 6]
UB 411 768 0.7 [0.3; 1.1] 615 1131 10 [8; 11]
NIV 0,7 lg/kg bw/d = 700 ng/kg bw/d (SCF 2002) LB 20.3 45.3 0 30.6 71.9 0
UB 34.1 66.6 0 59.0 119 0
T-2 toxin 60 ng/kg bw/d (JECFA, 2001) LB 1.78 4.83 0 4.0 9.03 0
UB 19.6 36.5 0.2 [0.02; 0.5] 38.0 72.8 11 [9; 12]
HT-2 toxin 60 ng/kg bw/d (JECFA, 2001) LB 7.16 14.5 0 10.5 22.3 0
UB 32.2 58.9 4 [3; 5] 53.1 104 35 [32; 37]
T-2 + HT-2 toxins 60 ng/kg bw/d (JECFA, 2001) LB 8.93 18.1 0 14.5 30.6 0.2 [0.05; 0.3]
UB 51.8 94.1 30 [29; 32] 91.1 175 74 [72; 77]
ZEA 0,2 lg/kg bw/d = 200 ng/kg bw/d (SCF, 2000b) LB 5.90 10.8 0 11.5 22.7 0
UB 25.5 42.5 0 46.2 87.5 0
FB1 2 lg/kg bw/d = 2000 ng/kg bw/d (JECFA, 2001) LB 7.45 22.9 0 15.4 50.4 0
UB 29.0 65.6 0 44.6 106 0
FB2 2 lg/kg bw/d = 2000 ng/kg bw/d (JECFA, 2001) LB 2.44 10.1 0 6.48 23.8 0
UB 15.8 42.2 0 30.4 83.3 0
FB1 + FB2 2 lg/kg bw/d = 2000 ng/kg bw/d (JECFA, 2001) LB 9.89 32.5 0 21.9 73.7 0
UB 44.9 101 0 75.2 182 0
V. Sirot et al. / Food and Chemical Toxicology 52 (2013) 111 9
authors noticed that the highest exposure levels mostly correspond
to certain groups of the population, such as those with low avail-
ability of other sources of carbohydrates, and local maize produc-
ers. The results are also lower than a recent Catalonian
evaluation, also based on marketed corn-based foods (Cano-San-
cho et al., 2012b). Even in children and adolescents, the highest
breakfast cereals and biscuits consumers, the exposure remained
under the health-based guidance value. Concerning another Fusar-
ium toxin, the ZEA mean and P95 exposures appeared to be higher
than a recent Catalonian evaluation, for adults as well as children
(Cano-Sancho et al., 2012a), by a factor 47 in LB and 517 in
UB. This difference can be due to higher analytical limits in the
TDS (LOQ 2.57 fold higher), leading to higher censorship rate
and overestimation of exposure in UB but also in LB for non-quan-
tied results. Moreover, in the Catalonian study, only eight food
groups were considered in the exposure assessment, versus 21 in
our study. Even if bread appeared to be the highest contributor
to the exposure, pastries and dairy-based desserts for instance
(not considered in the Spanish study) also contribute signicantly
to the total exposure in adults (>15%) as well as in children (>20%).
Besides, UB results are close to the estimations from different EU
countries reported in the SCOOP task from 2003, based on the
whole diet and generally corresponding to MB estimates (SCOOP,
2003).
Concerning aatoxins, the exposure appeared relatively low
compared with exposure from Brazilian studies for instance (Cal-
das and Jardim 2012), reporting until 42 ng/kg bw/day. This is
mainly due to the low concentrations reported in the French TDS
(there was no quantied result) and to the fact that the main con-
tributors to the exposure are different between Europe and South
America. The JECFA noted that the consumption of dried fruits
and oily seeds (almonds, Brazil nuts, hazelnuts, pistachios, and
dried gs), the most contaminated products, contributes greater
than 5% of the total AF dietary exposure in only ve of the 13
GEMS/Food cluster diets (JECFA, 2007). Even if the consumption
tended to increase in the last decade in adults (Dubuisson et al.,
2010), dried fruits, nuts and seeds are not highly consumed in
France. Consequently, the prevalence of cancer attributable to
AFs in the adult population has been calculated to range between
0.01 in LB and 5.2 in UB. Whatever the hypothesis, the increase
in the number of liver cancer in the general population appeared
insignicant (<0.07% in UB), taking into account the number of
cancer estimated in France in 2010 (INVS, 2011).
Total diet studies are designed to assess the background expo-
sure of the general population. In its last report, the JECFA experts
highlighted that this method was the best way to assess the dietary
exposure to DON for instance (JECFA, 2011). Atypical dietary
behaviors cannot be considered, such as high consumers of some
products that may be associated with higher risk. For instance, in
the case of PAT, high level of apple juice consumption can be asso-
ciated with signicant risk (Verger et al., 1999). Another example
concern AFs, which were detected only in chocolate; high level of
consumption of chocolate is associated with a higher risk, but
few high consumers were included in the consumption survey.
Other particular dietary patterns such as ethnic food high con-
sumption (cuscus, corn our, wheat our, corn cream and corn
grits) have been identied as of high interest, regarding risk linked
with mycotoxins exposure (Cano-Sancho et al., 2011). Consump-
tion data should be collected. Moreover, the use of probabilistic ap-
proach could be considered to rene the exposure by taking
account of the fact that the level of contamination is not constant,
but varies from individual to individual and from one day of con-
sumption to the next. Stochastic methods would allow to take ac-
count of the shape of the contamination or consumption
distributions. In particular, those statistical methodologies may
be used in case of high left-censorship, or to select randomly con-
tamination or consumption values, especially for acute exposure
(Tressou et al., 2004a,b), and to assess high percentiles of intake
with the tail distributions (Tressou et al., 2004a,b). Nevertheless,
if those approaches appear to be very interesting in the case of
acute exposure, in chronic dietary exposure assessment, determin-
istic approach has been shown to be preferred when there is high
uncertainty around contamination data (Counil et al., 2005), which
is the case for mycotoxins especially.
5. Conclusions
Considering the low or insignicant percentage of exceeding
the health-based guidance values, the risk linked with the expo-
sure to AFs, OTA, PAT, ZEA, and FBs was considered to be out of
concern for the general population. In conclusion, only exposure
to DON and T-2 and HT-2 toxins appeared to be of health concern.
Then, the results showed the necessity to rene the estimation for
T-2 and HT-2 toxin exposure due to uncertainty in analytical re-
sults, and to reduce the dietary exposure to DON and its deriva-
tives. Reducing the exposure of the consumer could be achieved
by reducing the consumption and/or the maximal limits in food,
but focusing on the main contributors to the exposure, as sug-
gested by the JECFA (JECFA, 2007). Additional work is needed to as-
sess the impact of different management measures, e.g. maximal
limits in main food contributors, based on the general methods de-
ned by the Codex Alimentarius Commission (CAC, 2005), as done
for example by (Baert et al., 2007).
Conict of Interest
The authors declare that there are no conicts of interest.
Acknowledgements
This research was granted by the French Ministry of Health, the
French Ministry of Agriculture, and the French Agency for Environ-
mental and Occupational Health Safety.
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