Presentation by Dan Brown at the "Priorities for Addressing Mycotoxins in Haiti" workshop in Port au Prince, Haiti June 12, 2015.

1. Aflatoxin contamination and
exposure along the peanut value chain
in Haiti
Dan Brown, Professor
Jeremy Schwartzbord, PhD Candidate
Department of Animal Science, Cornell University

2. Key Points
1. Brief review of aflatoxin (AF) toxicity,
occurrence, global exposure, and economic
implications
2. AF Contamination from 2005-2015
3. Studies of urban and rural AF Exposure
4. Future research

3. Aflatoxins: structure and dietary occurrence
Photo of Aspergillus flavus courtesy of
Santiago Mideros, lab of Rebecca Nelson

4. A. flavus (et al.) on peanuts

5. Aflatoxins: toxicity and health effects
● Hepatocarcinogen
● Synergy with hepatitis B virus
● Associations with immune dysfunction and
stunting in children

6. Global Human Exposure to Aflatoxins

7. Location Detection rate
(total subjects)
Reference
Ashanti region, Ghana 91.2% (91) (Jolly et al., 2006)
Sao Paulo, Brazil 65% (69) (Romero et al., 2010)
Lower Kindia, Guinea 64% (50) (Polychronaki et al., 2008)
Qidong, China 54% (145) (Sun et al., 1999)
Nile Delta region, Egypt 48% (93)
(Piekkola et al., 2012)
Quartier Morin, Haiti 22% (241) (Schwartzbord 2015)
Shanghai, China 21% (317) (Qian et al., 1994)
Nasarawa and Kaduna
states, Nigeria
14.2% (120)
(Ezekiel et al., 2014)
Western Cameroon 14% (220) (Njumbe Ediage et al.,
2013)
Port au Prince, Haiti 14% (214) (Schwartzbord 2015)
Bangkok, Thailand 5% (60) (Warth et al., 2014)

8. Regulatory standards and
economic impacts of aflatoxins
Regulatory Standard Limit for peanut, direct human
consumption (μg/kg)
US Food and Drug
Admin
20
European Union 4
FAO Codex 10

9. Regulatory standards and
economic impacts of aflatoxins
Type of economic cost Impact/Cost Study
Health related
Causative role in 4.6-
28.2% of global liver
cancer cases
Liu and Wu (2010)
Market rejection
$500 million/yr in USA Vardon et al. (2003)
Animal health impact
Cost of management
$20-50 million/yr in
USA
Robens and Cardwell
(2003)

10. Key Points
1. Brief review of aflatoxin (AF) toxicity,
occurrence, global exposure, and economic
implications
2. AF Contamination from 2005-2015
3. Studies of urban and rural AF Exposure
4. Future research

11. What do we currently know about AF
contamination in Haiti?

12. Origin of raw peanuts and peanut butters
tested for aflatoxins: 2005-2015

13. Methods of aflatoxin testing by Acceso,
Cornell and MFK

14. Samples Tested by Aflatest
Samples Tested Agristrip and Aflatest

15. Aflatoxin analysis by testing
organization

16. Why is this a problem?
Aflatoxin concentration (ppb)

17. Economic: >20 ppb AF, limited export
opportunities
Public health: more aflatoxin exposure, greater
public health risks
Aflatoxin concentration (ppb)

18. Key Points
1. Brief review of aflatoxin (AF) toxicity,
occurrence, global exposure, and economic
implications
2. AF Contamination from 2005-2015
3. Studies of urban and rural AF Exposure
4. Future research

20. ANOVA of detectable aflatoxin-lysine among
Port-au-Prince patients ingesting peanuts

21. ANOVA of detectable aflatoxin-lysine among
Port-au-Prince patients ingesting maize

22. AF Exposure in Port-au-Prince and a rural
community in Quartier Morin, Haiti
x urines
from 367
patients
Sample collection
during 2012 and 2013

23. Peanut consumption was significantly
predictive of detection of urinary AFM1

24. Non-dairy animal-sourced food consumption
was predictive of detection of urinary AFM1

25. Key Points
1. Brief review of aflatoxin (AF) toxicity,
occurrence, global exposure, and economic
implications
2. AF Contamination from 2005-2015
3. Studies of urban and rural AF Exposure
4. Current and Future research

26. Monitoring exposure to other mycotoxins
Gerding, Ali, Schwartzbord, Cramer, Brown, Degen, Humpf. (2015). Mycotoxin Research.

27. Take responsibility for rejected
peanuts or stop sorting them
1. Why?
1. How?
1. Technically Feasible?
2. Culturally and Economically Feasible?

28. Take responsibility for rejected
peanuts or stop sorting them
1. Burn them
2. Rehabilitate them
3. Divide into groups:
A. Lowest [AF] : Use as feed for animals
B. Moderate [AF] : Clean, then use for animals
C. High [AF] : Grind with shells, form patties with
cassava starch glue, burn with charcoal to recover
energy from oil and shells.
D. Very High [AF] : Burn them

29. Take responsibility for rejected
peanuts or stop sorting them
A. Lowest [AF] : 20-100ppb* ? (Or lower?)
B. Moderate [AF] : 100 to 600 ppb ? (Or lower?)
C. High [AF] : 600ppb-1000ppb
D. Very High [AF] : > 1000ppb
• <20ppb for people and dairy animals
Current and future research these figures:
Poultry and cattle trials with peanut-based diets
Improved fuel patties, oil and marketing tests

30. Feasible interventions for farmers and food
processors to minimize aflatoxin exposure
from peanuts
disease- and drought-
resistant seed
varieties Fuel patties from highly
contaminated kernels
Ethanol-rinsed oil
Ethanol-rinsed peanut meal
for chicken feed

31. BIG PICTURE: Management of mycotoxin
contamination in Haiti and beyond
IMPROVED PUBLIC
HEALTH
FOOD
SAFETY
FOOD
SECURITY
AND VALUE
CHAINS
RESOURCE-LIMITED
SYSTEM:
FARMERS,
FOOD PROCESSORS,
REGULATORY AGENCIES

32. Questions?
Thank you

33. Peanut and press cake triage
>800ppb: Grind up with shells and/or rejected whole peanuts and form raw briquettes. Don't waste time trying
to clean it up.
>100ppb but <800ppb: Press out oil. Rinse press cake with 50% ethanol/water (and 0 to 0.9% NaCl). Rinse with
water, filter through cheesecloth, dewater, dry, and, if reduced to <100ppb use in poultry and swine grower
rations.
>20ppb but <100ppb: Can be used directly for poultry and swine feed mixtures.
>20ppb but <80ppb: Can be rinsed for milk goat, cow feed and human food.
<20 ppb: Direct human or dairy use.
Oil:
>100ppb: Filter and use as SRVO in diesel engines
>20ppb but <100ppb: Filter and strip with ethanol for human use.
<20ppb: Human use
 Always retest end product aflatoxin content before use as feed or food!

34. Here are some things UFl/Cornell has
accomplished so far this fiscal year:
Peer Reviewed Publications:
Schwartzbord, Jeremy, Dan Brown and Linda
Severe. 2015 Detection of trace aflatoxin M1 in
human urine using a commercial ELISA
followed by HPLC Biomarkers: In Press