This document provides a review of milk quality in Pakistan. It begins with an introduction to milk composition and recommendations for dairy consumption. It then discusses how adulteration is a major issue affecting milk quality in Pakistan. Common adulterants added to milk like water, hydrogen peroxide, and formalin are outlined. The document details the health effects of various adulterants on consumers, especially children and pregnant women. It concludes that widespread milk fraud is occurring in Pakistan, with many studies finding over 80% of milk samples to contain adulterants that pose serious risks to public health.

2. Quality of Milk consumed in Pakistan (A Review)
By
Asif Irshad
(Intern)
at
Balochistan Food Authority, Quetta.

3. Outlines
Introduction
What does quality of milk means?
Adulteration of Milk in our society
Adulterants used in milk and their
effect on the quality characteristics of
milk
Side effects of Milk adulterants to
Human health
Impacts of Milk Fraud on Food Safety
in Pakistan

4. INTRODUCTION
 Milk is a white fluid secreted by the mammary glands of female mammals for the
nourishment of their young, consisting of minute globules of fat suspended in a
solution of casein, albumin, milk sugar, and inorganic salts.
 These constituents are present in the milk of all mammals, though their
proportions differ from one species to another and within species. The milk of
each species seems to be a complete food for its own young for a considerable
time after birth.
 Although slightly varies in composition and properties, the milk of different
species contain the same constituents in general. On average, milk is made up of
87.4% water and 12.6% milk solids (3.7% fat, 8.9% milk solids-not-fat). The
milk solids-not-fat contain protein (3.4%), lactose (4.8%), and minerals (0.7%).
 Early-lactation milk contains colostrum, which carries the mother's antibodies to
its young and can reduce the risk of many diseases. It contains many other
nutrients including protein and lactose.

5.  Interspecies consumption of milk is not uncommon, particularly among humans,
many of whom consume the milk of other mammals.
 According to food guide pyramid, it is recommended for an adult to consume 2-3
servings of dairy based food commodities in a day for better health and
maintenance of life.
 The dairy milk sector is vital and necessary element of Pakistan’s socio-economic
infrastructure and economy. The market value of milk is alone greater than
combined value of sugarcane, maize, rice and wheat in the country.
 Pakistan is the 4th largest milk producing country in the world after United States,
Russia and India (GOP, 2016).
 In Pakistan the modern dairy sector is relatively small and only 3% of the total
milk produced is processed (FAO, 2002). Due to lack of proper facilities the
quality of milk is very poor regarding to the health of consumers.

6. What does quality of milk means?
 The term quality for milk means absence of harmful bacteria, dirt, antibodies, bad
flavors, abnormal numbers of body cells, chemical analysis to check presence of
sufficient amounts of nutrients, verification of hygiene through microbial
investigation (Singhal et al., 1997).
 The quality of milk is associated to milk which should be fresh, pure, and free
from pathogenic bacteria, harmful toxic components and good in keeping quality.
 Microbial load in milk is a major factor for the determination of milk quality. It
indicates the hygienic level exercised during milking, cleanliness of utensils,
condition of storage, transportation technique and udder hygiene of individual
animal.
 Quality deterioration of milk starts just after milking, when it is carried out under
unhygienic conditions. The main sources that affect the quality of milk at farm are
animal mishandling, unhygienic milking, transportation equipments and poor
storage conditions (Oliveria et al., 1999). All such practices results in poor quality
of milk in terms of its compositional and bacterial quality (Rizvi, 2002).

7. Adulteration of Milk in our society
 Adulteration is an act of intentionally debasing the quality of food offered for sale either
by admixture or substitution of inferior substances or by the removal of some valuable
ingredients (FDA, 1998).
 The adulterants used in milk are mainly water, detergent, foreign fat, starch, sodium
hydroxide, sugar, urea, pond water, salt, maltodextrin, sodium carbonate, formalin, and
ammonium sulphate.
 Adulteration of milk is one of the most serious issues that the dairy sector of Pakistan is
facing today, which not only causes major economic losses for the processing industry,
but also a major health risk for the consumers.
 Milk is transported from the point of production, to the processing units and finally to
consumers by middlemen. So debasing can be done at any of these points.
 Adulterated milk can have threatening consequences for growing children, pregnant
women, developing fetus and patients who are the primary consumers of milk. Hence, it
is important that the consumer has an access to unadulterated pure milk.

8. Adulterants used in milk and their effect on the quality
characteristics of milk
 Water is the most common adulterant used to increase the volume of milk.
 Urea is added for whitening of milk and only few grams of urea are enough to bring milk
in its original state (Walker et al., 2004).
 Hydrogen peroxide is used as preservative usually in summer season when
environmental temperature is very high. This unethical activity is usually adapted to
prevent the financial losses due to the spoilage of milk during its transportation and sale
(Naz, 2000).
 Thickening agents like starch, flour, skimmed milk powder, whey powder or other
ingredients are added to counter the dilution and extend the solids content of the milk
(Fakhar, and Law Walker, 2006); vegetable oil, sugarcane or urea to compensate the fat,
carbohydrate or protein content of diluted milk.
 Some chemicals such as hydrogen peroxide, carbonates, bicarbonates, antibiotics,
caustic soda and even the most lethal chemical formalin used to increase the storage
period of milk, ice to enhance the shelf life of milk.
 Detergents are added to enhance the cosmetic nature of milk which diminishes foamy
appearance and whitening of milk and giving it a genuine look (Tariq, 2001; Walker et
al., 2004).

9. Side effects of Milk adulterants to Human health
The addition of water to milk decreases its nutritional value; for infants and
children this may be a serious concern as they are at a critical stage of growth and
development and are dependent on milk products for supplies of vital nutrients
and so may be at risk of malnutrition. Indicators of undernourishment are
manifested as child-stunting, underweight, wasting, and nutrition-related child
mortality (FAO, 2013).
If the milk is adulterated with sugar then this may contribute to problems in
diabetics through elevation of blood sugar levels. If such milk is regularly
consumed by individuals who are already diabetic or have a cardiac problem, it
can be hazardous to them (Malik et al., 2006; Singuluri and Sukumaran, 2014).
Formalin is highly toxic to humans in small amounts and is classified as a
carcinogen. Its ingestion is known to induce acute poisoning, causing irritation,
often leading to dry skin, dermatitis, headaches, dizziness, tearing eyes, sneezing
and coughing, and even the development of allergic asthma. (Tang et al., 2009;
Gwin et al., 2010).

10. Hydrogen peroxide damages the gastrointestinal cells which can lead to gastritis,
inflammation of the intestine, and bloody diarrhea (Afzal et al., 2011; Singh and
Gandhi, 2015).
Detergents have been shown to cause food poisoning and gastrointestinal
complications (Tay et al., 2013; Singuluri and Sukumaran, 2014). Some detergents
also contain the toxic ingredient dioxane, which is carcinogenic in nature (Mudgil
and Barak, 2013).
Chlorine causes low blood pressure, nausea, vomiting, and abdominal pain
(Hattersley, 2000; Barham et al., 2014).
The presence of urea in milk above the cut-off limit (typically accepted at 70
mg/dL) may cause severe human health problems such as impaired vision,
diarrhea, and malfunctioning of the kidneys. Moreover, unnecessary hairs might
appear on the face, especially in women and children. It may also lead to swollen
limbs, irregular heartbeat, muscle cramps, chills and shivering fever, and cancers,
though these are less likely with the concentrations present in the adulterated milk.
(Bhatt et al., 2008; Trivedi et al., 2009; Kandpal et al., 2012).

11. Carbonates and bicarbonates can cause disruption in hormone signaling that
regulates development and reproduction (Singuluri and Sukumaran, 2014).
Sodium carbonate on ingestion may cause irritation along the digestive tract as
well as causing vomiting and diarrhea (Mudgil and Barak, 2013).
Boric acid causes eye irritation, nausea, vomiting, diarrhea, kidney damage, skin
problems, and central nervous system irritation (See et al., 2010).
Short-term exposure to benzoic acid can irritate the eyes, skin, and respiratory
tract, and in sensitive persons can produce adverse effects such as asthma,
metabolic acidosis, and convulsions (Qi et al., 2009).

12. Impacts of Milk Fraud on Food Safety in Pakistan
• Recent reports in Pakistan have shown widespread fraud of milk products, with 80% of
the total milk sold in packages or in bulk being adulterated (Akhtar, 2015).
• A study conducted by Barham et al. (2014) found water to be the most common
adulterant (73%) in the majority of the 100 milk samples analyzed from the city of
Mirpurkhas, Pakistan.
• Further, the water used is typically muddy instead of clean tap water in order to increase
density and maintain the viscosity of the milk, therefore posing a further and serious risk
to human health.
• In the Barham et al. (2014) study, several of the milk samples were also positive for
multiple substances, including detergent (32%), cane sugar (22%), caustic soda (20%),
rice flour (17%), sodium chloride and skimmed milk (each 15%), hydrogen peroxide
(13%), starch (12%), formalin (11%), urea and vegetable oil (each 10%), boric acid
(8%), ammonium sulfate (6%), glucose (5%), sorbitol (4%), and arrowroot (1%).
• In 2017, Pakistan Council of Scientific and Industrial Research (PCSIR) conducted tests
on 16 brands of packaged milk given Ultra High Temperature (UHT) and pasteurization
treatment, only 6 brands were safe for consumption.

13. • A study by Faraz et al. (2013) showed that 97% and 93% of the milk samples from
canteens of educational institutes and public places, respectively, included additional
water. The study also reported the presence of soil in approximately 67% of all milk
samples tested, which, again, may have been deliberate or merely due to carelessness.
Various adulterants such as urea, formalin, hydrogen peroxide, and cane sugar were
also present in the milk samples.
• Another recent study by Soomro et al. (2014) examined a total of 80 milk market
samples from the city of Badin, Pakistan for the presence of a range of adulterants,
including water, skim milk powder, neutralizers, and thickening agents, and their
impact on chemical characteristics of market milk. Among these samples, only water
was found in the majority of samples, and this appeared to affect the chemical
characteristics of the milk. The moisture content of the market milk samples was
found to be considerably higher to that of the control samples, while the average fat
content of the market milk samples did not reach the minimum level of fat of control
samples. However, the average protein content of the market milk samples appeared
higher than the control samples.