The current study is based on the AFM₁ contamination of milk determined from April 2013 to December 2018 in the framework of a self-control plan of six milk processing plants in Italy. These data – together with the consumption data of milk consumers – were evaluated and used for the calculation of the Estimated Daily Intake (EDI), the Hazard Index (HI), and the fraction of hepatocarcinoma cases (HCC) due to AFM₁ exposure in different population groups. Altogether a total of 31,702 milk samples were analyzed, representing 556,413 tons of milk, which is an outstanding amount compared to published studies. The results indicate the monthly fluctuation of AFM₁ levels through a period of nearly 6 years. The EDI of AFM₁ in different population groups was in the range of 0.025–0.328 ng kg⁻¹ body weight (bw) per day, based on the average consumption levels and weighted mean contamination of the milk in the study period. Considering average consumptions, in the groups of infants and toddlers, the HI calculation resulted in 1.64 and 1.4, respectively, while for older age groups, it was <1. The estimated fractions of HCC incidences attributable to the AFM₁ intakes were 0.005 and 0.004 cases per 100,000 individuals in the 0–0.9 and 1–2.9-year age groups, respectively, and below 0.004 cases in the other age categories. The monthly average AFM₁ contamination of tested milk consignments ranged between 7.19 and 22.53 ng kg⁻¹. Although the results of this extensive investigation showed a low risk of HCC, the variability of climatic conditions throughout years that influence AFB₁ contamination of feed and consequently AFM₁ contamination of milk justifies their continuous monitoring and update of the risk assessment.

The study presents a systematic review of published scientific articles investigating the effects of interventions aiming at aflatoxin reduction at the feed production and animal feeding phases of the milk value chain in order to identify the recent scientific trends and summarize the main findings available in the literature. The review strategy was designed based on the guidance of the systematic review and knowledge synthesis methodology that is applicable in the field of food safety. The Web of Science and EBSCOhost online databases were searched with predefined algorithms. After title and abstract relevance screening and relevance confirmation with full-text screening, 67 studies remained for data extraction, which were included in the review. The most important identified groups of interventions based on their mode of action and place in the technological process are as follows: low-moisture production using preservatives, acidity regulators, adsorbents and various microbiological additives. The results of the listed publications are summarized and compared for all the identified intervention groups. The paper aimed to help feed producers, farmers and relevant stakeholders to get an overview of the most suitable aflatoxin mitigation options, which is extremely important in the near future as climate change will likely be accompanied by elevated mycotoxin levels.

The study reports the results of testing the sensitivity of an early warning sampling plan for detecting milk batches with high aflatoxin AFM₁ concentration. The effectiveness of the method was investigated by the analysis of 9017 milk samples collected in Italian milk processing plants that applied control plans with different action limits (AL). For those milk processing plants where 30 ng kg⁻¹ AL has been applied, the AFM₁ contamination was significantly lower at or above the 95th percentile of the milk samples when compared with plants that used 40 ng kg⁻¹ AL. The results show that the control plan can be used effectively for early warning of occurrence of high AFM₁ contamination of milk and to carry out pro-active measures to limit the level of contamination. Estimation of dietary exposure was also carried out, based on the aflatoxin M₁ content of the milk samples and on Italian food consumption data. Estimated Daily Intakes (EDI) and Hazard Indices (HI) were calculated for different age groups of the population. HIs show that no adverse effects are expected for the adult population, but in the case of children under age three, the approximate HI values were considerably higher. This underlines the importance of the careful monitoring and control of aflatoxin M₁ in milk and dairy products.

The mycotoxin contamination of foods also appears in the food chain. Aflatoxin is metabolized in animals and its aflatoxin M1 (AFM1) metabolite, which is similarly, but ten times less genotoxic and carcinogenic than aflatoxin B1 (AFB1), is also present in milk, liver and eggs. Of these, the most significant food safety risk is posed by the contamination of milk with AFM1. In our article, the deterministic exposure estimation of Hungarian consumers is presented, based on the AFM1 contamination of milk and dairy products. The results indicate that the exposure of children under three years of age clearly poses a health risk, while the exposure of the 3 to 6 year old age group is borderline. The exposure of older age groups in ng/kg body weight does not pose an immediate health risk due to the increasing body weight. However, it needs to be emphasized that the presence of carcinogenic compounds should be kept to a minimum in all age groups. To this end, we propose an amendment to the regulation regarding the factory inspection of milk.