Governor Gavin Newsom has retracted the proposed budget cuts to the Medi-Cal acupuncture program for low-income Californians for the 2024-2025 budget year. This decision marks a significant victory for health care providers and advocates who have long championed acupuncture as a vital component of comprehensive medical care.
Important Safety Issues on Mycotoxins
A mycotoxin is a toxic secondary metabolite produced by an organism of the fungus kingdom, including mushrooms, molds and yeasts. While there are several different groups of mycotoxins, this article will focus on aflatoxins and ochratoxins.
Aflatoxins are produced by the Aspergillus flavus and A. parasiticus fungi. These fungi will grown in/on foods and animal feeds during preharvest, storage, and/or processing periods under favorable conditions of warm temperature and high humidity. Those items most likely to be affected include corn and corn products, peanuts and peanut products, cottonseed, grains, tree nuts, milk, cheese, figs and spices. Aflatoxins will remain indefinitely, since these toxins are very stable and cannot be destroyed by cooking or freezing.1,2
The major aflatoxins of concern are designated B1, B2, G1 and G2. Aflatoxins are designated as "B's" and "G's" because when they are analyzed by thin-layer chromatography and viewed under ultraviolet light, B1 and B2 appear blue, and G1 and G2 appear green.3 Aflatoxins B1, B2, G1, and G2 are hepatotoxic and carcinogenic. Aflatoxin B1 is the most predominate and the most toxic (Figure 1). They cause acute necrosis, cirrhosis and carcinoma of the liver. No animal species is resistant to the acute toxic effects of aflatoxins. The toxicity can be influenced by environmental factors, exposure level and duration, age, health and nutritional status.4
![](https://acupuncturetoday.com/_images/content/aflatoxin_b1_14666_1_1_4394_14668_1_1_4326.gif)
Aflatoxicosis is poisoning caused by consumption of aflatoxins. Aflatoxicosis is common among animals, such as birds, fish and cattle that consume contaminated animal feed. Acute aflatoxicosis is characterized by hemorrhage, acute liver damage, edema, alteration in digestion, absorption and/or metabolism of nutrients, and possibly death. Chronic aflatoxicosis is usually subclinical and difficult to recognize, but may include common symptoms such as immune deficiency, increased susceptibility to infections, impaired food conversion, slower rates of growth and in severe cases, liver cirrhosis and liver cancer.5,6
Table 1. Safety Limits of Aflatoxins | |||
US FDA9 | AHPA10 | EUP11 | |
Aflatoxins B1 | 5 ppb | 2 ppb | |
Aflatoxins B1, B2, G1, G2 | 20 ppb | 20 ppb | 4 ppb |
*ppb = parts per billion |
Ochratoxins are produced by certain the Aspergillus ochraceus, Aspergillus alliaceus and Penicillium verrucosum fungi. These fungi are present virtually everywhere, and will grow under optimal condition of warm temperature and high humidity. As a result of fungal growth, ochratoxins are produced and the foods and feeds become contaminated.12 Ochratoxins are commonly found in foods such as grape juice, coffee, wine, beer, cereals, dried vine fruit (e.g., raisins and currants), corn, peanuts, grains, cottonseeds, rice and beans.13,14
![](https://acupuncturetoday.com/_images/content/ochratoxin_a_14668_1_1_7244_14745_1_1_5879.gif)
There are two types of ochratoxins: ochratoxin A and ochratoxin B. Ochratoxin A (Figure 2) is the predominate form and the most toxic. Ochratoxin B is much less toxic and rarely found as a natural contaminate. High levels of ochratoxin A (> 200 ppb) or prolonged exposure has been linked to serious animal illnesses, such as hepatocellular tumor, renal-cell tumors, hepatomas and hyperplastic hepatic nodules. Fortunately, low levels of ochratoxin A (<20 ppb) does not pose risks to human health at all. Overall, reports of ochratoxin A toxicity in humans are very rare.
Table 2. Safety Limits of Ochratoxin A | |||
US FDA16 | AHPA17 | EUP18 | |
Ochratoxin A | n/a | n/a | 3-10 ppb |
*ppb = parts per billion |
References
- Goldbatt LA. Aflatoxin: Scientific Background, Control, and Implications. New York: Academic Press, 1969. pp. 1-40.
- Wyllie TD, Morchause LG. Mycotoxin Fungi, Mycotoxins, Mycotoxicoses: An Encyclopedic Handbook. New York: Marcel Dekker, Inc., 1978.
- Heathcote JG, Hibbert JR. Aflatoxins: Chemical and Biological Aspect. New York: Elsevier, 1978, pp. 173-86.
- Walderhaug M. Food and Drug Administration. January 1992.
- Aflatoxins: Occurrence and Health Risks. Department of Animal Science. Cornell University.
- Finley JW, Robinson SF, Armstrong DJ. Food Safety Assessment. Washington, D.C.: American Chemical Society, 1992, pp. 261-75.
- Mycotoxins, Economic and Health Risks. Council for Agricultural Science and Technology, Report No. 116, p. 91.
- Eaton DL, Groopman JD. The Toxicology of Aflatoxins. New York: Academic Press, 1994, pp. 383-426.
- U.S. Food and Drug Administration. Safety Limits of Aflatoxins for Human Food and Animal Feeds.
- American Herbal Products Association. Recommended Safety Limits for Aflatoxins in Dietary Supplements.
- European Union Pharmacopoeia. Safety Limits of Aflatoxins for Botanical Drugs.
- Bayman P, et al. Ochratoxin production by the Aspergillus ochraceus group and Aspergillus alliaceus. Appl Environment Microbiol May 2002;68(5):2326-9.
- Food and Agriculture Organization of the United Nations. World Health Organization. Joint FAO/WHO Expert Committee on Food Additives. 68th Meeting. Geneva, June 19-28, 2007.
- U.S. Department of Agriculture. Grain Inspection, Packers and Stockyards Administration. Federal Grain Inspection Service. Ochratoxin A Testing.
- Food and Agriculture Organization of the United Nations. World Health Organization. Joint FAO/WHO Expert Committee on Food Additives. 68th Meeting. Geneva, June 19-28, 2007.
- U.S. Food and Drug Administration. No Safety Limit Has Been Established for Ochratoxin A.
- American Herbal Products Association. No Safety Limit Has Been Established for Ochratoxin A.
- Official Journal of the European Communities. Commission Regulation (EC) No 472/2002.