Interindividual differences in the activation of two hepatic carcinogens to mutagens by human liver

Aflatoxin and outcome from acute lower respiratory infection in children in The Philippines

Aflatoxin is immunosuppressive in experimental conditions. This study addressed its potentially contributory role in the poor outcome of acute lower respiratory infections (ALRI) in children in The Philippines. The catchment area included peri-urban slums and middle-class housing. One hundred and fifteen children (mean age 2.1, range 0.08-12 years) were enrolled and their serum and urine obtained at presentation with ALRI. Aflatoxins in serum and aflatoxin metabolites in urine were measured by previously validated ELISA tests. Using the 1986 WHO criteria for the severity of ALRI, 31% had mild, 12% moderate, 49% severe and 8% severe complicated pneumonia. Eighty of 97 (82%) chest radiographs were abnormal. Ninety per cent of the children were below average weight for age, using Filipino standards, with a mean of 79% (range 27-157%). Thirteen (11%) children died. Aflatoxin in their serum, reflecting recent ingestion, was detected in 33%, with a mean positive value of 462 pg/ml. Aflatoxin metabolites (reflecting chronic ingestion) were detected in 64 of 65 urines collected, with a mean value of 0.1-4.77ng/ml. None of the children with detectable serum aflatoxin died. Anorexia and impaired consciousness were strongly associated with a poor outcome (prolonged fever or death). There was a strong association between undetectable serum aflatoxin concentrations and death (p = 0.004), perhaps reflecting anorexia. There was no relationship between the concentration of urinary aflatoxin metabolites and outcome. Serum was also obtained from 29 mothers on admission and none contained detectable aflatoxin. As virtually all the children had evidence of exposure to aflatoxin, a potentially immunosuppressive role in the context of pneumonia cannot be excluded.

Data-derived safety factors for the evaluation of food additives and environmental contaminants

A safety factor of 100-fold is commonly applied to animal data to derive the acceptable daily intake (ADI) of food additives; other factors have been used in some cases and higher values are used more frequently for determining the tolerable daily intake (TDI) of environmental chemicals. The 100-fold factor is considered to represent the product of a 10-fold factor to allow for species differences between the test animal and humans and a 10-fold factor to allow for inter-individual differences. A scheme is proposed whereby data relevant to the safety assessment of a compound, e.g. species differences in toxicokinetics, can contribute quantitatively to the safety factor and therefore to the ADI or TDI. For this to be possible, it is necessary to subdivide each of the 10-fold factors into two separate factors to allow for differences in toxicokinetics and toxicodynamics. For any compound, data on one particular aspect may be used to derive a specific data-derived factor for that aspect. The overall safety factor will then be calculated as the product of the known data-derived factor(s) and default values for the remaining unknown factors. In this way the derivation of the safety factor would be clearly defined and the potential impact of additional data on other aspects identified. Additional safety factors (over and above the 100-fold or overall data-derived factor) are also proposed to allow for the nature or severity of the toxicity and the adequacy of the database. These factors are consistent with previous evaluations and will allow the logical derivation of factors greater than either 100 or the appropriate data-derived factor. These additional factors will be of greatest value in the derivation of safety factors for the calculation of the TDIs of environmental contaminants but may also be applied if necessary to the safety assessment of food additives. In such cases the rationale and logic for a safety factor in excess of 100 will be clearly defined.