Biomonitoring study of deoxynivalenol exposure and association with typical cereal consumption in Swedish adults

Deoxynivalenol (DON) is a mycotoxin of the trichothecene family commonly found in cereals infested with different Fusarium species. DON acts primarily on the gastrointestinal and immune system and is suspected to be an underlying agent causing several outbreaks of gastrointestinal disorder among humans, which prompts studies of human exposure and estimations of intake among populations. However, assessing human exposure to mycotoxins is associated with several difficulties. Therefore, a study was undertaken among adults (18-80 years) in a subgroup of Riksmaten, the Swedish national survey investigating dietary habits, examining both the association between urinary DON concentration and dietary intake of cereals, and estimations of daily DON intake. The results indicate that exposure to DON is common among Swedish adults, as this mycotoxin was detected in 292 out of 326 urine samples (90%) at levels ranging from non-detectable to 65.8 ng DON/mI urine with a median level of 2.9 ng/ml. Furthermore, urinary DON (ng/mg creatinine) was associated with intake (g/day) of total cereal grain as well as whole grain. Urinary DON was also significantly associated with breakfast cereals and porridge consumption (P<0.05). Estimated DON intake in this study ranged between 2.5 and 5,443 ng/kg body weight (bw). 1% of the individuals had estimated intakes above the group provisional maximum tolerable daily intake (PMTDI; 1 mu g/kg), whereas the mean and median intakes of 159 and 84 ng DON/kg bw, respectively, were considerably below the PMTDI. Along with the toxicological profile of DON, no serious health implications are to be expected for the majority of Swedish adults, although a potential health concern remains for some high cereal consumers. In conclusion, biomonitoring could prove to be a valuable tool for observing DON exposure among populations.