Global impacts of aflatoxin in maize: trade and human health

Maize is one of the most important agricultural commodities worldwide in terms of amounts produced, consumed, and traded. Hence, naturally occurring aflatoxin contamination in maize has important ramifications for both global trade and health. Aflatoxin is produced by certain species of the genus Aspergillus in a variety of food crops, including maize, peanuts, and tree nuts. Over 100 nations have aflatoxin regulations, which are intended to protect human and animal health, but also incur economic losses to nations that attempt to export maize and other aflatoxin-contaminated commodities. These economic effects must be balanced against the health protection afforded by the regulations. It is important to acknowledge that, even in nations that have aflatoxin regulations, many individuals consume maize that has undergone no regulatory inspection, especially in nations where subsistence farming is widespread. Hence, aflatoxin contamination, exposure, and lack of regulation can also contribute to adverse effects on trade and health worldwide. This review, part of a special issue on aflatoxin in maize, describes economic and health effects of aflatoxin in maize on a global level. It ends with a story of an intervention that reduced maize consumption in one population in China, which is likely the main determinant of the reduction in liver cancer mortality in that population over the last 30 years, from reduced aflatoxin exposure.