Heavy metal levels in milk and dairy products and health risk assessment: A systematic review of studies in China

Previous studies have indicated that heavy metal levels in milk vary partly depending on environmental metal concen-trations. Given the increasing consumption of milk in China, it is essential to pay attention to milk safety. We per-formed a systematic review of relevant published studies to evaluate the heavy metal levels in milk and dairy products and the associated health risks, discuss environmental sources of heavy metals, and propose future research directions. A literature search was implemented in the Web of Science Core Collection and PubMed using multiple key-words such as "metal," "milk," "dairy products," and "China". A total of 16 published studies that analyzed metal levels in milk and dairy products in 20 provincial administrative regions were included. Most studies detected toxic heavy metals in milk and dairy products samples, including mercury, lead, cadmium, chromium, and arsenic. The lead con-centration in milk from these studies did not exceed the Chinese standard for milk. However, three studies detected relatively high lead levels in both commercial and raw milk, exceeding the European Commission standard. The pol-luted environment surrounding the farm, feed, and packaging materials are likely sources of metals in milk and dairy products. The hazard index for the 11 analyzed metal elements in milk and dairy products was lower than 1, indicating negligible non-carcinogenic health risks from exposure to these metals. Children are at a higher risk than adults. This review illustrates that research in this field is limited to China. More research should be conducted in the future, such as evaluating the contribution of each environmental source of metal in milk and dairy products.