Saad-Hussein Amal, Taha Mona M, Beshir Safia, Shahy Eman M, Shaheen Weam, Elhamshary Mohamed
Int J Occup Environ Health. 2014 Jul-Sep;20(3):215-9. doi: 10.1179/2049396714Y.0000000069.
Epidemiological studies have demonstrated that serum aflatoxin B1 (AFB1) is a hepatocarcinogenic mycotoxin and contributor to the high rate of hepatocellular carcinoma (HCC). The prevalence of liver cancer in Egypt is particularly worrisome. In a registry-based analysis of occupational risk for HCC, significant excesses were observed especially for grain mill workers.
The aim of this study was to assess the hepatic carcinogenicity of AFB1 in wheat handlers.
Serum AFB1/albumin (AFB1/Alb), alpha-fetoprotein (AFP), alpha-l-fucosidase (AFU), and arginase were estimated in exposed wheat handlers including millers and bakers. The control group was composed of non-occupationally exposed workers.
AFB1/Alb and AFU were significantly higher among workers employed as bakers compared to mill workers and controls. Mill workers had higher levels of AFB1/Alb than the controls. AFB1/Alb, AFP, and AFU were all significantly higher and arginase was significantly lower among HCC cases compared to the other groups. There was a significant correlation between AFU and AFB1/Alb in bakers and between AFP and AFB1/Alb in HCC cases. Arginase was inversely correlated with AFB1/Alb in HCC cases. AFB1/Alb was significantly correlated with the duration of exposure in bakers.
Wheat handlers exposed to Aspergillus flavus have a high risk of elevated serum AFB1/Alb levels and AFU.
流行病学研究表明，血清黄曲霉毒素B1（AFB1）是一种致癌的霉菌毒素，也是导致肝细胞癌（HCC）高发的一个因素。埃及肝癌的患病率尤其令人担忧。在一项基于登记处的HCC职业风险分析中，发现存在显著超额风险，尤其是谷物磨坊工人。
本研究旨在评估AFB1对小麦加工人员的肝脏致癌性。
对包括磨坊工人和面包师在内的接触小麦的人员测定血清AFB1/白蛋白（AFB1/Alb）、甲胎蛋白（AFP）、α-L-岩藻糖苷酶（AFU）和精氨酸酶。对照组由非职业接触的工人组成。
与磨坊工人和对照组相比，面包师的AFB1/Alb和AFU显著更高。磨坊工人的AFB1/Alb水平高于对照组。与其他组相比，HCC病例的AFB1/Alb、AFP和AFU均显著更高，而精氨酸酶显著更低。面包师中AFU与AFB1/Alb之间以及HCC病例中AFP与AFB1/Alb之间存在显著相关性。HCC病例中精氨酸酶与AFB1/Alb呈负相关。面包师中AFB1/Alb与接触时间显著相关。
接触黄曲霉的小麦加工人员血清AFB1/Alb水平和AFU升高的风险很高。
