Is the milk we drink safe from elevated concentrations of prioritised heavy metals/metalloids? - A global systematic review and meta-analysis followed by a cursory risk assessment reporting.

Milk has been globally recognised as a comprehensive and vital food source for centuries. However, the presence of heavy metals and metalloids (metal(loid)s) in milk is a global problem. As metal(loid)s are present in the soil due to natural geogenic and various anthropogenic activities, these metal(loid)s are bio-transferred into animal feed, which further results in the presence of metal(loid)s in milk due to bio transfer/accumulation. This systematic review collated information from published literature between 2000 and 2021. It focused on the global issue of metal(loid)s in milk, posing potential health risks. These contaminants enter the food chain through the bio-transfer/accumulation process from soil to animal feed to milk. The key metal(loid)s examined are arsenic (As), mercury (Hg), lead (Pb), and cadmium (Cd). A meta-analysis of 66 selected papers revealed the widespread presence of these contaminants in milk samples globally, with Pb being the most studied (43 %). This research estimated metal(loid)s levels or concentrations as 12.71 (95 % Confidence Interval (CI) = 0.16-25.26), 16.09 (95 % CI = 4.31-27.70), 197.04 (95 % CI = 75.28-318.18), 31.67 (95 % CI = 20.14-43.20) μg/kg (ppb) for As, Hg, Pb, and Cd, respectively using Stata™. The metal(loid) concentrations in milk were within the threshold limits other than Pb and Cd. Some studies in America, Africa, and Asia reported elevated Pb and Cd concentrations, raising health concerns. The simulated Risk Quotients (RQ) and Integrated Risk Quotient (IRQ) values generally remain above one, indicating potential human health risks. Notably, the IRQ value increases with more metal(loid)s consideration. Subgroup analysis indicates low-fat milk contains higher metal(loid)s concentrations. While metal(loid)s concentrations in milk largely comply with safety limits, some regions exhibit concerning concentrations. Therefore, continued surveillance to address potential health risks associated with metal(loid)s in milk is necessary to ensure dairy products' safety.