Human biomonitoring of mycotoxins: key challenges and future directions

Mycotoxins pose a major health risk for humans in many parts of the world. For exposure assessment human biomonitoring (HBM) based on the analysis of serum, plasma, whole blood, urine or breast milk samples is a powerful approach which has been extensively used. However, there are several major challenges and pitfalls to be considered to achieve reliable and standardized data which can be used for risk assessment. These challenges include sampling (spot urine, 24 h urine, plasma, serum etc.) and analytical issues (missing reference standards, matrix effects, protein adducts, recovery, limit of detection, stability during storage, etc.). Further critical aspects needed for biomarker interpretation and human health risk evaluation are a lack of data for several mycotoxins such as (a) health-based guidance values (b) long-term biomarkers, (c) reliable food intake data (d) toxicokinetic parameters in humans, for example clearance and transfer rates to urine or milk and (e) HBM guidance values. In this review, these issues will be discussed based on recent HBM studies and recommendations for future studies as well as research needs will be derived.