The wide range of mycotoxins recognized as potential food contaminants are discussed elsewhere in this volume as are details of the regulations and requirements for trade in mycotoxin-prone commodities (FAO, 2004). We focus on the consequences of these food contaminants both in developing and developed countries. The obvious consequences, and those that have attracted the most attention and action, are related to trade and the potential of these compounds to be non-tariff trade barriers in international trade. Recent papers, e.g., Otsuki et al. (2001a,b) and Wilson and Otsuki (2003), pointing to the trade-off between health gains in Europe and trade consequences for Africa of the new levels of allowable aflatoxin are demonstrative of this focus on trade, and the resulting controversy is indicative of this attention (Couli-baly et al., Chapter 7). For most African countries, reduction in agricultural trade is the least important of the plethora of problems associated with these toxins because only a few countries export the majority of these commodities that they produce. Instead, most of these agricultural products are consumed domestically, which means that the major economic cost of mycotoxin contamination is that required to assure safe food, i.e., the developed country scenario, or to deal with the alternative health costs of failing to do so in developing countries.
The importance of mycotoxins is much greater than is generally recognized. Failure to satisfy mycotoxin standards can result in significant monetary loss as the producers and processors of foods are accountable for the quality of their produce. Thus, they must develop ways to meet the standards, with the additional costs of achieving compliance passed on to the consumer as the cost of assuring a healthy food supply. The additional cost of managing mycotoxins across the full value chain for major commodities may be as much as 10-15% of the final price. For example, aflatoxin contamination in peanuts increases if drought occurs dur ing the last six weeks of the crop's growth. Many farmers have irrigation to avoid this risk, even though simulations of response to irrigation in Florida (Williams and Boote, 1995) show that significant production losses attributable to drought at this stage of production seldom occur. These farmers are responding to the market's requirement for food low in aflatoxins and expect a quality premium on their produce in return. Similarly, there are one-time fixed costs of infrastructure for, and recurring costs associated with, taking samples and analyzing them for toxins. Investments in drying and electronic sorting after harvest to segregate potentially contaminated grains all increase the economic burden imposed by mycotoxins. Despite these investments there are times when a significant fraction of agricultural production is lost in developed countries because it is contaminated. In the United States these losses can be as high as $1.5 billion across all the range of mycotoxins (Robens and Cardwell, 2003). The use of contaminated produce in animal feeds also is recognized as a major source of economic loss (Fink-Gremmels, Chapter 14). Although acute poisoning is relatively rare, the consequences of chronic mycotoxin exposure can be very significant - lowering feed conversion rates, increasing reproductive failures and veterinary medicine costs and escalating the use of antibiotics in feed to protect animals with weakened immune systems.
When there are no investments to assure that foods are not contaminated by mycotox-ins, a different importance of these toxins is evident but seldom recognized. In this regard the range of toxicities that may occur must be considered. Exposure to many of these myco-toxins has carcinogenic and teratogenic consequences, so the consequences of exposure need not be immediately connected with exposure and often are not considered because they are deferred or attributed to more obvious causal agents. For example, many mycotoxins have significant immune suppressing capabilities, but mycotoxins are only rarely connected with their impacts on disease epidemiology. As the toxins exert their effects through immunity and nutrition the problems they cause often are missed since current medical training and philosophy focus on responding to symptoms and curing diseases rather than preventing occurrence. Consequences similar to those observed for animal production on farms are observed in human populations in developing countries.
Two independent studies have estimated that the burden of disease connected with af-latoxin alone is > 40% of the disease burden in developing countries (Miller, 1996; Williams et al., 2004), even though there is no way to determine exactly what fraction of this disease burden is attributable to mycotoxins. Based on epidemics in farm animals, the impact of mycotoxins on nutrition and immunity probably is significant. Other data indicate that the potential cost of even marginal changes in the health situation is enormous. As little as a 1% change in the burden of disease in response to managing only aflatoxin would likely increase economic growth rates significantly. The basis for this projection is derived from the data for malaria (which contributes 3% of the burden of disease on a world scale (http://www.globalhealthreporting.org/malaria.asp?id=62) where a 10% change in the incidence of malaria in endemic countries would increase their economic growth on a per/capita annual basis by 1.3% (Gallup and Sachs, 2001). Another example is that there are significant statistical relationships between aflatoxin exposure and HIV incidence that are supported by epidemiological mechanisms (Williams et al., 2005); and there is little doubt of the economic costs of HIV/AIDS.
An analysis of the WHO health risks (Rodgers et al., 2002) combined with the known immunotoxicities and nutritional interferences of mycotoxins suggests that the seven most important identified risk factors (malnutrition of children, sexually transmitted diseases, unsafe water, smoke from open fires, Zn deficiency, Fe deficiency, and vitamin A deficiency) are all subject to modulation by mycotoxin exposure. This fact alone makes health a critical objective for agricultural production and research. Across the world there is a growing realization, as is evidenced by the HarvestPlus program (http://www.harvestplus.org/ about.html) that agricultural technologies that can build on the established connections of good nutrition with health-based immune competence and cognitive development are very cost effective ways to increased public health. Mycotoxins are part of that opportunity and might be the single most important part.
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