Urinary Biomonitoring of Mycotoxins in Spanish Adults: Predictors of Exposure and Health Risk Evaluation

Mycotoxins are toxic secondary metabolites produced by fungi, frequently present in food and representing significant health hazards. Exposure occurs through the consumption of contaminated foods or animal-derived products from livestock fed with contaminated feed. This study evaluated internal exposure to twelve mycotoxins in 492 first-morning urine samples from adults, aged 18-65 years, in the Valencian Community, Spain. Samples were analysed using a "dilute-and-shoot" approach followed by UHPLC-MS/MS. Aflatoxins (AFs) were the most frequently detected, with a geometric mean (GM) of 1.17 ng/mL and a 95th percentile (P95) of 6.04 ng/mL. Alternariol (AOH), present in 63% of samples, showed high concentrations (GM: 0.98 ng/mL; P95: 4.74 ng/mL). Emerging mycotoxins such as alternariol monomethyl ether (AME), citrinin (CIT), and sterigmatocystin (STER) were also considered due to their potential health impacts. Exposure levels correlated with variables including sex, age, annual income, smoking status, and recent consumption of meat and cereals. Probable daily intakes (PDIs) were estimated from urinary concentrations to support risk assessment. Hazard Quotients (HQs), Margins of Exposure (MOEs), the Hazard Index (HI) and the total Margin of Exposure (MOET) were calculated to evaluate the risk associated with mycotoxin exposure. Findings suggest that potential health risks cannot be excluded.