Inhalation exposure to mycotoxins in occupational settings: an underrecognized and unregulated health hazard

Mycotoxins represent secondary metabolic products generated by fungal genera, including Aspergillus, Penicillium, and Fusarium, and are known to trigger hepatotoxic, nephrotoxic, carcinogenic, and immunotoxic effects in humans. While well-defined regulatory thresholds exist to manage dietary mycotoxin intake for major mycotoxins such as aflatoxins, ochratoxins, fumonisins, deoxynivalenol, and zearalenone, the health consequences stemming from inhalation among the agricultural and food-processing workforce are still poorly understood. Importantly, there are no health-based occupational exposure limits specifically for airborne mycotoxins, which creates a substantial knowledge gap within occupational health practice. Data indicate that local cytochrome-P450-dependent bioactivation may put exposed individuals at risk of airway inflammation, impaired immune responses, alongside plausible mechanistic risk for lung-carcinogenic effects following mycotoxin inhalation. Even so, robust human epidemiological data supporting such adverse respiratory outcomes remain scarce. This narrative review compiles available toxicological findings, field-measured exposure levels, and health-related observations, centering on occupational inhalation scenarios. By sorting evidence according to its inferential strength, the present work aims to unpack inhalation-linked hazards and lay the groundwork for subsequent risk assessment work and targeted protective measures for susceptible working groups.