title: Aflatoxin contamination of wheat flour and the risk of esophageal cancer in a high risk area in Iran.
abstract: BACKGROUND
  Golestan province in northeastern Iran has been known as a high-risk area for esophageal cancer (EC). This study was conducted to assess aflatoxin (AF) contamination of wheat flour (WF) samples in high and low EC-risk areas of Golestan province.
  
  
  METHODS
  Four WF samples were collected randomly from each of 25 active silos throughout the province in 2009. The levels of AFs were measured using the High-performance liquid chromatography method. Using the data of EC rates obtained from Golestan population-based cancer registry, the province was divided into high and low risk areas for EC. Student t-test and multivariate regression analysis were used to compare the levels of aflatoxins as well as the condition of silos between the two areas.
  
  
  RESULTS
  One hundred WF samples were collected. The mean levels of total aflatoxin and aflatoxin B1 was 1.99 and 0.53 ng g(-1), respectively. The levels of total AF (p = 0.03), AFG2 (p = 0.02) and AFB1 (p = 0.003) were significantly higher in samples obtained from high risk area. Multivariate regression analysis showed that humidity of silo was the most important source of difference between silos of the two areas (p = 0.04).
  
  
  CONCLUSIONS
  We found a positive relationship between AF level of WF samples and the risk of EC. So, AF contamination may be a possible risk factor for EC in our region. We also found that humidity of silos was the most important determinant of AF contamination of WF. Intensive control of silos conditions including humidity and temperature are needed especially in high EC-risk areas.
authors: Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.
authors: Fatemeh
authors: F
authors: Ghasemi-Kebria
authors: Hamidreza
authors: H
authors: Joshaghani
authors: Negar Sadat
authors: NS
authors: Taheri
authors: Shahryar
authors: S
authors: Semnani
authors: Mohsen
authors: M
authors: Aarabi
authors: Faezeh
authors: F
authors: Salamat
authors: Gholamreza
authors: G
authors: Roshandel
mesh_terms: D000348:Aflatoxins / Q000032:analysis*; D002851:Chromatography, High Pressure Liquid; D003430:Cross-Sectional Studies; D004938:Esophageal Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D005433:Flour / Q000032:analysis*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D012307:Risk Factors; D014908:Triticum / Q000737:chemistry*; D000096702:Aflatoxin Poisoning
chemical_list: D000348:Aflatoxins