Background: Aflatoxins (AFs), as secondary metabolites, are mainly produced by fungi of Aspergillus genus. The determination of contamination rate, dietary exposure, and health risk assessment for aflatoxin M1 (AFM1) was conducted aimed to estimate potential health risks for the population of North Macedonia. Methods: A total of 974 dairy samples, including 404 Ultra-High Temperature (UHT) milk, 291 ice cream, 178 yogurt, and 101 cheese were collected from the markets in North Macedonia. Analysis of AFM1 was done using Enzyme-Linked Immunosorbent Assay and High-Performance Liquid Chromatography with Fluorescence Detection. Results: The AFM1 incidence was highest in yogurt samples (93.8%) and lowest in UHT milk samples (67.8%). AFM1 concentrations were 49.1±68.4, 30.9±30.0, 35.1±40.4, and 40.1±90.1 ng/kg for UHT milk, ice cream, yogurt, and cheese samples, respectively. The Estimated Daily Intake (EDI) for the average population and high consumers (upper bound; samples with AFM1<Limit of Detection (LOD) were 0.150 and 0.456 ng/kg body weight (bw)/day, respectively. The Hazard Index (HI), Margin of Exposure (MoE), and the fraction of Hepatocarcinoma (HCC) cases per 100,000 inhabitants for the average population reached values of 0.33, 8533, and 0.004, respectively. Conclusion: To our best knowledge, this is the first report of dietary exposure and risk assessment of AFM1 in dairy products of North Macedonia, revealing a potential risk of AFM1 in population of this country.
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