May 1986, Volume 36, Issue 5

Original Article


Fatima Nizami  ( Pakistan Medical Research Council, Research Centre, Jinnah Postgraduate Medical Centre, Karachi. )
H.M. Nizami  ( Institute of Environmental Studies, University of Karachi. )
Mahmood Ahmad  ( Deptt. of Physiology, University of Karachi. )


Two hundred urine samples from apparently healthy subjects were examined for aflatoxin.
Aflatoxin was detected in the urine of 9.5% of subjects from the lower and 5% from the upper socioeconomic groups. Liver cancer is also more common in less privileged individuals. Aflatoxin excretion had no relationship with the age or sex of the subjects studied (JPMA 36: 112, 1986).


Primary liver cancer is more prevalent in Sind than other provinces of Pakistan.1 Factor associated with this pattern have not been studied. Aflatoxin consumption has often been correlated with primary liver cancer.2-6Since the climatic conditions in Karachi are conducive to the growth of Aspergillus species, cereals, spices and dry fruits get contaminated with this fungus2,4,5 Fungus contamination is more likely in areas where edibles are sold in open markets rather than in hygienically packed food items in supermarkets.
It was planned to study the pattern of consumption of aflatoxin by analysing the urine samples of healthy subjects collected from various areas of Karachi and correlate it with their age, sex and socio-economic status.


Collection of urine sample: 24 hours samples were collected from 200 apparently normal subjects belonging to various socio-economic status from different areas of Karachi.
Column Gel clean up for Aflatoxin: Each sample of 24 hours urine to which 2m1 of HC1 was added to prevent aflatoxin decomposition was mixed with chloroform in a ratio of 2: 1 respectively. The analysis of aflatoxin in urine was done by TLC method followed by column Gel clean up and then column chromatography.7 Flourescence of aflatoxins was visualised with especially constructed lamp hood which corresponded with the excitation wave length of 365 nm for all the major aflatoxins.


Tables I, II and III show the number of cases from different areas of the city. The population examined irrespective of communities was roughly divisible into three socio-economic groups. People belonging to the upper class (p.a. income more than 36000/.) were examined from 6 localities (Table I): those belonging to the middle class (p.a. income Rs.13000/. Rs.36,000/.) from 6 localities (Table II) and the rest belonging to the lowest class (p.a. income up to 12000/.) were examined from 11 localities (Table III).Five per cent were positive in the 1st, 6% in the 2nd, and 9.5% in the third group. Analysis of data of liver cancer at the PMRC Research Centre, Karachi also shows a higher prevalence of liver cancer in in­dividuals of low socio-economic group (Figure 1).

Table IV shows the number of aflatoxin positive males and females as well as number of male and female patients suffering from hepatic carcinoma belonging to the 3 socioeconomic strata.


1. Siddiqi, M.A. Incidence of liver carcinoma in Pakistan. Proceeding of the AFOCC. 2nd Asian Cancer Conference, Singapore, 1976, P. 34.
2. Keen, P. and Martin, P. Is aflatoxin carcinogenic in man. The evidence in Swaziland. Trop. Geogr. Med., 1976;23:44.
3. Shark, R.C., Gordon, J.E., Wogan, G.N., Nodasuta, A. and Suihawani, B. Dietary aflatoxin and human liver cancer. III. Field survey of rural Thai families for ingested aflatoxin. Fd. Cosment Toxical., 1972; 10: 71.
4. Nizami, H.M., Saify, S.J. and Arain, M. Aflatoxin contamination of food. A sample based study of Karachi Unit. Karachi. J. Sd., 1978; 6:17.
5. Nizami, H.M. and Zuberi, S.J. Aflatoxin and liver cancer in Karachi, a preliminary survey. JPMA., 1977;27 : 351.
6. Reddy, T.V., Viswanathan, L. and Venkitasu­brmanian, T.A. Thinlayer chromatography of Aflatoxins. Arch. Biochem., 1970; 38:568.
7. Hartley, R.D., Nesbitt, B.F. and O’Kelly, J. Toxic metabolities of aspergillus flavus. Nature, 1963; 11: 288.
8. Hasany, S.H., Yousuf, M. and Husain, S.S. Study on stored grain fungi. Pakistan J. Sci. Ind Res., 1971; 11:288.
9. Husain, S.S. and Ahmed, M.A. Studies on stored food and grain fungi..Pakistan J. Sci. Ind. Res., 1971; 14:13.
10. Ahmed, M.A. and Husain, S.S. Studies on stored grain fungi. Pakistan J. Sci. Ind. Res., 1971; 14: 237.
11. Husain, S.S. and Ahmed, M.A. Studies on stored food grain fungi. Pakistan J. Sci. Ind. Res., 1971; 14: 507.


The greatest risk for aflatoxin contamination was present in the developing countries where dietary staples were often stored under conditions which favoured the growth of fungi. Such a condition exists in Pakistan especially in Karachi where the climate is hot and humid and even in the winter the climate is favourable to promote the growth of fungi thus an increased risk of contamination of cereals and other spices whichare sold open in the market and freely consumed by the local population.3,5,9-12 The report of PMRC1 has indicated a gradual increase in liver cancer as we travel south from the northern areas and in Karachi it has been found to be the highest.
Results of this study indicate that excretion of aflatoxin in urine is directly related to the environmental and economic conditions prevailing in various areas of Karachi. The liver cancer data also shows the similar results (Figure 1). The pattern of aflatoxin ingestion and excretion and that of liver cancer suggest a cause and effect relationship between fungal toxins and hepatic malignancy.

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