A comprehensive systematic review and health risk assessment of potentially toxic element intakes via fish consumption in Iran

Risk assessment of heavy metals is critical in controlling and preventing risks of foodborne diseases. Fish can be used as bioindicators for exposure to potential toxic elements (PTEs), which can represent potential risks for humans. The long Iranian coastline and three major fishery regions in the country, including the northern (Caspian Sea) and southern (Persian Gulf and Gulf of Oman) seas as well as inland waters and aquacultures (rivers, dams, wetlands and fish farms) have made Iran a large producer of fish. In the first step of the present study, data collection and report of PTEs in fish from the three fishery regions (2010–2022) were carried out. In the second step, health risks were assessed using Monte Carlo simulation in child and adult consumers. The average concentrations of Cd, Hg and Pb for the northern sea, southern sea, and inland waters and aquacultures were 0.273, 0.249, 1.077; 0.430, 0.423, 1.182; and 1.387, 0.232, 1.703 μg/g per dry weight, respectively. Based on the target hazard quotient results, Hg intake of Iranian children from all the three fishery regions was more than 1, which was alarming. In the adult age group, southern sea fish consumers were at risk of Hg adverse health effects. Moreover, Cd included the highest carcinogenic risk of toxic elements in fish from the three fishery regions of Iran. Estimation of THQ, HI, ILCR and EDI revealed that consumption of fish might induce health complexities for the consumers in Iran. Moreover, Iranians from northern and southern regions of the country consumed further seafood due to the availability of high seafood sources in these regions. Hence, various indices must be used for the risk assessment of general human health. Due to the high risks of carcinogenicity/non-carcinogenicity estimated in the risk assessment, consumption of fish by infants and pregnant women must critically be assessed.