The current investigation was undertaken to take a review of the performed studies regarding the concentration and prevalence of aflatoxin M₁ (AFM₁) of the consumed cow milk in the Middle East. In this context, all available studies published in databases include Science Direct, PubMed, Scopus, and Web of Science among 1995 to December 2017; were screened accordingly. Also, the carcinogenic risk was estimated by calculating hazard index (HI) using the Monte Carlo simulation (MCS). The result of conducted meta-analysis for 49 articles containing 7484 data indicated that the rank order of type of milk based on the concentration of aflatoxin M₁ was Ultra-high temperature processing (UHT) milk (82.57 ng/kg) > raw milk (60.37 ng/kg) > pasteurized milk (PAS) (45.81 ng/kg). The pooled concentration of aflatoxin M₁ in raw and UHT milk was higher than EC (European Committee, 50 ng/kg) standard limit. The rank order of countries based on the concentration of aflatoxin M₁ in raw milk was Syria > Turkey > Iran > Egypt > Lebanon > Palestine; pasteurized milk, Turkey > Iran > Lebanon; and UHT milk, Iran > Turkey > Saudi Arabia. The overall prevalence of aflatoxin M₁ in the raw milk of Iran, Turkey, Lebanon, Palestine, Egypt, and Syria was identified as 76%, 12%, 67%, 85%, 38%, and 14%; pasteurized milk, in the Iran, Lebanon, and Turkey was 77%, 36%, and 11%; and finally UHT milk in Iran, Saudi Arabia, and Turkey was 81%, 82%, and 62%, respectively. HI in the adult's consumer's raw milk in the Iran, Turkey, Syria, Palestine, Lebanon, and Egypt were calculated as 0.26, 0.47, 0.52, 0.34, 0.23 and 0.18; However, the HI for adult consumers of pasteurized milk in the Iran, Turkey, and Lebanon were 0.28, 0.31 and 0.11. Also, the measured HI for adult consumers of UHT milk in the Saudi Arabia, Turkey, and Iran was 0.20, 0.33 and 0.50, respectively. The obtained HI for consumers of raw milk in the children age group of the Iran, Turkey, Syria, Palestine, Lebanon, and Egypt were 1.03,2.20, 2.42, 1.59, 1.05, and 0.84. The calculated HI for consumers of pasteurized milk in the children age group of the pasteurized milk in of Iran, Turkey, and Lebanon were 1.30, 1.56, and 0.50. Finally, in term of UHT milk in Saudi Arabia, Turkey, and Iran were 0.94, 1.44 and 2.35, respectively. Unlike Adults, children consumers in the several Middle East countries are at considerable cancer risk due to consumption of raw, pasteurized and UHT milk contain AFM₁(HI > 1).

当前的调查是对中东地区食用的牛奶中黄曲霉毒素M ₁（AFM ₁）的浓度和患病率进行的研究的回顾。在这种情况下，数据库中发表的所有可用研究包括1995年至2017年12月间的Science Direct，PubMed，Scopus和Web of Science；被相应地筛选。此外，通过使用蒙特卡洛模拟（MCS）计算危险指数（HI）来估算致癌风险。对包含7484项数据的49篇文章进行的荟萃分析结果表明，基于黄曲霉毒素M ₁的浓度，牛奶类型的等级顺序是超高温加工（UHT）牛奶（82.57 ng / kg）>生牛奶（60.37 ng / kg）>巴氏灭菌奶（PAS）（45.81 ng / kg）。原奶和超高温灭菌奶中黄曲霉毒素M ₁的合并浓度高于EC（欧洲委员会，50 ng / kg）标准限值。基于原料奶中黄曲霉毒素M ₁浓度的国家排名依次是叙利亚>土耳其>伊朗>埃及>黎巴嫩>巴勒斯坦；巴氏杀菌牛奶，土耳其>伊朗>黎巴嫩；和超高温灭菌牛奶，伊朗>土耳其>沙特阿拉伯。黄曲霉毒素M ₁的总体患病率伊朗，土耳其，黎巴嫩，巴勒斯坦，埃及和叙利亚的原奶中的比例分别为76％，12％，67％，85％，38％和14％；在伊朗，黎巴嫩和土耳其，巴氏杀菌奶分别为77％，36％和11％；最终，伊朗，沙特阿拉伯和土耳其的超高温灭菌牛奶分别为81％，82％和62％。在伊朗，土耳其，叙利亚，巴勒斯坦，黎巴嫩和埃及，成人消费者的原奶中的HI分别计算为0.26、0.47、0.52、0.34、0.23和0.18；但是，伊朗，土耳其和黎巴嫩的巴氏杀菌牛奶成人消费者的HI为0.28、0.31和0.11。同样，在沙特阿拉伯，土耳其和伊朗，UHT奶成人消费者的测得的HI分别为0.20、0.33和0.50。伊朗，土耳其，叙利亚，巴勒斯坦，黎巴嫩和埃及的儿童年龄段的原奶消费者获得的HI为1.03、2.20、2.42、1.59、1.05，和0.84。在伊朗，土耳其和黎巴嫩，巴氏杀菌奶的儿童年龄组中，巴氏杀菌奶的消费者计算得出的HI为1.30、1.56和0.50。最后，就沙特阿拉伯，土耳其和伊朗的超高温灭菌牛奶而言，分别为0.94、1.44和2.35。与成人不同，由于食用含有AFM的生，巴氏杀菌和UHT牛奶，中东一些国家的儿童消费者处于相当大的癌症风险中₁（HI> 1）。