This systematic review presents the potential toxicity of heavy metals such as lead (Pb), mercury (Hg), cadmium (Cd), iron (Fe), nickel (Ni), aluminum (Al), and copper (Cu) in raw cow milk, focusing on their contamination sources and on the assessment of the related human health risk. Multiple keywords such as "raw cow milk, heavy metals, and human health" were used to search in related databases. A total of 60 original articles published since 2010 reporting the levels of these metals in raw cow's milk across the world were reviewed. Data showed that the highest levels of Ni (833 mg/L), Pb (60 mg/L), Cu (36 mg/L) were noticed in raw cow milk collected in area consists of granites and granite gneisses in India, while the highest level of Cd (12 mg/L) was reported in barite mining area in India. Fe values in raw cow milk samples were above the WHO maximum limit (0.37 mg/L) with highest values (37.02 mg/L) recorded in India. The highest Al level was (22.50 mg/L) reported for raw cow's milk collected close to food producing plants region in Turkey. The Target Hazard Quotients (THQ) values of Hg were below 1 suggesting that milk consumers are not at a non-carcinogenic risk except in Faisalabad province (Pakistan) where THQ values = 7.7. For the other heavy metals, the THQ values were >1 for Pb (10 regions out of 70), for Cd (6 regions out of 59), for Ni (3 out of 29), and for Cu (3 out of 54). Exposure to heavy metals is positively associated with diseases developments. Moreover, data actualization and continuous monitoring are necessary and recommended to evaluate heavy metals effects in future studies.
Keywords: Contamination level; Contamination sources; Heavy metals; Permissible limits; Raw cow milk; Risk assessment.
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