Case reports of tropane alkaloid contamination in spinach from Italy and its potential implications for consumer health

This study reports cases of intoxication that occurred in various regions of Italy in October 2022. These incidents were linked to the consumption of leafy vegetables contaminated with tropane alkaloids (TAs), likely due to suspected cross-contamination with toxic plants from the Datura genus. Although official controls were unable to identify the specific weed responsible for the contamination, chemical analysis of the remaining spinach and spinach-based foods consumed by the affected patients revealed concentrations of atropine and scopolamine up to 4642 μg/kg and 8158 μg/kg, respectively. While European regulations currently lack maximum limits for TAs in leafy vegetables, the concentrations detected in 4 out of 5 samples exceeded the maximum limits currently established for cereal-based foods, infant cereal-based foods, and herbal infusions. To assess the acute dietary exposure to atropine and scopolamine, estimated daily intakes of the Italian population were calculated using the TA concentrations measured in spinach samples or assuming the presence of 1 % of the weight of one Datura stramonium leaf in a 500 g spinach pouch. Both exposure scenarios resulted in concerning exposure levels, far exceeding the acute reference dose of 0.016 μg/kg bw by 2–1200 times. Toddlers exhibited the highest mean and 95th percentile acute dietary exposures compared to adults and the elderly. These findings emphasize the necessity of intensifying monitoring efforts and enacting regulatory measures to minimize exposure to TAs from dietary sources that are less commonly associated with contamination, especially for mitigating potential health risks for vulnerable population groups.