Researchers have highlighted cases of tropane alkaloid contamination in Italy and called for increased monitoring and regulation.

The study detailed recent cases of tropane alkaloid intoxication after the consumption of spinach and spinach-based foods in Italy during October 2022. Symptoms can include a dry mouth, difficulty speaking and swallowing, tachycardia, drowsiness, dizziness, hallucinations, and delirium.

Incidents were linked to leafy vegetables contaminated with tropane alkaloids, likely due to cross-contamination with toxic plants from the Datura genus. Controls were unable to identify the specific weed responsible but chemical analysis of the remaining spinach and spinach-based foods consumed by affected people revealed atropine and scopolamine. 

Italian examples
Leaves of Datura species can be responsible for cross-contamination of different vegetable products because of their similarity to other frequently consumed vegetables, according to the study published in the journal Food Control.

In the Campania region of southern Italy, eight individuals from three families were hospitalized after consuming spinach potentially mixed with tropane alkaloid-producing plants. 

In the same region, two people from the same family, showing symptoms of tropane alkaloid intoxication were reported to authorities in Naples by their doctor. Food leftovers consisting of boiled spinach were recovered from the patients’ home and analyzed. The producer was identified, and 100 baskets of spinach were seized.

In the Lombardy region of northern Italy, two individuals from the same family were hospitalized after experiencing symptoms, which were attributed to eating spinach-stuffed puff pastry rolls. In the Lazio region, one suspected case due to consumption of boiled spinach potentially contaminated with tropane alkaloid-producing plants was reported by a hospital in Rome.

The concentrations of tropane alkaloids were high in all analyzed samples, except for spinach residues from tests on the fourth example, wher atropine was below the LOQ, and only small amounts of scopolamine were detected.

Mitigating the risk
There are no maximum levels for tropane alkaloids in leafy vegetables in European legislation but concentrations in leftover spinach-based food exceeded the limits for certain grains and dried herbs. Researchers said this underscores the need to reinforce the monitoring of these food matrices as well as the requirement for regulatory measures.

In France, a family experienced severe neurological symptoms such as agitation and hallucinations after eating spinach contaminated with atropine and scopolamine. In Athens, seven people were hospitalized with anticholinergic syndrome after having boiled blites contaminated with Datura innoxia. In Slovakia in 2021, over 100 cases of intoxication were reported due to consumption of deep-frozen spinach puree contaminated with atropine and scopolamine, resulting from the accidental presence of Datura plant residues. 

Due to the invasive nature of Datura, the risk of food crop contamination during harvesting and processing is significant. To mitigate this risk and effectively manage the problem, it is crucial to implement prerequisite programs such as Good Agricultural Practices (GAPs) and Good Manufacturing Practices (GMPs). These programs should include proper training and education of farm workers, as well as the cleaning, sieving, storing, and transporting of raw materials, said researchers.