The double-edged sword of meat preservation: a review of nitrosamine genotoxicity, exposure in the egyptian market, and future alternatives

Abstract Global population growth and the rising demand for food have necessitated effective preservation techniques to prevent spoilage and ensure food security. Nitrite and nitrate salts are the most common methods used for meat preservation. However, their use presents a significant public health dilemma: under acidic conditions, these salts can be converted into the procarcinogenic, nitrosamines (NAs). The International Agency for Research on Cancer (IARC) classifies processed meat as carcinogenic to humans (Group 1). Many studies link their consumption to colorectal cancer (CRC), the third most common cancer worldwide and the eighth in Egypt, with an estimated incidence in Egypt of approximately 9.8 per 100,000 cases. The levels of NAs in processed meat differ widely, from being below detectable levels (< 1 μg/kg) in certain foods to thousands of μg/kg in others. Most existing studies on nitrosamine exposure rely on the Western market, creating a critical knowledge gap in the Egyptian market. This review bridges the gap by analysing residue levels especially in the Egyptian market and integrating these findings with a review of molecular toxicity mechanisms. Additionally, it provides a risk assessment that includes cumulative exposure from non-dietary sources and evaluates sustainable preservation alternatives.