Purpose. We examined the relationship between various health parameters and aflatoxin B1 (AFB1) albumin adduct levels in plasma. Design. A cross-sectional field study was conducted in four villages in the Ashanti region of Ghana. Methods. A survey on socio-demographic and health characteristics was administered to 162 volunteers and blood (20 ml) was donated by 140 participants. AFB1 albumin adduct levels, liver function, hepatitis B and C viruses (HBV, HCV) and malaria infections were determined. Results. AFB1 levels ranged from 0.12 to 2.995 pmol mg-1 albumin (mean ± standard deviation = 0.89 ± 0.46) and was categorized based on the median as low (<0.80 pmol mg-1) or high (≥0.80 pmol mg-1) and used in the analyses. By multivariate analysis, significantly higher levels of AFB1 were obtained for participants who reported symptoms of acute aflatoxicosis: history of yellow mouth (odds ratio = 5.5, confidence interval = 1.04-29.07, p = 0.04); history of sore swollen stomach (odds ratio = 4.54, confidence interval = 1.28-15.62, p = 0.01). A history of painful vomiting was marginally associated (p = 0.09) with high AFB1 levels. Between 30 and 40% of the study group had abnormal liver function and HBV/HCV infections. Total protein and alanine transaminase (ALT) were positively correlated to AFB1 levels (p<0.01 and p = 0.02, respectively). For every unit increase in AFB1, total protein increased by 0.27 units and ALT increased by 0.20 units. HBV was associated with high AFB1 levels (p = 0.055) and HCV was marginally associated with low AFB1 levels (p = 0.08). Approximately 20% of study participants were positive for malaria antigen in blood. A number of symptoms and disease markers were not significantly associated with AFB1. Conclusions. These results show high levels of AFB1 and symptoms of acute aflatoxicosis in a population that also has high levels of HBV/HCV infections and abnormal liver function. Thus, a high proportion of these study participants are at significant risk of developing hepatocellular carcinoma. © 2007 Informa UK Ltd.