Toward Greater Implementation of the Exposome Research Paradigm within Environmental Epidemiology

Abstract

Investigating a single environmental exposure in isolation does not reflect the actual human exposure circumstance nor does it capture the multifactorial etiology of health and disease. The exposome, defined as the totality of environmental exposures from conception onward, may advance our understanding of environmental contributors to disease by more fully assessing the multitude of human exposures across the life course. Implementation into studies of human health has been limited, in part owing to theoretical and practical challenges including a lack of infrastructure to support comprehensive exposure assessment, difficulty in differentiating physiologic variation from environmentally induced changes, and the need for study designs and analytic methods that accommodate specific aspects of the exposome, such as high-dimensional exposure data and multiple windows of susceptibility. Recommendations for greater data sharing and coordination, methods development, and acknowledgment and minimization of multiple types of measurement error are offered to encourage researchers to embark on exposome research to promote the environmental health and well-being of all populations.

Keywords: environmental epidemiology; exposome; life-course epidemiology; multiple exposures.

Figure 1

Framework for methodologies that integrate across individual studies to assess the exposome. Each square represents a cohort at a specific life stage. Arrows illustrate the potential bidirectional relationships between measures of exposure assessment, -omics technologies, and health outcomes assessed within each cohort. Integrating across the ages represented by the different life-stage cohorts will allow investigators to explore the exposome across the life course.