A precision environmental health approach to prevention of human disease

Abstract

Human health is determined by the interaction of our environment with the genome, epigenome, and microbiome, which shape the transcriptomic, proteomic, and metabolomic landscape of cells and tissues. Precision environmental health is an emerging field leveraging environmental and system-level ('omic) data to understand underlying environmental causes of disease, identify biomarkers of exposure and response, and develop new prevention and intervention strategies. In this article we provide real-life illustrations of the utility of precision environmental health approaches, identify current challenges in the field, and outline new opportunities to promote health through a precision environmental health framework.

Fig. 1. Hallmarks of precision environmental health.

Precision Environmental Health seeks to prevent disease by understanding risk and tailoring interventions at the level of the individual. To reach this goal, precision environmental health research seeks to understand mechanisms by which environmental exposures cause disease and the basis for interindividual differences in susceptibility. This information will contribute to the attainment of this goal through the development of more precise biomarkers of exposure and risk and the development of advanced risk prediction models that incorporate “omic” data.

Fig. 2. Translational framework of environmental epigenomics and precision environmental health.

While human cohort studies can examine associations between environmental exposures and health outcomes, only surrogate tissues are available to assess molecular mechanisms involved in complex biological functions. Animal models can provide additional mechanistic insight by allowing for multi-tissue and multi-age comparisons. Animal models and in vitro cell culture studies can provide both mechanistic insights and a basis for moving beyond correlation to causality via reverse translation. Red people mean “unaffected”; blue people mean “susceptible”. Created with BioRender.com.

Fig. 3. Precision environmental health applications to primary, secondary, and tertiary prevention.

Precision environmental health research can contribute to primary prevention (left) by mitigating individual risk, secondary prevention (middle) by slowing the progression of subclinical disease, and tertiary prevention by reducing disease impact (right). Colors are used to indicate diversity within exposed populations. Created with BioRender.com.

Fig. 4. Use of epigenetic data and machine learning to develop a new blood-based biomarker of cumulative lead (Pb) exposure in the Boston area Veteran Affairs Normative Aging Study.

Epigenome-scale blood methylation data were used to train and test against benchmark bone-Pb data, which reflect long-term Pb exposure and were available in the study. This type of epigenetic biomarker holds great promise to capture and accurately assess long-term, cumulative exposures to environmental and lifestyle factors. Created with BioRender.com.