Abstract
Humans are exposed to a milieu of environmental stressors of a chemical, physical, and social nature that may change over time. Interaction of these stressors with various intrinsic factors such as genetics, sex, life stage, and health status determines susceptibility to related diseases. Cumulative risk assessment seeks to determine the combined risks to health from exposures to multiple agents or stressors. This can be achieved by expanding beyond a G × E approach—where “G” represents genetic susceptibility and “E” (environment) represents a limited range of exposures—to an I × E approach—where “I” (intrinsic) represents the many inter-related biological factors that contribute to disease susceptibility and “E” (extrinsic) represents all nongenetic factors including the exposome. Exposomics is poised to advance this concept and make significant advances in environmental health science and our understanding of the causes of chronic diseases. The internal exposome can be assessed using targeted and untargeted exposomics tools to measure individual chemicals, groups of chemicals, or the totality of chemicals acting on a particular receptor or biological pathway in a functional assay. Comprehensive data on the internal, external, and public health components of the exposome together could inform risk assessment and ultimately guide risk management. These approaches could be applied in vulnerable populations such as migrants or those burdened with multiple types of stressor simultaneously as identified through map- or indicator-based approaches. Development and refinement of additional exposomics tools that can be applied in prospective human epidemiology studies should be a focus of future studies.
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Acknowledgments
We thank our lab colleagues Sarah Daniels, Sylvia Sanchez, Fenna Sille, Phum Tachachartvanich, Luoping Zhang, and Felicia Castriota and collaborators Laura Fejerman, Stephen Rappaport, Esther John, Anthony Macherone, Paul Elliott, Jaspal Kooner, John Chambers, Michele La Merrill, Craig Steinmaus, Allan Smith, Daniel Nomura, Jen-Chywan Wang, Kurt Pennell, Michael Denison, and Catherine Thomsen for their collaboration in pursuing exposomics. This work was supported by NIH grant P42 ES004705 from the National Institute of Environmental Health Sciences and award 21UB-8009 from the California Breast Cancer Research Program.
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Smith, M.T., McHale, C.M., de la Rosa, R. (2019). Using Exposomics to Assess Cumulative Risks from Multiple Environmental Stressors. In: Dagnino, S., Macherone, A. (eds) Unraveling the Exposome. Springer, Cham. https://doi.org/10.1007/978-3-319-89321-1_1
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