From the Outside In: Integrating External Exposures into the Exposome Concept

  • Yuxia Cui
  • David BalshawEmail author


The exposome comprises exposures arising from both endogenous processes and the external environment, which include not only chemical compounds but also nutrients, drugs, infectious agents, the microbiome, physical stress, and psychosocial stress. But where do those exposures come from, and what can we do about them? This chapter will focus on two distinct but interrelated questions: (1) Why understanding the environment outside of the body is critical for unraveling the exposome; and (2) How to measure the exposome from the outside the body. The external environment is critical to unraveling the exposome for it provides a depth of context that analysis of biological samples cannot, it also informs data interpretation by providing linkage between external sources of exposure and the internal dose, and in some cases, external assessment is the only way to objectively evaluate an exposure such as social and built environment as well as behavioral factors. The grand challenge lies in how to provide a comprehensive and rigorous characterization of the external environment on the exposome scale. This chapter will discuss
  • Scientific advances, emerging technologies, and novel opportunities to unravel the exposome from the external environment

  • The importance of multi-scale data integration in assessing the temporal and spatial dynamics of the exposome

  • Strategies and the value of integrating external and internal environments in studies of the exposome

  • The opportunity of applying the exposome to inform citizen science and disease prevention


Integrating external exposures with exposomics Multi-scale data integration 


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Authors and Affiliations

  1. 1.Exposure, Response, and Technology BranchNational Institute of Environmental Health SciencesDurhamUSA

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