Exploring the Exposome
A Focus on Totality of Exposures Could
Mean New Opportunities for
Industrial Hygienists
BY JOHN A. DECKER, GAYLE DEBORD, AINSLEY WESTON, AND MARK D. HOOVER
Despite decades of research, the etiology of many diseases re- mains largely unknown. Evidence indicates that the origins of certain chronic diseases have both genetic and environ- mental components.1 Studies have suggested linkages be- tween depression and heart disease, inadequate vitamin D and risk of stroke and heart disease, and a variety of occupa- tional exposures and associated health outcomes. Also, the
rates of certain diseases among immigrants change to match
those of the population where they move, which suggests an
environmental component of disease.1 To better define the
study of this environmental component, a new term, “
exposome,” has arisen in the scientific literature.2
The Exposome Defined
Success in mapping the human genome has generated considerable
scientific interest in the complementary concept of the exposome
—the totality of exposures over a lifetime that predispose and
predict health effects in an individual. The exposome describes
response to any and all insults from conception—injuries, irritations, stressors and traumas, including those from occupational
and environmental sources. These include lifestyle and diet,
which are likely (in combination with the genome) to have a
significant role in the etiology of disease (see Figure 1). Thus,
research on the exposome may help understand the multitude
of interactions leading to disease (see Figure 2).
Clearly, the exposome is a compelling topic for those whose
objective is to prevent illnesses caused or exacerbated by workplace exposure, and it has the potential to be a major focus of
research.
Exposome Studies
While exposure assessment, existing biomarkers and epidemio-logic approaches inform the study of the exposome, these traditional approaches are not sufficient. Exposure assessment related
to the exposome will require other biologically based technologies that can offer fingerprints or signatures of exposures across
a broad spectrum of insults and stimuli.
Promising areas of study may involve the advancing “omic”
technologies (“technomics”), such as epigenomics, proteomics,
metabolomics, and adductomics. The suffix “omic” is derived
from genomics and often indicates a focus on complex, large-scale systems rather than individual biological structures. (
Proteomics, for example, is the study of a large collection of proteins
in a cell or tissue.) One of the hallmarks of the technomics is the
need for high-throughput analysis—that is, simultaneous measurement of thousands of data points considering protein expression levels and complete pathways.
Figure 1. Conceptual view of how complex interactions among
the genome, the exposome, and disease may determine our
state of health.
