Assessing the Exposome with External Measures: Commentary on the State of the Science and Research Recommendations

Turner, Michelle C.; Nieuwenhuijsen, Mark; Anderson, Kim A.; Balshaw, David M.; Cui, Yuxia; Dunton, Genevieve F.; Hoppin, Jane A.; Koutrakis, Petros; Jerrett, Michael

doi:10.1146/annurev-publhealth-082516-012802

Cited by 88 publications

(55 citation statements)

References 110 publications

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“…Having an easily accessible inventory of exposure assessment tools would also facilitate the sharing of methods and data across studies. As part of the NIEHS exposome workshop in January 2015 (9), working groups began the process of cataloging available tools for assessing environmental exposures and associated biological responses within their respective fields (11, 12, 44). Thus, this recommendation can likely be implemented soon.…”

Section: Recommendations For Future Research and Societal Investmentmentioning

confidence: 99%

Toward Greater Implementation of the Exposome Research Paradigm within Environmental Epidemiology

Stingone

Louis

Nakayama

et al. 2017

Annu. Rev. Public Health

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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.

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Section: Recommendations For Future Research and Societal Investmentmentioning

confidence: 99%

Toward Greater Implementation of the Exposome Research Paradigm within Environmental Epidemiology

Stingone

Louis

Nakayama

et al. 2017

Annu. Rev. Public Health

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“…For example, orthogonal external exposure data sources such as air pollution sensors and cell phones generate a wealth of complementary data that present opportunities for new analyses as well as shared challenges, including autocorrelation and missing data. Some challenges and opportunities regarding the use of external sensors to assess the expo-some are described in an accompanying review (61). We recommend that the scientific community devote efforts to extend NHANES-like epidemiological biomonitoring surveys to ascertain baseline and reference intervals of exposome-based measurements to capture the extent of variability of the exposome in diverse populations (Table 1, recommendation 2).…”

Section: What Is the Human Exposome Data Structure?mentioning

confidence: 99%

Informatics and Data Analytics to Support Exposome-Based Discovery for Public Health

Manrai

Cui

Bushel

et al. 2017

Annu. Rev. Public Health

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111

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The complexity of the human exposome—the totality of environmental exposures encountered from birth to death—motivates systematic, high-throughput approaches to discover new environmental determinants of disease. In this review, we describe the state of science in analyzing the human exposome and provide recommendations for the public health community to consider in dealing with analytic challenges of exposome-based biomedical research. We describe extant and novel analytic methods needed to associate the exposome with critical health outcomes and contextualize the data-centered challenges by drawing parallels to other research endeavors such as human genomics research. We discuss efforts for training scientists who can bridge public health, genomics, and biomedicine in informatics and statistics. If an exposome data ecosystem is brought to fruition, it will likely play a role as central as genomic science has had in molding the current and new generations of biomedical researchers, computational scientists, and public health research programs.

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“…Several different modalities exist to assess environmental exposures (Table 1) [for Review (29)] which can include external measures (30), biomonitoring (31), and measurements of biological effect (32). These measurements may be classified as either “individual-level” (e.g., serum levels of heavy metals measured on each participant or self-reported diet), or “ecological-level” which is based on spatiotemporal information on individuals, such as zip code at a certain point of time or with respect to an event.…”

Section: Part 2 Types Of Traditional and Emerging Exposure Measuremementioning

confidence: 99%

Opportunities and Challenges for Environmental Exposure Assessment in Population-Based Studies

Patel

Kerr

Thomas

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background A growing number and increasing diversity of factors are available for epidemiological studies. These measures provide new avenues for discovery and prevention yet they also raise many challenges for adoption in epidemiological investigations. Methods We evaluate 1) designs to investigate diseases that consider heterogeneous and multi-dimensional indicators of exposure and behavior, 2) the implementation of numerous methods to capture indicators of exposure, and 3) the analytical methods required for discovery and validation. Results Case-control studies have provided insights into genetic susceptibility but are insufficient for characterizing complex effects of environmental factors on disease development. Prospective designs are required but must balance extended data collection with follow-up of study participants. Two phase designs are described. We discuss innovations in assessments including the microbiome, mass spectrometry and metabolomics, behavioral assessment, dietary, physical activity and occupational exposure assessment, air pollution monitoring and global positioning and individual sensors. The availability of extensive correlated data raises new challenges in disentangling specific exposures that influence cancer risk from among extensive and often correlated exposures. Conclusions New exposure assessments offer many new opportunities for environmental assessment in cancer development. Impact We describe and evaluate the state of the art for evaluating high dimensional environmental studies.

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Assessing the Exposome with External Measures: Commentary on the State of the Science and Research Recommendations

Cited by 88 publications

References 110 publications

Toward Greater Implementation of the Exposome Research Paradigm within Environmental Epidemiology

Toward Greater Implementation of the Exposome Research Paradigm within Environmental Epidemiology

Informatics and Data Analytics to Support Exposome-Based Discovery for Public Health

Opportunities and Challenges for Environmental Exposure Assessment in Population-Based Studies

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