Exposome within the Context of the Public Health Perspectives

Genetics account for a small proportion of diseases, and the remaining causes appear to be environmental. The classic epidemiological approach is to study each cause-effect relationship separately. This does not consider the linked and complex interactions between different exposures throughout the life course. The exposome is a new concept in health research. It focuses on integrating environmental exposures from conception to death with the human genome to study their effects on human health. It complements but does not mirror the genome. It is dynamic and includes many domains, and the relationship between different domains is complex. These domains include the internal biological processes, the general external environment, and the external individual’s local immediate environment. Environmental exposures need to be studied to understand the causes and mechanisms of diseases to formulate prevention strategies. Many study designs, assessment tools, and methods are currently used to unravel its effects at levels of the population throughout the life span. While the application of the genome to health may be at the individual level, the exposome will be applied to the general population. Therefore, the exposome is likely to benefit public health rather than clinical practice. This narrative review aims to provide readers with the current status of exposome research, its relevance to public health and medicine, as well as its future challenges. The most important challenges are methodological and statistical issues, identification of novel biomarkers, big data management using artificial intelligence, ethical and economic considerations, integration with one health and syndemic approaches, and lastly, data sharing and international cooperation.