Exposome in the News! Understanding and Addressing Policy Challenges in Exposome Research

The European Human Exposome Network (EHEN) Scientific Meeting took place from May 30th to June 1st in Leuven, Belgium.

The focus of the third day of the meeting was “Exposome Research: Understanding and Addressing Policy Challenges.” Benoit Nemery, Emeritus Professor at the Faculty of Medicine in KU Leuven, welcomed the speakers and audience attending the event by saying, "We have speakers from the European Union who will discuss the exposome goal and challenges from a European perspective. The speaker from WHO will highlight the global challenges faced by researchers and policymakers.”

We have previously covered the exposome in other blog posts. Check out an overview on the topic here before you continue reading this article!

Understanding The Human Exposome

The first speaker was Dr. Peter Hoet, Professor at the Faculty of Medicine in KU Leuven and Coordinator of the EXIMIOUS project. He started with the classical definition of the exposome [1,2] and classified exposures as mainly external and internal [3]. He then further classified these exposures into general and specific. Dr. Hoet pointed out that data collection is highly complicated, but numerous techniques are developed for general and specific exposure. He listed the various types of exposures and techniques to collect their data [3].

Dr. Hoet briefly explained the workflow of exposome research and talked about EHEN in detail. He said, "EHEN has one common goal to understand the health impacts of a lifetime of environmental health. EHEN currently has nine large-scale projects involving 126 research groups across 24 countries supported by the European Commission (EC) with a grant of 106 million euros.” The nine large-scale projects in EHEN are listed below [4]. 

1. The Exposome from Evidence to Translation (ATHLETE) aims to “measure a wide range of environmental exposures to better understand how the exposome impacts human health from pregnancy to adolescence. The project follows 80,000 pairs of mothers and children across Europe to study the health effects of early-life exposure to environmental hazards.”
2. Exposome Project for Health and Occupational Research (EPHOR) aims to “develop methods and tools to characterize the working-life exposome, as applying these to both existing data and for the collection of new data will enhance our knowledge of the working-life exposome.”
3. Early environmental quality and life-course mental health effects (Equal-Life) project aims to “develop and test combined exposure data using a new approach to multi-modal exposures and their impact on children’s mental health and development. A combination of birth cohort data with new sources of data will provide new insights into aspects of physical and social exposures. It will do this for various scales and time frames while accounting for the distribution of exposures in social groups based on gender, ethnicity, and social vulnerability.”
4. Mapping Exposure-Induced Immune Effects: Connecting the Exposome and the Immunome (EXIMIOUS) aims to “bring about a new way of assessing the human exposome by linking innovative ways of characterizing and quantifying multiple and combined environmental exposures (exposomics) with high-dimensional immunophenotyping and profiling platforms to map early immune effects induced by these exposures (immunomics).”
5. Exposome-powered tools for healthy living in urban settings (EXPANSE) aims to “study the complex mixture of social and environmental factors in the urban environment that collectively have an impact on health to find the answer to how to improve one’s health and well-being in a modern urban environment.”
6. Human exposomic determinants of immune-mediated diseases (HEDIMED) aims to “find out prevention for immune-mediated diseases, including type 1 diabetes, celiac disease, asthma, and allergies. This will be accomplished by identifying the environmental exposures contributing to the development of these diseases.”
7. Human Exposome Assessment Platform (HEAP) aims to “develop an informatics platform to analyze large datasets on environmental exposures and their health effects.”
8. LongITools aims to “measure how exposure to air and noise pollution and the built environment, and an individual’s lifestyle, psychological and social situation, interact with genetic factors and contribute to the risk of developing diseases such as obesity, type 2 diabetes, heart disease, and atherosclerosis.”
9. Impact of exposome on the course of lung diseases (REMEDIA) aims to “better understand the contribution of the exposome to two untreatable respiratory diseases: chronic obstructive pulmonary disease and cystic fibrosis.”

At the end of his talk, Dr. Hoet listed EHEN-anticipated outputs such as new toolbox development, scientific publication, policy briefs, and integration of the EU with the global exposome community.

The EU Perspective on Exposome Policy Challenges

Dr. Rita Araujo, Policy Officer and EC Directorate General (DG) for Research and Innovation, was the first speaker to share the EU perspective. She spoke on “The EC Exposome context: goal and expectations.” She outlined the European Green Deal, whose primary objective is to mobilize research for fostering innovation and a zero-pollution ambition for a toxic-free environment. She highlighted how the EU has focused on studying the environment and health since 2000 and has contributed 3 billion euros to 700 projects over a 22-year timespan.

Dr. Araujo briefly discussed the cluster of projects focusing on understanding the impacts of micro and nano-plastics on human health (CUSP). CUSP is a group of five large-scale research projects involving 75 organizations from 21 countries. She further highlighted how the EHEN project was a follow-up project after the success of the EU Exposome Initiative which took place over 2012-2018 and contributed 29 million euros. She said that the EHEN project would follow the EIRENE project, whose objective is to bring together exposome data and lead the global governance network on exposomes. She concluded her talk by saying that these exposome research networks are some of the largest networks in the world.

Dr. Lorena Korosec, Policy Officer and EC DG for Environment Unit A3 (Green Knowledge & Research Hub Life), spoke on the EU action plan “Towards Zero Pollution.” She gave a statistic on how environmental pollution affects health, with cancer topping the list.

Dr. Korosec explained the zero pollution vision for 2050: "Air, water, and soil pollution is reduced to levels no longer considered harmful to health and natural ecosystems and that respect the boundaries our planet can cope with, thus creating a toxic-free environment.” The EU has developed Action Plan 2030 targets into six major targets to achieve this vision. These six targets are defined by a coloring pattern, wherein blue represents health, green represents biodiversity & ecosystem, and orange shows consumption.

She informed the audience that one of the key findings from the first zero pollution monitoring & outlook report was that air pollution reduction is on track, with a likely reduction of 66% by 2030. Conversely, environmental noise reduction is not on track according to the action plan targets, as the likely maximum reduction between 2017 and 2030 is only 19%.

The WHO Perspective on Understanding Policy Challenges

Dr. Sinaia Netanyahu, Program Manager of Environment and Health Impact Assessment at the WHO European Centre for Environment and Health (ECEH), shed light on the WHO perspective. Dr. Netanyahu gave a brief about the role of ECEH in policymaking. She emphasized that ECEH provides state-of-the-art evidence on existing and emerging environmental health risks to the 53 member states (European and Central Asian countries). Dr. Netanyahu also discussed the core function of WHO, the 2030 agenda of environment and health, and various WHO frameworks [5]. She also highlighted the 2017 Ostrava Ministerial Conference on Environment and Health, wherein the key public health priorities of Ostrava were the following [6]:

• Improve indoor and outdoor air quality.
• Ensure access to safe drinking water, sanitation, and hygiene.
• Minimize adverse effects of chemicals.
• Strengthen adaptation to and mitigation of climate change.
• Prevent/eliminate adverse effects of waste management & contaminated sites.
• Support cities and regions to become healthier.
• Build the environmental sustainability of the health systems.

Dr. Netanyahu listed WHO’s six key points for building forward better with emphasis on mutual benefits for the environment and health while making a healthy recovery from COVID-19 [7-13]. She further explained the WHO Supporting Action on air quality guidelines, environmental noise guidelines, mental health & urban green/blue space, and chemical safety & biomonitoring [14-18]. She informed the audience that the new WHO global air quality guidelines were developed at ECEH, and they have a better insight into the contribution of air pollution to the worldwide disease burden. She also shared the WHO support on environmental and health assessment [16,18,19].

She concluded her lecture by outlining the upcoming 7th Ministerial Conference on Environment and Health in July taking place in Budapest. The conference will address the health dimension of the “triple environmental crisis (pollution, climate change, and biodiversity loss & land degradation)” while recovering from COVID-19.

Conclusion

The event concluded with a talk from Sylvain Sebert, Professor of Life Course Epidemiology at the University of Oulu in Finland, Coordinator of LongITools, and Co-coordinator of EHEN. He defined health as a collective value, suggesting that “my health cannot be at the expense of others nor through the excessive use of natural resources [20,21].” He drew attention to the significant challenges faced by policymakers in going the exposome way is that the majority of data available are omics-based. To develop exposome-based policies, data should come from a broad population, and the environment should not be reduced to one element. He underlined that EHEN science-based policies are designed by triangulating multiple disciplines (experimental research, health economics, ethics & policies, epidemiology, city labs, and SME innovation) for better health. 

Prof. Sebert ended his lecture with a thought-provoking quote previously said at the Rio+20 United Nations Conference on Sustainable Development in 2012, which summarized the essence of the meeting; that for better health, we need a pollution-free environment: 

"Why treat people only to send them to the environment that made them sick in the first place?"

If you are a practitioner and have interest in integrating detection and correction strategies specifically for the exposome into your practice, go to homehope.org for more information. 

References

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2. Wild, C. P. The exposome: From concept to utility. International Journal of Epidemiology vol. 41 24–32 Preprint at https://doi.org/10.1093/ije/dyr236 (2012).

3. Ronsmans, S. et al. The EXIMIOUS project—Mapping exposure-induced immune effects: connecting the exposome and the immunome. Environmental Epidemiology 6, (2022).

4. European Commission. Projects of EHEN. https://www.humanexposome.eu/11842-2/projects/.

5. Organization, W. H. European Programme of Work (2020–2025)–“United Action for Better Health in Europe”. Preprint at (2020).

6. Organization, W. H. Report of the Sixth Ministerial Conference on Environment and Health: Ostrava, Czech Republic, 13–15 June 2017. (2017).

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12. Organization, W. H. A health perspective on the role of the environment in One Health. in A health perspective on the role of the environment in One Health (2022).

13. Organization, W. H. Urban planning for resilience and health: key messages–summary report on protecting environments and health by building urban resilience. in Urban planning for resilience and health: key messages–summary report on protecting environments and health by building urban resilience (2022).

14. Organization, W. H. Environmental noise guidelines for the European region. (World Health Organization. Regional Office for Europe, 2018).

15. Braubach, M. et al. Green and blue spaces and mental health:: new evidence and perspectives for action. (2021).

16. Organization, W. H. WHO global air quality guidelines: particulate matter (PM2. 5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide: executive summary. (2021).

17. Organization, W. H. Mercury and human health: educational course. (2021).

18. Salud, O. M. de la, Weltgesundheitsorganisation, Organization, W. H. & Environment, E. C. for. WHO global air quality guidelines: particulate matter (PM2. 5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide. (World Health Organization, 2021).

19. Organization, W. H. WHO expert consultation: available evidence for the future update of the WHO Global Air Quality Guidelines (AQGs): meeting report Bonn, Germany 29 September-1 October 2015. (2016).

20. McCartney, G., Popham, F., McMaster, R. & Cumbers, A. Defining health and health inequalities. Public Health 172, 22–30 (2019).

21. Huber, M. et al. How should we define health? Bmj 343, (2011).