How does exposure to chemicals, air pollution, stress or noise affect human health over the course of a lifetime? What about the complex interactions between environmental exposures, social determinants of health and genetics? The ‘exposome’ concept offers a framework for understanding and analyzing this complex reality of our health.
The ESMH spoke with Prof. Roel Vermeulen, author of an upcoming study on human exposome research, launched by the European Parliament’s Panel for the Future of Science and Technology (STOA).
What is exposomics? How does this concept differ from established environmental health research?
Roel Vermeulen: Imagine your body as a diary – not one filled with words, but with the silent traces of everything you’ve encountered throughout your life: the air you breathe, the food you eat, the stress you feel, the chemicals in your home, and the social environment you live in – they all leave a mark. Over time, these exposures write a personalized story in your body, shaping your health in ways we’re now starting to understand. This lifelong collection of environmental influences is called the exposome.
Exposomics is the science of studying the whole of that story. So unlike currently established environmental research, which often looks at one factor at a time—say, air pollution or noise— exposomics zooms out to see the whole picture. It asks: How do all these exposures, together, affect our biology and health?
What makes exposomics urgent and distinctive is its discovery-based approach. Rather than starting with one specific hypothesis, researchers use new tools and big data to generate new hypotheses and uncover hidden connections between our environment and health – patterns we might not even think to look for.
Many established methods are too slow and too narrow for today’s ever-changing environmental landscape. Exposomics is an innovative, and needed approach designed to catch up with the reality of how we actually live, how our societies change through multiple transitions, and why we stay healthy or get sick. It allows the collection of environmental information at scale.
Can exposomics help us understand the root causes of chronic diseases, and what are some of the most significant findings from your research in this area?
Roel Vermeulen: When we think about chronic diseases, we must remember that a large part of their cause lies in the exposome – the totality of environmental and lifestyle exposures that affect us throughout life. Twin studies estimate that over 70% of chronic disease risk is linked to environmental factors, not genetics.
By better understanding these environmental factors, we gain crucial insights to improve public health. This is essential if we are to shift from a reactive, curative-based healthcare infrastructure to a proactive, prevention-focused system.
Such a shift is not only necessary to reduce the growing burden on healthcare systems, but also vital for building a healthier, more economically resilient, and socially competitive European population.
A powerful example of how we can take a comprehensive, discovery-based approach to the exposome comes from a study carried out by Vermeulen’s team using the unique pan-European biobank of the EPIC-Europe cohort. In one study [under review, publication pending] , we analyzed blood samples from individuals years before they developed Parkinson’s disease. We screened for hundreds of chemicals – including nearly 300 pesticides – to identify links to future disease. This led to the discovery of a pesticide previously unknown to be associated with Parkinson’s, opening new doors for early detection and prevention.
In the EXPANSE study, part of the European Human Exposome Network, we showed that environmental risks are not equally distributed across Europe. Often, people in more vulnerable or disadvantaged situations are exposed to more harmful environmental conditions. This underscores the crucial role of socioeconomic determinants of health. Our findings show that pollution and socioeconomic status are intertwined – and that environmental exposures can have even more damaging effects in already at-risk communities.
A striking study from the Helmholtz Centre for Environmental Research further highlights the complexity of the exposome. Researchers found that the neurotoxic potential of chemical mixtures in the blood of pregnant women could not be explained by the presence of individual chemicals alone. They also observed “something from nothing” effects, where chemicals that appear harmless in isolation cause harm when combined. This reveals the hidden dangers of chemical mixtures and the urgent need to study exposures in context, not in isolation.
Together, these insights show why we must take a broader view of health – one that considers not only what we’re exposed to, but also how those exposures interact with our biology, our social environment, and with each other. Understanding the exposome is key to building a healthier, fairer future.
The ‘7 Cs’ policy areas: In your report, exposomics research is mapped onto seven key policy areas (cities, chemicals, climate, child health, career, clinical practice, and citizens). Which of these areas do you think has the most immediate potential for impactful change, and why?
Roel Vermeulen: Exposomics is already making an impact across each of the 7Cs, and the report highlights how new knowledge from this field is informing areas ranging from climate to care. In my own work, I focus on urban health, and I see enormous potential in bringing exposome science into initiatives like the New European Bauhaus. This isn’t a mere speculative vision – it’s something we can already do.
For example, in recent research, Tabea Sonneschein [a PhD-student in Vermeulen’s group] developed a digital twin of Amsterdam – think of it like a real-life version of SimCity. This virtual model includes a synthetic population that mirrors the actual citizens in the city in terms of age distribution, health conditions, and even behavior. In this simulated environment, we can test out new urban designs and policies, and predict the health impacts: who benefits, where, and when.
What’s truly innovative is that this AI-powered system allows us to experiment before we build. By involving citizens, planners, and policymakers in the process, we can co-create healthier neighborhoods based on real evidence – merging creativity with science for lasting impact. Every time we build and design, we have the opportunity to make Europe a bit more healthy.
Occupational health and workplace exposures are a significant but under-recognized health factor. What are some key findings in this area, and how can exposomics improve workplace health policies?
Roel Vermeulen: We spend a large part of our lives at work – and workplace exposures to harmful substances are often much higher than what we experience in our everyday environment. Also, novel substances that are potentially harmful can appear earlier in the workplace than in other environments. That’s why studying exposures at work isn’t just important for protecting workers’ health; it also acts as an early warning system for what might later emerge in the general population as chemicals become more widespread.
In one of our studies, we looked at trichloroethylene (TCE) – a common industrial solvent and environmental pollutant. By measuring not only TCE but also its full range of breakdown products (metabolites), we discovered something surprising: the strongest biological effects weren’t caused by TCE itself, but by previously unknown metabolites. If we had only measured TCE, we might have missed these effects entirely, underestimating the true health risks.
Now, we’re expanding this approach to study other workplaces. Rather than just testing for the chemicals we expect to find, we’re casting a wide net – looking for unexpected substances, reaction products, and metabolites that may also be influencing health. This is where exposomics makes a real difference. Established methods search only under the metaphorical lamppost – where it’s easiest to look. But exposomics, using in this case the power of innovative mass-spectrometry analytical techniques, illuminates the whole street, allowing us to look everywhere, even in places we never thought to search on the basis of predefined hypotheses.
What policy measures do you believe are most critical for public health and how can exposomics help?
Roel Vermeulen: I strongly believe that improving public health requires structural policies. Our health is not only the result of individual choices but is largely shaped by the physical, societal, and political fabric of our environment. If we want to truly shift health outcomes, we need to develop policies that promote healthy behaviors and protect against unhealthy ones.
For a long time, we’ve focused on advising people in preventative health – telling them what to eat or encouraging them to be more active – but these efforts have had limited impact. Changing behavior is complex: people need to understand the message, translate it into action, and have the means and opportunity to make that change.
What if we made the healthier choice the easier or cheaper one? Imagine buildings where stairs are visible and inviting, while elevators are less prominent. Imagine cities where walking or cycling is faster, cheaper, and more convenient than driving. Think of policies that restrict advertising for unhealthy products or make unhealthy behaviors more costly – just as we’ve done with smoking.
This is where exposomics can play a powerful role: by helping us identify which policy levers can be pulled, and by providing evidence of who benefits, when, and where. With this knowledge, we can move from simply informing individuals to designing systems that naturally support better health for everyone.
AI and real-time environmental monitoring are mentioned as game-changers for exposomics. Can you share some examples of how these technologies are currently being applied and their potential for the future?
Roel Vermeulen: In the report, we highlight several key areas where artificial intelligence (AI) can significantly support and accelerate exposome research. One of the most important roles for AI is in helping us analyze the massive volumes of data we now collect to understand how the exposome affects health. Before we had these new AI tools, the complexity and interdependencies between environmental exposures and biological responses were simply beyond what we could meaningfully analyze – AI helps us disentangle these layers of complexity.
Another promising use of AI is in predicting the potential health effects of new chemicals, including their biological implications. By recognizing patterns from existing data – for example, effects already observed for other chemicals or pharmaceuticals – AI can flag potential risks earlier and more accurately than many established methods.
AI also has the potential to model human behavior in real-world environments. For instance, it can help predict how people might respond to new urban policies – like adding more bike lanes, raising parking prices, or limiting the number of fast-food outlets in a neighborhood. This kind of modelling can guide more effective, health-promoting decisions in urban design and public policy.
As in many other fields, AI is poised to have a major impact on exposomics. But with that potential comes responsibility. We must ensure that we properly understand the value of AI-based results and how we can meaningfully act on them to improve human health. This includes ensuring models are trained on datasets with enough data on health-relevant subpopulations, so that predictions are valuable across genders, ages, and socioeconomic backgrounds
By investing in and guiding the use of AI in exposome science, we can not only advance the field itself – we also have the opportunity to drive innovation and entrepreneurial applications that improve public health across society. This will make the EU population economically and societally more competitive.
The report suggests creating a 10-million-people European exposome cohort. What logistical, ethical, and scientific challenges do you foresee in launching and maintaining such an initiative?
Roel Vermeulen: To accelerate our understanding of how the environment shapes health, we must build sustainable, harmonized research resources that reflect the full diversity of the European population – including people of all ages, regions, and lifestyles. This is essential not only to detect emerging risks, but to provide the statistical power and subpopulation diversity required to study life-course exposures and their biological impact at scale. These are goals that currently fragmented studies cannot meet.
A shared European exposome resource would enable us to systematically monitor environmental and lifestyle exposures, detect emerging risks early, and uncover new connections between exposures and health outcomes. Combined with the analytical capabilities of the Environmental Exposure Assessment Research Infrastructure EIRENE, bridging several European Strategy Forum on Research Infrastructures domains, this would form a powerful and globally relevant platform for exposome science.
At present, we lack such a unified infrastructure. As a result, research efforts remain fragmented, and we often recognize health risks too late. A coordinated, large-scale resource would not only benefit public health, but also offer tremendous value to the private sector. Biotechnology and pharmaceutical companies could use this platform to identify novel drug targets, diagnostics, and prevention strategies. The UK Biobank has already demonstrated how public-private co-investment in such infrastructures can be both effective and mutually beneficial.
Realizing this vision will require a strong central organization – something akin to CERN – that enables researchers across Europe to access data, request analyses, and collaborate. While ethical oversight and data privacy are essential, the European Health Data Space (EHDS) already provides much of the necessary framework. Now is the time to establish an Exposomics Working Group within EHDS, to ensure that the exposome is fully integrated into Europe’s data-driven health future.
Is this investment worth it? Absolutely. A healthier population translates to greater productivity, fewer sick days, and enhanced social well-being. Even a small reduction in absenteeism across Europe would yield enormous economic returns. And as we saw with the Human Genome Project, which some projected to currently have delivered a return of 1:141 through advances in biotech, an exposome infrastructure could generate similar – if not greater – benefits. Given the exposome’s critical role in determining health, investing in this kind of resource would be an investment in Europe’s future – one that’s worth every penny.
Citizen empowerment is a core component of exposomics. How can individuals access and use their exposomics data to make informed decisions about their health?
Roel Vermeulen: I strongly believe in citizen involvement and open data. When data and actionable insights are made accessible to all relevant stakeholders, we create a level playing field – one that fosters more informed, balanced dialogue and leads to decisions with potentially broader societal support.
A strong example comes from the Netherlands, where the national public health institute consolidates, among other types of data, air pollution data from national monitoring systems, local programs, and citizen science initiatives into a single open data portal. In addition, they provide user-friendly analytical tools, enabling everyone – from policymakers to local residents – to explore, interpret, and act on this information.
But citizen involvement shouldn’t stop at access. It also means co-creating solutions and setting priorities together with communities, especially those most affected. Empowering people with knowledge and a voice is essential to building trust and achieving lasting, collective impact.
Useful links:
• The European Human Exposome Network
• The International Human Exposome Network (IHEN)
• The EPRS publication “What if focusing on the system, not just the symptoms, were key to health?”
• Presentation of the study on Human Exposome Research in the STOA Panel on 13 March