Water in the Exposome

The exposome encompasses lifelong exposure to non-genetic factors like lifestyle, diet, socio-economic conditions, and environmental elements. It complements the human genome in explaining health and disease. Environmental risk factors, including pollution, contribute to a substantial part of global morbidity and mortality, with air pollution being a leading cause. However, our understanding of the exposome’s full impact on health is still widely incomplete. The present report presents an integrated exploratory study gathering knowledge about exposome research and attempts to identify interfaces with various facets of (drinking) water practice.
To start, the exposome concept is explained in detail. The definition includes environmental influences and biological responses throughout life which highlights the exposome as being as fundamental to medicine and public health as, for example, the genome. Currently, research on the exposome is dispersed across traditional scientific fields, hindering a holistic understanding of its impact, including in the drinking water sector. All exposure domains contribute to chronic diseases and should be studied collectively. To this end, large exposome projects have recently been initiated in the European Union.
Current research and regulations do not yet fully address the complexity of environmental, biological, and social factors affecting human health. To protect current and future generations from the health impacts of environmental pollutants and other factors, a systematic and coherent effort is needed to devise relevant and complementary approaches. This involves recognizing and deeply exploring the connection between the external environment (e.g., air, water, food) and the internal environment within the body, where harmful chemicals can disrupt physiological processes.
An increasingly coordinated effort by various stakeholders (incl. universities, government agencies, companies, and foundations) to explore and understand the exposome is called for since it involves collecting diverse exposome data types and sources, leading to increased complexity. While recognizing that the complete exposome may never be fully characterized, the development of new risk assessment methods and synergistic dialogues across disciplinary realms hold promise in the investigation of the complex environment and can help steer science, regulation, and society into a healthier future.
In this report, the significance of the exposome concept for the drinking water practice is explored and an outlook is given on the possibilities to formulate new research or use tools from the exposome field. In addition, exposome research topics that are in line with the current BTO program are identified. Ultimately, exposome research topics were identified and prioritized for the (drinking) water sector, such as integrated assessment of relevant water contaminants and pathogens, identification of context-specific exposure factors contributing to health risks, standardization of data collection and analysis to help ascertain causal links, support methodological synergism between chemical and biological screening methods in waters and strengthen cross-domain experts cooperation.