An estimated 90% of diseases have environmental triggers. These researchers want to build a framework for prevention

Rima Habre, ScD, Gary Miller, PhD, and Chirag Patel, PhD, who are leading the Network for Exposomics in the United States, speak at the Exposome Moonshot Forum in May, 2025.

When Gary Miller, PhD, was starting his postdoctoral research on Parkinson's disease 30 years ago, the biomedical field was fixated on genetics.

The Human Genome Project, a 13-year, nearly $3 billion endeavor to map the makeup of the more than 20,000 genes that humans are made of, was in full swing. Magazines featured cover stories predicting a near future in which virtually all diseases could be traced back to specific genes and, thus, cured by genetic modification.

But Miller, who is now vice dean for research strategy and innovation at the Columbia University Mailman School of Public Health, was frustrated by how little genetics seemed to account for variation in Parkinson's disease. In fact, he and other researchers in the field found that genetic mutation accounted for only about 10% of Parkinson's disease incidence. The other 90%, they hypothesized, was caused by environmental exposures.

In the lab, Miller studied how specific chemicals, particularly those in pesticides, impacted Parkinson's development in mice, but he also found that approach to be too piecemeal. Throughout the 1990s and early 2000s, federal grants funneled funding into gene studies, but after the Human Genome Project was completed and scientists discovered ways to compare complete sets of DNA from many people in 2005, it became clear that few diseases could be completely explained - or cured - through genomics, the study of the entire genome. Many of the initial gene studies that looked at one gene at a time - for example, with major depressive disorder - couldn't be replicated.

This method of looking at single genes or exposures at a time "was a very scattershot approach," he says. "That's just not how you do good science."

In 2011, when Miller heard from a friend about a workshop that the National Academies of Sciences, Engineering, and Medicine had hosted about a relatively unknown new framework called exposomics, he was intrigued.

"When I heard about the exposome, I was like, 'Well, that's what I've been looking for for 15 years!'" Miller recalls.

Exposomics, a study of disease that takes into account the various physical, biological, chemical, environmental, and social exposures a person experiences across the lifespan, was originally envisioned as a field of scientific study 20 years ago. Just as the genome was the collection of a person's genes, the exposome was the collection of their exposures. But the idea was slow to catch on, according to an April 2025 article by Christopher Wild, PhD, the British scientist who coined the term "exposome" in a 2005 commentary.

Now, Miller and other leaders in the field say, it is picking up momentum.

In May 2025, more than 500 people, including researchers, activists, and policymakers, gathered at the inaugural Exposome Moonshot Forum in Washington, D.C., for a four-day conference intended to firm up a strategy for advancing the field.

And last year the National Institutes of Health announced a $7.7 million grant for the creation of the Network for Exposomics in the United States (NEXUS), a national coordinating center that will be co-led by Miller; Rima Habre, ScD, an associate professor of environmental health and spatial sciences at the University of Southern California Keck School of Medicine; and Chirag Patel, PhD, an associate professor of biomedical informatics at Harvard Medical School.

"A large bit has been accomplished in the last year or so," says Patel, whose lab focuses on applying computational technology to exposomics research. "We've seen immense support from federal and commercial institutes for exposomics research, new grant opportunities, new commercial ventures, and a larger body of people interested in this research."

"The field is young and emerging, and it brings together a lot of expertise from different domains," Habre adds. "We are working hard to get to more operational definitions of what counts as an exposomics study: what are the exact analytical and data approaches - the nitty-gritty methods. Just defining what we mean by everything and discovering how we take that and translate it to solutions."

From satellite images to measuring molecules

Part of the challenge of exposomics is in its vastness. The field brings together researchers across different disciplines, including environmental science, public health, behavioral health, bioinformatics, genetics, and geospatial science. The researchers seek to quantify the health impacts of both specific triggers and complex interactions. And they reach for solutions on both the population-health level and the individual level through precision medicine, Habre explains.

"It's a big and lofty goal," she says. "There's so much involved."

Among the factors driving the rise of exposomics are a focus on using big data and a surge in technological capacity to analyze that data.

Habre, for example, co-runs NEXUS' Geospatial Sciences Hub with Arcot Rajasekar, PhD, a data science professor at the University of North Carolina at Chapel Hill (UNC). The hub compiles methods and best practices for using satellite images and data about exposures, such as air pollution, water quality, and social determinants of health, to study how place-specific exposures impact health across the lifespan.

In 2018, Michael Snyder, PhD, a professor and director of the Center for Genomics and Personalized Medicine, at Stanford University's School of Medicine, together with his lab created an "exposometer," a wearable device that collects samples of the chemical and biological exposures the wearer encounters. Using a small sampling of people, including himself, he and his lab have analyzed thousands of exposures and found that the samples vary significantly based on location, season, and other environmental conditions. Using the device, he discovered he's allergic to the eucalyptus trees in his backyard and that his house had mold.

"I do think we need to map both chemicals and biologicals," Snyder says. "Knowing this stuff is really important."

Snyder is one of 10 scientists from universities across the United States and Europe who authored an article in Human Genomics on the need to advance translational research (converting scientific discovery into practical application) on the exposome. The paper emphasized the cross-disciplinary nature of exposomics and its interplay with genetics.

Another coauthor of the paper, Susan Sumner, PhD, a professor of nutrition and pharmacology at UNC and the director of the university's Metabolomics and Exposome Laboratory at the Nutrition Research Institute, applies technologies such as spectroscopy (the use of light and electromagnetic radiation to measure matter's composition) and mass spectrometry (the use of electromagnetic fields to observe the makeup of molecules) to study exposures in the human body.

"Using high-resolution mass spectrometry, we can detect tens of thousands of signals simultaneously. That provides us a snapshot of the molecules that are present in biospecimens such as blood, urine, saliva, or stool," Sumner says. "This can reveal information about our dietary exposures, chemical and environmental exposures, our nutritional status, and host and microbial metabolism."

With a more complete picture of how various exposures impact metabolism as well as drug interactions and efficacy, Sumner believes it's possible to craft personalized nutrition that can augment the beneficial effects of pharmacological treatments and minimize negative health effects of adverse environmental exposures.

"Exposome research is key to informing needs in exposure reduction, and in informing the development of precision nutrition strategies at the individual level," she says.

Patel and his team at Harvard approach the study of the exposome by using computational models and artificial intelligence to parse through huge amounts of data to identify complex interactions that the traditional scientific approach of studying disease may miss.

"We're moving away from looking at causes for disease in a targeted fashion, where we examine what we already know about, and moving toward what are non-targeted mass spectrometry approaches, which measure tens of thousands of data points simultaneously," Patel says.

This "agnostic" and systematic approach to science sets exposomics apart from most scientific fields that design experiments to test a specific hypothesis, Habre says.

"It's very discovery-based," she notes. "We scan everything and try to see what we can learn, and we can follow that up with specific hypothesis testing."

A holistic view of health

In 2013, before he moved to Columbia University, Miller helped launch the first exposomics research center in the United States at Emory University. He saw it as a Herculean task and crafted the acronym for the center to spell out HERCULES (Health and Exposome Research Center: Understanding Lifetime Exposures).

A key part of the center's approach has been to engage directly with people in the communities around Atlanta and across Georgia, explains Carmen Marsit, PhD, a professor, a dean at the Rollins School of Public Health, and the director of HERCULES. That has meant creating a stakeholder advisory board, awarding research that uses the principles of community engagement, and considering community members partners in research.

"When we worked with Atlanta regional communities and talked about this concept [of the exposome], it really resonated with the community," Marsit says. "[They said,] 'Finally you're thinking about a holistic approach to health. We don't just have lead exposure, but also low access to healthy foods.' These communities are really interested in this framework."

The greater challenge, Marsit says, is getting researchers and clinicians to think in these terms.

"We've learned that people still want to come in with a very specific angle," he says. "Trying to bring together those discussions is a big part of what we do at the center."

NEXUS also aims to bridge these scientific silos. Habre hopes that the field of exposomics could pave a way for the future of biomedical research and clinical science to be more cohesive.

"What I always recommend to early-career folks is to try to really be that person who is interdisciplinary," she says. "Listen to other experts in other domains. Think about how they think about problems. You'd be surprised how hard that is."

She envisions a future in which the various disciplines coordinate to build exposomic profiles for individuals that will be a part of their electronic medical records and that could inform a more personalized approach to treatment and prevention of disease.

"Among the first questions clinicians ask when they see their patients is to get their 'social' history - for example, how much they smoke, drink, and their family histories," Patel says. "Exposomics has an opportunity to operationalize that social history. The exposome expresses a source for finding modifiable risk factors for screening or prevention and, potentially, to be used at the bedside for clinical decision-making for patients who already have a disease."

Currently, Miller is leading a multicenter effort, funded by a $39.5 million grant from the Advanced Research Projects Agency for Health, focused on using exposomics, specifically with mass spectrometry and bioinformatics, to study how various exposures and drugs interact with one another to make medications more or less effective.

Part of that project is to create Clinical Laboratory Improvement Amendments (CLIA)-certified blood tests that physicians can order to better understand how to optimize medication management for individual patients.

"Clinicians are used to trial and error" when prescribing medications, Miller says. "Why don't we see if we can make that better?"

Habre is careful to note that this concept of personalized medicine doesn't negate the need for public health. Exposomics can identify specific environmental and social triggers for disease that will require a broader policy approach to address. Often, she observes, scientists become protective of their own approach, at times to the detriment of alternative ones.

"We need people who know how to work across fields and domains, and not just live in their silos," Habre says. "That's what it's going to take to get exposomics to the vision."

As part of their efforts to work globally on this vision, Miller, Patel, and Habre attended an international exposomics conference in the Czech Republic in mid-October 2025.

One of the events took place at the Mendel Museum, dedicated to Gregor Mendel, known as the father of experimental genetics. Miller says he had a long conversation with a leading European geneticist who, before they spoke, had never heard of exposomics.

"By the end of the conversation, he was saying that we have to have both," Miller says. "The genomics and exposomics. They complement each other."