Concept d'exposome et recherches en santé environnementale

The exposome corresponds to all exposures, notably to chemical, biological, physical agents and psycho-social stresses suffered by individuals throughout their life. It was conceived from the start as being the complement of the genome and as a major factor influencing the health and well-being of individuals and populations. Exposures grouped in the exposome are, for some of them, avoidable and, in this sense, a better understanding of the exposome will improve prevention. Different proposals and initiatives have contributed to better specifying certain aspects of the exposome to make it more operational, particularly concerning the chemical exposome. To better focus this report, we have excluded infectious and parasitic diseases, the effects of medications and other therapeutic accidents. In this report, the National Academy of Medicine issues recommendations to contribute to better consideration of the exposome in prevention. They aim to anchor the notion of exposome in the daily lives of populations and to prevent the health impacts of the environmental crisis. Specific recommendations are made to improve the capacity to measure exposures, develop health services capable of exploring and interpreting the impacts of exposures, integrate the exposome into regulatory developments, and develop a prevention at a population and individual levels taking into account in particular sex and stage of development. Taking the exposome into account in clinical practice is also recommended. A better understanding of the nature of environmental exposures and their impacts is a crucial step in the development of high quality preventive medicine.