Lifelong exposure to multiple stressors through different environmental pathways for European populations

Naixin Li, Rainer Friedrich, Cara N. Maesano, Emanuela Medda, Sonia Brescianini, Maria Antonietta Stazi, Clive E. Sabel, Dimosthenis Sarigiannis, Isabella Annesi-Maesano

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10 Citations (Scopus)


Traditional exposure studies provide valuable insights for epidemiology, toxicology, and risk assessment. Throughout their lives, individuals are exposed to thousands of stressors in the environment which are not static, but influenced by environmental, temporal, spatial, and even socio-demographic factors. Existing exposure studies have usually focused on specific stressors for a constrained period of time. In response, the concept of the exposome has been raised, which is defined as the totality of exposure experienced from conception until death. The EU FP7-ENVIRONMENT research project HEALS was launched with the aim of incorporating a series of novel technologies, data analysis, and modelling tools to efficiently support exposome studies in Europe. The authors have developed a framework of modelling tools for estimating the long-term external exposure of selected population groups to multiple stressors through different pathways. As the starting point, the stressors, including electromagnetic fields (EMF) and ultraviolet light (UV) through dermal uptake, phthalates (DEHP, DIDP, and DINP) through inhalation, as well as chromium, mercury, and lead through food intake, have been selected. The simulation for multiple stressors has been realised by developing a probabilistic model that integrates the micro-environment approach, time-activity patterns, and a life course trajectory model. The methodology has been applied to a selected sample of subjects enrolled in the Italian Twin Registry (ITR). The results show that long-term exposures to multiple stressors are affected by factors including age, gender, geographical location, and education level. The methods developed in this paper extended the temporal and spatial scales of exposure modelling in Europe. Moreover, the application of our methods provided a novel approach and crucial input data for future work on environment-wide association studies.

Original languageEnglish
Article number108744
Pages (from-to)1-12
Number of pages12
JournalEnvironmental Research
Publication statusPublished - Dec 2019
Externally publishedYes


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