Policymakers are warning that the EU is not looking enough at the cumulative health effects of citizens’ environments, and the impacts are already being felt. “It is really time to act because an epidemic is rising, an epidemic of non-communicable diseases. It is not perceived by policymakers as an epidemic, but it is, and it will have huge effects on Europe.”
That stark warning from Christophe Clergeau, a French centre-left member of the European Parliament, came at a gathering of scientists, policymakers and public health leaders in Barcelona, increasingly convinced that Europe is fighting the wrong battle if it focuses only on treatment rather than causes.
The epidemic in question is not infectious, but chronic: cancers, cardiovascular disease, diabetes, and respiratory illness. Together, these non-communicable diseases (NCDs) account for the overwhelming majority of deaths in Europe, and their rise is tightly linked to the environments people live in.
The Global Exposome Summit was held specifically to look at these cumulative effects that can cause NCDs. Put simply, the exposome is the sum of everything a person is exposed to over their lifetime. That includes obvious external factors such as air pollution, chemicals, diet and lifestyle, but also social conditions, stress, and even internal biological processes.
The concept was first proposed in 2005 by Christopher Wild, then head of the International Agency for Research on Cancer. He argued that biomedical research had overinvested in genetics while neglecting environmental exposures, leaving a missing piece in understanding the origins of disease.
Unlike traditional approaches that isolate single risk factors such as smoking or a specific toxin, the exposome treats health as the product of cumulative and interacting exposures.
Initially, the idea struggled to gain traction. Early papers received little attention, and the concept was considered too complex to measure. But over the past decade, advances in sensors, biomonitoring, big data and “omics” technologies have transformed it from a theoretical framework into an active research field. Today, exposomics – the science of measuring the exposome – is one of the fastest-growing areas in environmental health.
Moonshot needed
“The Exposome community is picking up more and more momentum,” Roel Vermeulen, a professor of Environmental Epidemiology and Exposome Science at Utrecht University, told the conference.
“Problems won’t be solved by one discipline or one geographical area; we need to come together to think about these larger societal problems we currently have.” He noted that work has been increasing in this area in the United States, with a ‘moonshot forum’ being held in Washington DC last year. Europe, he said, needs its own moonshot.
That will largely come down to financing. EU policymakers at the conference said they shared the enthusiasm for exposome research, but with limited funds available, they have to be selective about what will be prioritised for research.
Alex Mulet Indrayanti from the European Commission’s research and innovation department said the exposome is being looked at specifically in the context of the global ‘One Health’ idea, which started being integrated into EU policies on zoonotic diseases and food safety over the past decade, with the EU One Health Action Plan on antimicrobial resistance in 2017. There has been an even bigger focus since the Covid19 pandemic.
“At the moment, the political bus [you should be boarding] is One Health, which is going to become the topic in terms of health research and policy over the next decade,” he said.
Climate change impact
Mulet Indrayanti said the intersection with climate change is also being looked at by the Commission. “The climate crisis amplifies exposures that already exist. Adaptation alone isn’t going to cut it long term. There are risks that will emerge in the future that we don’t know what they are.”
He noted that the Horizon Europe research programme for 2026 to 2027 is specifically looking at “how climate change affects exposome and how new climate exposomes that have been in the past underrepresented in studies can be integrated more seamlessly.” He also pointed to the Life Sciences Strategy with €170 million in funds available, which has references to the exposome.
But MEP Clergeau said that’s not enough. He said he is fighting to get funding for exposome research into the EU’s next long-term budget for 2028-2034 by making an appeal to competitiveness – the key buzzword in Brussels at the moment.
“NCDs have a huge effect on European competitiveness, such as the availability of workforce and direct costs for Europe as a whole,” he said. “And it has a huge effect on the sustainability of healthcare systems. During the last ten years, the amount of money European states spent to protect people from diseases grew by 50% per year, because of ageing but also because of a rise in NCDs.”
“The Exposome community is a powerful input to describe and explain what is happening, but also to tackle this new epidemic and to try to set new solutions,” he said. “One and a half years ago, I didn’t even know the word Exposome. In the scientific community, you all know the word, but in Brussels still a lot of people who don’t know it. They don’t understand how your holistic approach is changing the game, and how taking into account the cocktail effect can lead to a totally different approach to healthcare policies.”
“You are the one I have to rely on if I want to achieve something with my colleagues in the European Parliament,” he added, urging them to contact their MEPs. He said he is also urging action at the national level, trying to set up an exposome alliance in France, which aims to have its first meeting next month.
New data
Tomislav Sokol, a Croatian centre-right MEP, approached the topic from a different angle. He is a co-rapporteur on the proposed European Health Data Space Regulation, which is currently being considered by the European Parliament.
“Health datasets which are now being unused in many cases in health institutions, hospitals, research facilities, universities, etc., will be categorised and systemised, made publicly available so anyone who needs them for research can access them,” he told the conference. Currently, medical privacy laws and a lack of cross-border information flows make such collaboration difficult.
Damien Weidert from the insurance company Macif Santé Prévoyance, agreed that these changes are needed to improve research and diagnosis: “A European exposome database is so important. It can support research and innovation while enabling concrete health improvements. But this development must go hand in hand with strong guarantees on data protection.”
Modern exposome research integrates multiple streams of data, such as wearable sensors tracking pollution exposure, satellite mapping of environmental conditions, biological samples revealing chemical signatures, and AI tools that detect patterns across massive datasets. Large-scale collaborative projects are already underway.
European initiatives such as the Human Early-Life Exposome (HELIX) project and broader exposome clusters are examining how early-life exposures shape lifelong disease risk. National programmes are also emerging.
The Netherlands’ Exposome-NL, for example, brings together universities across disciplines, from epidemiology to data science, to study links between environment and chronic disease at scale. Meanwhile, research infrastructures like EIRENE aim to create a coordinated European platform for exposome data, standardisation and collaboration.
Risk of moving backwards
Spanish centre-left MEP Marcos Ros Sempere pointed out that the exposome concept is popping up in some unexpected areas of policy. “Health isn’t only protected in hospitals by doctors, it’s also protected in our homes and neighbourhoods,” he said.
“The European Bauhaus initiative can help us move from cities that simply avoid harm to cities that actively make us healthier.” The initiative, championed five years ago by European Commission President Ursula von der Leyen, aims to create purpose-built architecture which, among other goals, creates a healthy living environment.
“Now we’re facing the crucial moment where we’re defining the next MFF [long-term budget]. It’s the moment now to decide if we want to scale up the European Bauhaus initiative.”
But several speakers at the conference expressed concern that, at the moment, there is actually an impulse to move backwards on health and environment policy in Brussels, as President von der Leyen and her centre-right European People’s Party push the simplification agenda.
“In 2020, we had the chemical strategy for sustainability, and for us, that was the big ask we wanted,” said Génon Jensen from the nGO Health and Environment Alliance.
“It would phase out PFAS, look at mixtures of cocktails, promote safer chemicals, and have better coherence between REACH [EU chemicals legislation] with a focus on safety and other policies. But the reality is that what we’ve had recently is a turnback with the simplification and omnibus process. We’re having proposals from the Commission where we’re not looking at exposome science that’s out there, and they’re proposing legislation that rolls back safety protection, and doesn’t look at health impact assessments or health costs,” explained Jensen.
Clergeau said he shares her concerns: “We are obviously in a very strange and dangerous situation where an omnius is adjusting legislation to achieve target modification in order to simplify it. But it’s always about deregulation, not simplification. And what’s happening in the parliament is that when you open the file, any MEP can add amendments outside of the scope that was targeted by the Commission. It’s a mess, it’s a nightmare.”
Attendees said the urgency highlighted at the summit is not rhetorical. Non-communicable diseases already place enormous strain on European health systems and economies, and their drivers – pollution, ageing populations, sedentary lifestyles – are intensifying. That will require a change in mindset, reframing health as a lifelong interaction between people and their environments. The science is advancing quickly. The question now is whether policy will keep up.
[BM]
Source:
www.euractiv.com