The Next Big Thing in Health is Your Exposome

The Exposome is important in helping to make clear how we are different in our responses to common environmental things…

From sewer sludge to mosquito repellant, one scientist is exploring how daily exposures determine our health.

Michael Snyder, a Stanford biologist and pioneer in genomics, does. For the past several years, Snyder has been wearing a device he invented that measures the environment around him. It’s part of his quest to learn how the environment impacts our health by studying what he calls people’s “exposomes,” or the various air particles, pollutants, viruses, and more that we come into contact with each day.

In a recent paper in the journal Cell, Snyder and his colleagues describe what they’ve learned from affixing 15 people with these air-monitoring devices for up to 890 days. Each device is about the size of a big matchbox, and contains filters that trap particulates, chemicals, and microbes from the air around it. Medium talked to Snyder about the study, the exposome, and his own self-monitoring discoveries.

This is not your first foray into detailed self-monitoring. A few years ago you were monitoring your own blood over the course of 14 months, and you detected the onset of your own diabetes, right?

Michael Snyder: Yes. The monitoring started when I was doing genome sequencing and other profiles — like gene expression — on myself, 8 years ago. I was using myself as a test subject to get the technology going — I didn’t know I’d be interesting! Then I got diabetes. My genome predicted it, and I got the disease over the course of this profiling. These types of measurements helped me catch the onset of the disease and gave a much more detailed picture of people’s health.

With these techniques — like regular testing of blood for changes in gene expression and other readouts — we’re following a group of 109 folks now, many of them for four-and-a-half years or longer. We added wearables about five years ago to continuously monitor physiology, things like heart rate and blood oxygen levels. It helped me figure out when I got Lyme disease, actually. I was with my brother in rural Massachusetts putting up fences, and two weeks later I flew to Norway. When you fly, your blood oxygen levels will drop, but they usually recover after you land. Mine didn’t. And my heart rate was abnormally high. I got a low-grade fever and went to a doctor, who told me I had a bacterial infection. I told him I thought it was Lyme. He recommended penicillin, but I said I think I need doxycycline, which is what you take for Lyme. I measured myself when I got home, and sure enough, I was Lyme positive. It was a perfectly controlled experiment, because I’d given blood before I left and I was negative then.

We want to bring big data into health; that’s the motivation. I think the way we do medicine now is very primitive, compared to what it could be. Everybody is focused on disease, but we want to focus on health and transitions to disease. We’ve written algorithms based on the data we’ve collected, and we now think we tell can when you get sick before you realize it, because your heart rate goes up. We’ve shown that on myself and three other people. We’re now trying to set up a 1,000-person study to learn more.

How does your new research — which focuses on what you call the “exposome,” meaning the sum total of everything you are exposed to — fit into this picture?

That area has been a big hole. We know you’re affected by your genes and your environment, but nobody is capturing the environment individually. Nobody carries around something on their sleeve to monitor their exposure.

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