Exploring personal chemical exposures in China with wearable air pollutant monitors: A repeated-measure study in healthy older adults in Jinan, China

A deployable film method to enable replicable sampling of low-abundance environmental microbiomes

Urbanizing global populations spend over 90% of their time indoors where microbiome abundance and diversity are low. Chronic exposure to microbiomes with low abundance and diversity have demonstrated negative long-term impacts on human health. Sequencing-based analyses of environmental nucleic acids are critical to understanding the impact of the indoor microbiome on human health, however low DNA yields indoors, alongside sample collection and processing inconsistencies, currently challenge study replicability. This study presents a comparative assessment of a novel, passive, easily replicable sampling strategy using polydimethylsiloxane (PDMS) sheets alongside a representative swab-based collection protocol. Deployable, customizable PDMS films designed for whole-sample insertion into standardized extraction kits demonstrated 43% higher DNA yields per sample, and 76% higher yields per cm2 of sampler over swab-based protocols. These results indicate that this accessible, scalable method enables sufficient DNA collection to comprehensively evaluate indoor microbiome exposures and potential human health impacts using smaller, more space efficient samplers, representing an attractive alternative to swab-based collection. In addition, this process reduces the manual steps required for microbiome sampling which could address inter-study variability, transform the current microbiome sampling paradigm, and ultimately benefit the replicability and accessibility of microbiome exposure studies.

Association between Personal Abiotic Airborne Exposures and Body Composition Changes among Healthy Adults (60-69 Years Old): A Combined Exposome-Wide and Lipidome Mediation Approach from the China BAPE Study

BACKGROUND

Evidence suggested that abiotic airborne exposures may be associated with changes in body composition. However, more evidence is needed to identify key pollutants linked to adverse health effects and their underlying biomolecular mechanisms, particularly in sensitive older adults.

OBJECTIVES

Our research aimed to systematically assess the relationship between abiotic airborne exposures and changes in body composition among healthy older adults, as well as the potential mediating mechanisms through the serum lipidome.

METHODS

From September 2018 to January 2019, we conducted a monthly survey among 76 healthy adults (60-69 years old) in the China Biomarkers of Air Pollutant Exposure (BAPE) study, measuring their personal exposures to 632 abiotic airborne pollutions using MicroPEM and the Fresh Air wristband, 18 body composition indicators from the InBody 770 device, and lipidomics from venous blood samples. We used an exposome-wide association study (ExWAS) and deletion/substitution/addition (DSA) model to unravel complex associations between exposure to contaminant mixtures and body composition, a Bayesian kernel machine regression (BKMR) model to assess the overall effect of key exposures on body composition, and mediation analysis to identify lipid intermediators.

RESULTS

The ExWAS and DSA model identified that 2,4,5-T methyl ester (2,4,5-TME), 9,10-Anthracenedione (ATQ), 4b,8-dimethyl-2-isopropylphenanthrene, and 4b,5,6,7,8,8a,9,10-octahydro-(DMIP) were associated with increased body fat mass (BFM), fat mass indicators (FMI), percent body fat (PBF), and visceral fat area (VFA) in healthy older adults [Bonferroni-Hochberg false discovery rate ( FD R BH ) < 0.05 ]. The BKMR model demonstrated a positive correlation between contaminants (anthracene, ATQ, copaene, di-epi-α -cedrene, and DMIP) with VFA. Mediation analysis revealed that phosphatidylcholine [PC, PC(16:1e/18:1), PC(16:2e/18:0)] and sphingolipid [SM, SM(d18:2/24:1)] mediated a significant portion, ranging from 12.27% to 26.03% (p-value < 0.05 ), of the observed increase in VFA.

DISCUSSION

Based on the evidence from multiple model results, ATQ and DMIP were statistically significantly associated with the increased VFA levels of healthy older adults, potentially regulated through lipid intermediators. These findings may have important implications for identifying potentially harmful environmental chemicals and developing targeted strategies for the control and prevention of chronic diseases in the future, particularly as the global population is rapidly aging. https://doi.org/10.1289/EHP13865.

Personal exposure to airborne organic pollutants and lung function changes among healthy older adults

Epidemiological evidence on the impact of airborne organic pollutants on lung function among the elderly is limited, and their underlying biological mechanisms remain largely unexplored. Herein, a longitudinal panel study was conducted in Jinan, Shandong Province, China, involving 76 healthy older adults monitored over a span of five months repetitively. We systematically evaluated personal exposure to a diverse range of airborne organic pollutants using a wearable passive sampler and their effects on lung function. Participants' pulmonary function indicators were assessed, complemented by comprehensive multi-omics analyses of blood and urine samples. Leveraging the power of interaction analysis, causal inference test (CIT), and integrative pathway analysis (IPA), we explored intricate relationships between specific organic pollutants, biomolecules, and lung function deterioration, elucidating the biological mechanisms underpinning the adverse impacts of these pollutants. We observed that bis (2-chloro-1-methylethyl) ether (BCIE) was significantly associated with negative changes in the forced vital capacity (FVC), with glycerolipids mitigating this adverse effect. Additionally, 31 canonical pathways [e.g., high mobility group box 1 (HMGB1) signaling, phosphatidylinositol 3-kinase (PI3K)/AKT pathway, epithelial mesenchymal transition, and heme and nicotinamide adenine dinucleotide (NAD) biosynthesis] were identified as potential mechanisms. These findings may hold significant implications for developing effective strategies to prevent and mitigate respiratory health risks arising from exposure to such airborne pollutants. However, due to certain limitations of the study, our results should be interpreted with caution.

Occurrence differences of hexachlorobutadiene and chlorobenzenes in road dust and roadside soil media in an industrial and residential mixed area in Eastern China

The road dust and roadside soil can act as both sinks and sources of hexachlorobutadiene (HCBD) and chlorobenzenes (CBzs), but comparative research on these two adjacent media is extremely limited. In this study, HCBD and CBzs were simultaneously analyzed in road dust and roadside soil samples from an area containing both industrial factories and residential communities in Eastern China. The road dust there was found to have 2-6 times higher contents of HCBD (mean 1.14 ng/g, maximum 6.44 ng/g) and ∑Cl3-Cl6CBzs (22.8 ng/g, 90.6 ng/g) than those in the roadside soil. The spatial distributions of HCBD and CBzs in road dusts were affected by various types of sources, showing no significant discrepancy among the sites. On the contrast, HCBD and CBzs contamination in roadside soils occurring near several factories were strongly correlated to their industrial point sources. Risk assessments showed, at current contamination levels in the road dust and roadside soil, HCBD and CBzs are not likely to induce carcinogenic or non-carcinogenic risks to residents in the studied area. Nevertheless, road dust ingestion, as the major exposure pathway of HCBD and CBzs, should be avoided to reduce the exposure risk. These findings based on the contamination differences between two media provide a new perspective and evidence for screening important sources and exposure pathway of HCBD and CBzs, which would be helpful to their source identification and risk control.

Mobile Health and Preventive Medicine

Wearable devices providing health-related data (mobile health [mHealth]) have grown in numbers and types of data available over the past 2 decades. Applications in prevention with some of the longest track records are activity trackers to promote fitness (primary prevention), mobile electrocardiogram devices to detect arrhythmias (secondary prevention), and continuous glucose monitoring to improve glycemic control in type 2 diabetes (tertiary prevention). Continued integration of multiple diverse data streams and improved interfaces with individuals (such as artificial intelligence-driven health coaches), and health care teams (as in the hospital-at-home concept), promise to optimize use of mHealth to improve clinical and public health outcomes.

Application of wearable devices for monitoring cardiometabolic dysfunction under the exposome paradigm

Environmental factors, including chemical/physical pollutants, as well as lifestyle and psychological factors, contribute greatly to the pathways leading to cardiometabolic diseases with a heavy disease burden and economic loss. The concept of exposomes provides a novel paradigm for combining all exposure characteristics to evaluate disease risk. A solution-like exposome requires technological support to provide continuous data to monitor vital signs and detect abnormal fluctuations. Wearable devices allow people to conveniently monitor signals during their daily routines. These new technologies empower users to more actively prevent and manage cardiometabolic disease by reviewing risk factors of the disease, especially lifestyle factors, such as sleeping time, screen time, and mental health condition. Devices with multiple sensors can monitor electrocardiography data, oxygen saturation, intraocular pressure, respiratory rate, and heart rate to enhance the exposome study and provide precise suggestions for disease prevention and management.

Wearable Passive Samplers for Assessing Environmental Exposure to Organic Chemicals: Current Approaches and Future Directions

PURPOSE OF REVIEW

We are continuously exposed to dynamic mixtures of airborne contaminants that vary by location. Understanding the compositional diversity of these complex mixtures and the levels to which we are each exposed requires comprehensive exposure assessment. This comprehensive analysis is often lacking in population-based studies due to logistic and analytical challenges associated with traditional measurement approaches involving active air sampling and chemical-by-chemical analysis. The objective of this review is to provide an overview of wearable passive samplers as alternative tools to active samplers in environmental health research. The review highlights the advances and challenges in using wearable passive samplers for assessing personal exposure to organic chemicals and further presents a framework to enable quantitative measurements of exposure and expanded use of this monitoring approach to the population scale.

RECENT FINDINGS

Overall, wearable passive samplers are promising tools for assessing personal exposure to environmental contaminants, evident by the increased adoption and use of silicone-based devices in recent years. When combined with high throughput chemical analysis, these exposure assessment tools present opportunities for advancing our ability to assess personal exposures to complex mixtures. Most designs of wearable passive samplers used for assessing exposure to semi-volatile organic chemicals are currently uncalibrated, thus, are mostly used for qualitative research. The challenge with using wearable samplers for quantitative exposure assessment mostly lies with the inherent complexity in calibrating these wearable devices. Questions remain regarding how they perform under various conditions and the uncertainty of exposure estimates. As popularity of these samplers grows, it is critical to understand the uptake kinetics of chemicals and the different environmental and meteorological conditions that can introduce variability. Wearable passive samplers enable evaluation of exposure to hundreds of chemicals. The review presents the state-of-the-art of technology for assessing personal exposure to environmental chemicals. As more studies calibrate wearable samplers, these tools present promise for quantitatively assessing exposure at both the individual and population levels.

Personal air pollutant exposure monitoring in South African children in the VHEMBE birth cohort

The burden of disease associated with environmental exposures disproportionately impacts residents of low- and middle-income countries. Children living in rural regions of these countries may experience higher exposure to insecticides from indoor residual spraying used for malaria control and household air pollution. This study evaluated environmental exposures of children living in a rural region of South Africa. Quantifying exposure levels and identifying characteristics that are associated with exposure in this geographic region has been challenging due to limitations with available monitoring techniques. Wearable passive samplers have recently been shown to be a convenient and reliable tool for assessing personal exposures. In this study, a passive sampler wristband, known as Fresh Air wristband, was worn by 49 children (five-years of age) residing in the Limpopo province of South Africa. The study leveraged ongoing research within the Venda Health Examination of Mothers, Babies, and their Environment (VHEMBE) birth cohort. A wide range of chemicals (35 in total) were detected using the wristbands, including polycyclic aromatic hydrocarbons (PAHs), organochlorine pesticides, phthalates, and organophosphate esters (OPEs) flame retardants. Higher concentrations of PAHs were observed among children from households that fell below the food poverty threshold, did not have access to electric cookstoves/burners, or reported longer times of cooking or burning materials during the sampling period. Concentrations of p,p'-DDD and p,p'-DDT were also found to be elevated for children from households falling below the food poverty threshold as well as for children whose households were sprayed for malaria control within the previous 1.5 years. This study demonstrates the feasibility of using passive sampler wristbands as a non-invasive method for personal exposure assessment of children in rural regions of South Africa to complex mixtures environmental contaminants derived from a combination of sources. Future studies are needed to further identify and understand the effects of airborne environmental contaminants on childhood development and strategies to mitigate exposures.

Charting the landscape of the environmental exposome

The exposome depicts the total exposures in the lifetime of an organism. Human exposome comprises exposures from environmental and humanistic sources. Biological, chemical, and physical environmental exposures pose potential health threats, especially to susceptible populations. Although still in its nascent stage, we are beginning to recognize the vast and dynamic nature of the exposome. In this review, we systematically summarize the biological and chemical environmental exposomes in three broad environmental matrices-air, soil, and water; each contains several distinct subcategories, along with a brief introduction to the physical exposome. Disease-related environmental exposures are highlighted, and humans are also a major source of disease-related biological exposures. We further discuss the interactions between biological, chemical, and physical exposomes. Finally, we propose a list of outstanding challenges under the exposome research framework that need to be addressed to move the field forward. Taken together, we present a detailed landscape of environmental exposome to prime researchers to join this exciting new field.

Personal airborne chemical exposure and epigenetic ageing biomarkers in healthy Chinese elderly individuals: Evidence from mixture approaches

BACKGROUND

Air pollution is associated with accelerated biological ages determined by DNA methylation (DNAm) patterns, imposing further risks of age-related adverse effects. However, little is known about the independent and joint effects of exposure to gaseous organic chemicals that may share a common source.

METHODS

We conducted a panel study with the 3-day exposure assessment monthly among 73 Chinese healthy elderly people aged 60 to 69 years in Jinan, Shandong province during September 2018 to January 2019.Exposure to 26 ambient organic chemical contaminants were measured by wearable passive samplers, including volatile organic compounds, polycyclic aromatic hydrocarbons (PAHs), phthalates (PAEs), nitroaromatics (NIs), polybrominated diphenyl ethers, chlorinated hydrocarbons, and organophosphate esters. The Illumina MethylationEPIC BeadChip was used to measure DNA methylation levels in blood samples, and based on which, epigenetic ageing biomarkers, including Hannum clock, Horvath clock, DNAm PhenoAge, DNAm GrimAge, and DNAm estimator of telomere length (DNAmTL) were calculated. Linear mixed effect models were used to estimate the linear associations between 3-day personal chemical exposure and the epigenetic biomarkers, Weighted quantile sum (WQS) regression and the Bayesian kernel machine regression (BKMR) model were further used to evaluate the effect of chemical mixtures.

RESULTS

Multiple linear mixed effects regression models showed that DNAmPhenoAge acceleration was significantly and positively associated with exposure to PAEs, NIs, and PAHs in healthy elderly individuals. Both WQS regression and BKMR models showed a significant positive association with DNAmPhenoAge acceleration with chemical exposures, in which the effect of di-n-butyl phthalate exposure showed the greatest importance.

CONCLUSION

These findings suggest that exposure to a mixture of airborne chemicals significantly increase the acceleration of the epigenetic biomarker of phenotypic age. These findings serve to identify toxic chemicals in the air and facilitate the evaluation of their potentially severe health effects.

A review on the application of the exposome paradigm to unveil the environmental determinants of age-related diseases

Age-related diseases account for almost half of all diseases among adults worldwide, and their incidence is substantially affected by the exposome, which is the sum of all exogenous and endogenous environmental exposures and the human body’s response to these exposures throughout the entire lifespan. Herein, we perform a comprehensive review of the epidemiological literature to determine the key elements of the exposome that affect the development of age-related diseases and the roles of aging hallmarks in this process. We find that most exposure assessments in previous aging studies have used a reductionist approach, whereby the effect of only a single environmental factor or a specific class of environmental factors on the development of age-related diseases has been examined. As such, there is a lack of a holistic and unbiased understanding of the effect of multiple environmental factors on the development of age-related diseases. To address this, we propose several research strategies based on an exposomic framework that could advance our understanding—in particular, from a mechanistic perspective—of how environmental factors affect the development of age-related diseases. We discuss the statistical methods and other methods that have been used in exposome-wide association studies, with a particular focus on multiomics technologies. We also address future challenges and opportunities in the realm of multidisciplinary approaches and genome–exposome epidemiology. Furthermore, we provide perspectives on precise public health services for vulnerable populations, public communications, the integration of risk exposure information, and the bench-to-bedside translation of research on age-related diseases.

Silicone wristbands as personal passive sampling devices: Current knowledge, recommendations for use, and future directions

Personal chemical exposure assessment is necessary to determine the frequency and magnitude of individual chemical exposures, especially since chemicals present in everyday environments may lead to adverse health outcomes. In the last decade, silicone wristbands have emerged as a new chemical exposure assessment tool and have since been utilized for assessing personal exposure to a wide range of chemicals in a variety of populations. Silicone wristbands can be powerful tools for quantifying personal exposure to chemical mixtures in a single sample, associating exposure with health outcomes, and potentially overcoming some of the challenges associated with quantifying the chemical exposome. However, as their popularity grows, it is crucial that they are used in the appropriate context and within the limits of the technology. This review serves as a guide for researchers interested in utilizing silicone wristbands as a personal exposure assessment tool. Along with briefly discussing the passive sampling theory behind silicone wristbands, this review performs an in-depth comparison of wristbands to other common exposure assessment tools, including biomarkers of exposure measured in biospecimens, and evaluates their utility in exposure assessments and epidemiological studies. Finally, this review includes recommendations for utilizing silicone wristbands to evaluate personal chemical exposure and provides suggestions on what research is needed to recognize silicone wristbands as a premier chemical exposure assessment tool.

Emerging and Legacy Per- and Polyfluoroalkyl Substances in an Elderly Population in Jinan, China: The Exposure Level, Short-Term Variation, and Intake Assessment

Human exposure to per- and polyfluoroalkyl substances (PFASs) has gained worldwide attention due to their widespread presence in the environment and adverse health effects, but the exposure assessment in the elderly is still lacking. This study aimed to assess exposures to 3 emerging PFASs (chlorinated polyfluoroalkyl ether sulfonic acids, Cl-PFESAs) and 15 legacy PFASs. The temporal variability of internal exposures and intake amounts of these PFASs were evaluated among a population of 76 healthy elderly adults (age: 60-69) in Jinan, China over 5 consecutive months. Fifteen PFASs were detected in whole blood with the mean total concentration (ΣPFAS) at 20.1 ng/mL (range: 5.0-135.9 ng/mL) dominated by perfluorooctanoic acid (PFOA) (9.0 ng/mL), perfluorooctanesulfonic acid (PFOS) (5.3 ng/mL), and 6:2 Cl-PFESA (1.6 ng/mL). Across the 5 month assessment period, significant variation was only observed for short-chain (C4-C7) perfluoroalkyl carboxylic acids, and their variations ranged from 53 to 334%. The median intake of PFOA and PFOS was estimated to be 1.46 and 0.92 ng/kg bw/day, respectively. Regression analysis showed that dietary ingestion, especially fish, was likely an important exposure pathway for PFASs among the elderly adults. Various pathways (e.g., dietary, water, air, and dust) should thus be considered to fully understand human exposure to PFASs.

Environmental Chemicals: Integrative Approach to Human Biomonitoring and Health Effects

In recent decades, citizen awareness of toxic chemicals has been a topic of interest, particularly concerning national and international policy decision makers, expert/scientific platforms, and health protection organizations (WHO, UNEP, CDC, EFSA, IPEN, etc [...].

Assessing the External Exposome Using Wearable Passive Samplers and High-Resolution Mass Spectrometry among South African Children Participating in the VHEMBE Study

Children in low- and middle-income countries are often exposed to higher levels of chemicals and are more vulnerable to the health effects of air pollution. Little is known about the diversity, toxicity, and dynamics of airborne chemical exposures at the molecular level. We developed a workflow employing state-of-the-art wearable passive sampling technology coupled with high-resolution mass spectrometry to comprehensively measure 147 children's personal exposures to airborne chemicals in Limpopo, South Africa, as part of the Venda Health Examination of Mothers, Babies, and Their Environment (VHEMBE). 637 environmental exposures were detected, many of which have never been measured in this population; of these 50 airborne chemical exposures of concern were detected, including pesticides, plasticizers, organophosphates, dyes, combustion products, and perfumes. Biocides detected in wristbands included p,p'-dichlorodiphenyltrichloroethane (p,p'-DDT), p,p'-dichlorodiphenyldichloroethane (p,p'-DDD), p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), propoxur, piperonyl butoxide, and triclosan. Exposures differed across the assessment period with 27% of detected chemicals observed to be either higher or lower in the wet or dry seasons.

The exposome in practice: an exploratory panel study of biomarkers of air pollutant exposure in Chinese people aged 60-69 years (China BAPE Study)

The exposome overhauls conventional environmental health impact research paradigms and provides a novel methodological framework that comprehensively addresses the complex, highly dynamic interplays of exogenous exposures, endogenous exposures, and modifiable factors in humans. Holistic assessments of the adverse health effects and systematic elucidation of the mechanisms underlying environmental exposures are major scientific challenges with widespread societal implications. However, to date, few studies have comprehensively and simultaneously measured airborne pollutant exposures and explored the associated biomarkers in susceptible healthy elderly subjects, potentially resulting in the suboptimal assessment and management of health risks. To demonstrate the exposome paradigm, we describe the rationale and design of a comprehensive biomarker and biomonitoring panel study to systematically explore the association between individual airborne exposure and adverse health outcomes. We used a combination of personal monitoring for airborne pollutants, extensive human biomonitoring, advanced omics analysis, confounding information, and statistical methods. We established an exploratory panel study of Biomarkers of Air Pollutant Exposure in Chinese people aged 60-69 years (China BAPE), which included 76 healthy residents from a representative community in Jinan City, Shandong Province. During the period between September 2018 and January 2019, we conducted prospective longitudinal monitoring with a 3-day assessment every month. This project: (1) leveraged advanced tools for personal airborne exposure monitoring (external exposures); (2) comprehensively characterized biological samples for exogenous and endogenous compounds (e.g., targeted and untargeted monitoring) and multi-omics scale measurements to explore potential biomarkers and putative toxicity pathways; and (3) systematically evaluated the relationships between personal exposure to air pollutants, and novel biomarkers of exposures and effects using exposome-wide association study approaches. These findings will contribute to our understanding of the mechanisms underlying the adverse health impacts of air pollution exposures and identify potential adverse clinical outcomes that can facilitate the development of effective prevention and targeted intervention techniques.

Defining the Scope of Exposome Studies and Research Needs from a Multidisciplinary Perspective

The concept of the exposome was introduced over 15 years ago to reflect the important role that the environment exerts on health and disease. While originally viewed as a call-to-arms to develop more comprehensive exposure assessment methods applicable at the individual level and throughout the life course, the scope of the exposome has now expanded to include the associated biological response. In order to explore these concepts, a workshop was hosted by the Gunma University Initiative for Advanced Research (GIAR, Japan) to discuss the scope of exposomics from an international and multidisciplinary perspective. This Global Perspective is a summary of the discussions with emphasis on (1) top-down, bottom-up, and functional approaches to exposomics, (2) the need for integration and standardization of LC- and GC-based high-resolution mass spectrometry methods for untargeted exposome analyses, (3) the design of an exposomics study, (4) the requirement for open science workflows including mass spectral libraries and public databases, (5) the necessity for large investments in mass spectrometry infrastructure in order to sequence the exposome, and (6) the role of the exposome in precision medicine and nutrition to create personalized environmental exposure profiles. Recommendations are made on key issues to encourage continued advancement and cooperation in exposomics.