Online Program

Exposomics and public health ethics

Tuesday, November 3, 2015 : 1:10 p.m. - 1:30 p.m.

Leonard Ortmann, PhD, Office of the Associate Director for Science, Office of Scientific Integrity, Public Health Ethics Unit, Centers for Disease Control and Prevention, Atlanta, GA
Exposomics measures all the exposures of an individual over the lifespan and how they impact health. This presentation will describe this emerging field and the ethical issues it raises. Current assessments of environmental exposure tend to limit themselves to measuring one exogenous chemical or toxic exposure at a single point in time. Exposomics emphasizes the lifetime cumulative health impact of all exposures. It calls special attention to exposures in the intrauterine environment and how these exposures impact gene expression in the fetus. Knowledge of the profound effects of “fetal programming” on subsequent development and susceptibility to disease will impose greater moral responsibility on both parents and society. Exposomics takes into account not only environmental pollutants, chemicals, and toxins but also diet, life-style, psychosocial stressors, and social determinants of health. By using the tools of “big data” to assess the impact of these different stressors, it is hoped we will gain a better understanding of their synergistic effects.  This approach holds the promise of facilitating research that will lead to interventions that address health disparities. The presentation will examine the methodological and ethical challenges raised by this holistic, systemic approach of exposomics. Pooling data from various disciplines and data bases will demand major efforts in transdisciplinary training, research, and collaboration. To make this enormous pool of “big data” amenable to analysis will require standardizing and collating data sets, including more local, granular data. In order to be maximally useful for health interventions, the data will have to be linked to individual data and health records, which will raise issues of privacy and confidentiality. The public awareness of exposures and their consequences will generate social discussions that pit the scientific determination of risk against the public’s value judgments regarding safety. Public health ethics will have a significant role to play in translating the science of exposomics into the language of values that can resonate with the public. Finally, the presentation will explore how exposomics can help the field of public health achieve consensus on its reach and purpose and thereby guide ethical analysis and decision making in public health practice.

Learning Areas:

Environmental health sciences
Ethics, professional and legal requirements
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the emerging field of exposomics. Describe the public health ethics issues relevant to exposomics, including health equity. Discuss how exposomics can help the field of public health achieve consensus on its reach and purpose and thereby guide ethical analysis and decision making.

Keyword(s): Ethics, Risk Factors/Assesment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I serve as a public health ethicist working with the Public Health Ethics Unit in the Office of the Associate Director for Science, Centers for Disease Control and Prevention (CDC). I completed a two-year fellowship in public health ethics at CDC in 2010. Prior to this I taught ethics and bioethics at Tuskegee University National Center for Bioethics in Research and Health Care.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.