Context

• World Environment Day 2025 centres on the theme of ending plastic pollution, drawing urgent attention to the invisible but potent environmental threats impacting human health.
• From microplastics to air pollutants, our modern environment harbours a vast array of hazards that traditional public health tools often fail to detect or address adequately.
• Nowhere is this more evident than in India, where rapid economic growth has intensified the complexity and magnitude of environmental exposures.
• As India grapples with a disproportionate share of the global environmental disease burden, there is a critical need to transition from fragmented approaches toward integrated, data-driven strategies.

India's Growing Environmental Health Challenge

• India currently bears nearly 25% of the global environmental disease burden, a statistic that underscores the urgent public health implications of unchecked environmental degradation.
• With increasing urbanisation, industrialisation, and lifestyle changes, the population is exposed to a cocktail of risks, ranging from air pollution and water contamination to hazardous chemical exposure.
• According to the 2021 Global Burden of Disease (GBD) study, 18.9% of global deaths and 14.4% of all disability-adjusted life years (DALYs) are attributable to environmental and occupational risks.
• In India, this translates to nearly three million deaths annually, with serious repercussions for non-communicable diseases (NCDs) like heart disease, asthma, lung cancer, and chronic kidney disease.
• Notably, environmental risks such as lead exposure have devastating consequences on child development, with India accounting for 20% of total global IQ points lost in children under five.
• These figures point to a systemic and ongoing failure to integrate environmental determinants into mainstream health policy and practice.

Limitations of Current Approaches and The Promise of Exposomics

• Limitations of Current Approaches
  • While the GBD study offers valuable insights into the health burden of environmental factors, it is fundamentally constrained by a narrow scope of risk categories (around 11).
  • Many critical exposures, such as microplastics, chemical mixtures, solid waste, and noise pollution, are excluded due to a lack of exposure data and methodological tools.
  • Moreover, risk assessments often isolate individual variables without accounting for interactions between multiple environmental, behavioural, and genetic factors.
  • This reductionist approach not only misrepresents the complexity of disease etiology but also weakens the foundation for effective preventive strategies.
  • Furthermore, the spectre of climate change exacerbates existing vulnerabilities, intensifying hazards such as heatwaves, floods, air pollution, and food insecurity.
  • These compound events, when layered over socio-economic disparities and inadequate healthcare infrastructure, disproportionately affect already marginalised communities.
  • Yet, current frameworks lack the analytical depth to capture these synergistic effects, resulting in underestimations that skew public health priorities and investment.
• The Promise of Exposomics
  • In response to the limitations of genetic determinism and reductionist epidemiology, the emerging field of exposomics offers a paradigm shift.
  • Much like the Human Genome Project transformed our understanding of genetic risk, the Human Exposome Project seeks to map the totality of environmental exposures across the human lifespan.
  • By integrating chemical, biological, physical, and psychosocial exposures with individual-level variables such as genetics and lifestyle, exposomics provides a multidimensional view of health and disease.
  • Exposomics harnesses a range of cutting-edge technologies, wearable sensors for real-time exposure monitoring, high-throughput biomonitoring, organ-on-a-chip systems, and AI-driven data analysis, to construct dynamic, individualised exposure profiles.
  • These insights can feed into Exposure-Wide Association Studies (EWAS), which complement genome-wide analyses to identify new environmental determinants of disease.
  • The successful implementation of exposomics depends on creating an interoperable data ecosystem, where harmonized datasets can be shared across disciplines.
  • This requires strategic investments in data infrastructure, standardisation, and training, particularly in low- and middle-income countries like India.

Exposomics in the Indian Context: A Strategic Imperative

• While exposomics may appear aspirational in a country where basic environmental health interventions remain underdeveloped, India has a unique opportunity to leapfrog to advanced, technology-driven models.
• The country's experience with digital health tools and rapid scaling of tech infrastructure (e.g., during COVID-19) demonstrates its capacity to adapt and innovate.
• By investing in exposomic research and infrastructure, India can build more predictive, personalised, and equitable public health systems.
• The integration of exposomic frameworks into national health strategies could significantly enhance the precision and cost-effectiveness of disease prevention, especially for chronic diseases where environmental contributors are poorly understood.
• It also aligns with India’s broader goals of health equity, sustainability, and technological leadership on the global stage.

Conclusion

• World Environment Day 2025’s call to action against plastic pollution is a reminder of the broader crisis facing environmental health, particularly in vulnerable nations like India.
• Current methods of assessing and addressing environmental risks are not only inadequate but may also perpetuate inequalities by ignoring complex, compounding exposures.
• The science of exposomics, although nascent, holds the promise of a more holistic, data-integrated approach that captures the true scope of environmental influences on health.
• By embracing exposomics, India can move beyond reactive, fragmented health policies to adopt proactive, precision-driven strategies that better safeguard the health of its population and environment.