In March 2026, NEXUS MPI and Data Science Hub Co-lead Chirag Patel, PhD, Harvard Medical School, published the paper “ An atlas of exposome-phenome associations in health and disease risk” in Nature Medicine with co-authors John PA Ioannidis, PhD, Stanford University and Arjun K Manrai, PhD, Harvard Medical School.
"An atlas of exposome-phenome associations in health and disease risk."
https://www.nature.com/articles/s41591-026-04266-0
This is a pivotal publication in the field of exposomics and one of the largest studies to date examining the links between environmental exposures and health outcomes, testing more than 100,000 associations. This paper uses an Exposome-Wide Association Study framework (ExWAS) to systematically map and analyze 619 exposure indicators and 305 quantitative phenotypes across 10 independent waves of the US Centers for Disease Control and Prevention National Health and Nutrition Examination Survey ( CDC NHANES).
This paper highlights the significant role of the exposome in human health, demonstrating that specific combinations of environmental exposures can influence health outcomes as strongly as genetic factors. With more than 5,600 associations considered statistically significant, this paper highlights which exposures are most beneficial for disease risk assessment, population surveillance, exposure prioritization, and next-generation longitudinal exposomics.
Published alongside this paper, his team released The Phenome-Exposome Atlas, which is an interactive R statistical package that allows users to browse data by phenotype and exposure group to identify associations. In addition, Patel’s team has developed a publicly available course “ Conducting Exposome-Wide Association Studies” which uses CDC NHANES data and the Phenome-Exposome Atlas to walk through ExWAS, including nine different modules, two assignments, and a course project which guides users through the material.
Chirag Patel comments “It is absolutely amazing how we can make inferences about the exposomic complexity of phenotypes using resources such as CDC NHANES and UK Biobank. A future that incorporates new measurements and developments in longitudinal personalized sampling, I believe will reap many fruits that will be helpful to so many and to advance exposomics for precision medicine and health.”
Overall, this large-scale exposome study represents a shift in how we understand the relationship between the environment and human health by examining combinations of exposures rather than single exposures in isolation. Leveraging large datasets and analytical methods such as ExWAS can further identify associations that cannot be explained by genetics alone. This work greatly advances the field of exposomics and data-driven, systems-level public health research.
“People often ask for examples of a comprehensive exposome study. It has been difficult to point to individual papers because much of the analysis is spread over multiple papers and projects due to the complexity. This paper will serve as a template for the field of exposomics, and science and health more broadly,” noted Gary Miller, NEXUS MPI. He also remarked, “I have heard people state that the complexity of exposomics would prevent this sort of comprehensive analysis, that the number of potential associations could not surpass multiple comparison and false discovery thresholds. The naysayers were wrong. This works.”
Chirag Patel, is a leader in the field of Exposomics, learn more in his NEXUS Spotlight: https://www.nexus-exposomics.org/news/patel_spotlight_May2025.html
In The Press: “A Large-Scale Look at the Exposome” By: Harvard Medical School https://hms.harvard.edu/news/large-scale-look-exposome