Dr. Snyder: Yeah, your exposome is all the things you're exposed to. And what we're measuring is your airborne exposure. So we have a device, this is the second generation, a third one's coming that's smaller. What it's doing is it's sucking up air at about one-fifth of what you breathe. And what we have, it's measuring things like PM 2.5, and temperature and humidity. But the power of this is that it actually has a filter under the intake valve that captures all the particulates like pollen and bacteria and fungi that you're actually breathing. And under that, we have a chemical absorbent that sucks up all the chemicals that you would also be breathing.

And then we analyze them, we don't analyze them in real-time, we take it apart and take the cartridge out actually. And we can measure all the biologicals, meaning pollen, and bacteria, and fungi that you're exposed to. And we can measure all the chemicals that you're exposed to too. You know, pesticides, turns out there are plastics everywhere, pesticides are everywhere, but their amounts will vary quite a bit. And certain carcinogens are everywhere, too. And some locations will have a ton of this stuff and others, you know, generally not so much. So that's what we're trying to measure.

And the ultimate goal is to try and understand how exposures will contribute to, you know, your disease. Because there's no question that your risk for disease, it depends upon genetics, but it also depends upon environment. And we think this is...that's the one thing that's always been very poorly measured is the environmental exposure. So that's what we're actively working on now, amongst other things, to try and capture that information.

Dr. Patrick: It's also the one thing that's not as easy to control. For example, you know, you can make a decision about what you're going to have for breakfast, lunch, or dinner, or whether you're going to fast and not eat or, you know, when you'll eat your food or if you're going to exercise. But the things you're breathing in, with the exception of, I guess, if you live somewhere close to a, you know, busier street or a highway, for example, where there's likely to be more particulate matter and air pollution and benzene, it's very difficult to control the air you're breathing in.

And there's been so many studies that have been coming out over the last few years. And of course, these are observational studies. There's all sorts of potential confounding factors that come along with observational data. But I think, you know, there has just been a pretty, I think, clear picture that air pollution increases the risk for a variety of age-related diseases in addition to just, you know, respiratory disease, Alzheimer's disease, you know, for one.

I mean, this is even something that's been shown in children that live in, for example, Mexico City, that have, you know, passed away. There's been some post-mortem studies that have looked at amyloid plaques in their brain, and it's just, like, looks like an old person's brain in a young child in a place where the air pollution and air quality is so poor. So have you guys been looking at, you know, maybe where people are living or if they have a HEPA filter, or some kind of filter, whether or not that makes a difference?

Dr. Snyder: So, great question. So the answer is...I'll say to some extent, what you're talking about is the more non-specific stuff like pollution, smoking, we know those are harmful, no question. And so we have looked at that, we actually discovered it looks like for one group we were studying speculated that actually there's some heavy metal mining upstream, and they speculated there's a high incidence of autoimmune disease. They thought that that might be due to the mining. And actually, it does correlate that way that as people live along the river, we discovered actually are seen to have a much higher incidence of autoimmune disease. So I suspect their hypothesis is correct. And so smoking, yes. I mean, those are documented studies by a lot of people, you know, inner-city kids, you know, exposed to pollution have a lot of this. I'll back up a little bit though. I do think you can have a better control, at least some control over this, in the sense you mentioned HEPA filters, sure, that's good.

But one of the things I discovered...I would argue we don't really know enough to make informed decisions about what's going on. And as a good example, I used to have more severe allergies, they are, kind of, mild now. And I always assumed they were pine, they came out, you know, April, May, like everybody's. But then when I actually did the correlation, when I looked at my data, and I looked at allergies, something called eosinophils, which are involved in your allergic response, and I correlate it with my exposures and guess what? Didn't correlate with pine, it correlated with eucalyptus. You say, well, how's that actionable? Well, I got two trees behind my house, a pine and eucalyptus. If I'm ever going to take one of them down, you can guess which one goes down first, it's going to be that eucalyptus tree.

So I honestly think that having more information can sometimes lead to more informed decisions. And I hope that'll be true about some of the other technical things. Like, there's just a ton we don't know. It's been speculated, you know, why are, you know, girls reaching puberty earlier? And it's been speculated that some of the plastics look similar to, you know, estrogen, and nobody knows if that's true or not. How do you know? There's never been a proper study to do that sort of thing. We can make those measurements, we might be able to see if any of that's true. And so I feel like we need...everybody knows the environment, you know, is important for disease, but we don't know what aspects of the environment. Crohn's, you name the disease, Crohn's, you mentioned aging, absolutely true. It's there and it's just never been measured.

So we don't know exactly which molecules are leading to these problems. Some of them may be just general particulates, like pollution, air pollution, but some of it may be very, very specific ones. And let's see if we can get those things outlawed, like, right get those metals out of the gas, was something that was...and now the paint was something...get lead out of paints was only because studies took a while to realize that lead was causing, you know, neurological problems. And so you have to identify that, you have to measure it, you have to see it first to know what's going on. And I think that's what the measurement is all about, you know, we're just taking tons of measurements. You're exposed to thousands of species, and which ones are associated with what aspects of your health? We don't know until we measure it.

Dr. Patrick: Have you guys measured...done the exposome of firefighters, people that are, you know, fighting these wildfires?

Dr. Snyder: Yeah, believe it or not, we are. So when these fires in California burst out, we've been trying to get our monitors out to as many people as possible. And including firefighters, you have to put them a little carefully because they obviously can't interfere with their duties. But yeah, so we are trying to do this. And I don't know what you know, but it's something you alluded to that kids in these poor areas, like in Fresno where there's a lot of pollution, where there's a lot of firefighters, there's a lot of studies that show that they have a much, much higher incidence of allergies and asthma when they're in these areas. And it does seem to be associated with firefighters.

So we're trying to measure exactly what they're getting exposed to. And maybe there's some way to help control that or figure out ways to try and extract that, I guess we can see what the harmful elements are. Maybe even if we can't control the exposure, we'll try to as much as possible to expose, but maybe there's a way to try and chelate it and remove it out of focus. I don't know, that's not exactly my area of expertise.

Dr. Patrick: I do know a little bit about not chelating but...so there's a couple of...not to get too far off-topic, but you might find it interesting. So one, there's a compound found in some cruciferous vegetables, particularly in broccoli sprouts, the young sprout of mature broccoli, called sulforaphane, which has been shown in now quite a few studies. There's been, you know, intervention trials where people are specifically given sulforaphane concentrate, and it causes...so a lot of these studies have been done in China where there's also terrible air pollution problems. It increases the excretion of benzene, which is found in you know, air pollution, cigarette smoke, for example, by, like, 60% after 24 hours. Also acrolein is now the one that it increases the excretion of...by activating the Nrf2 pathway, which then downstream a lot of these phase two detoxification enzymes get activated, for example.

The other interesting thing is sweat. And you know, there's been a variety of studies that have looked at which kind of, for example, heavy metals or other xenobiotic, like, parabens or BPA, things like that, which are excreted through a variety of different, you know, mechanisms. Some are excreted more prominently through urine and others through sweat. And so things like exercise and even sauna bathing can...you know, for example, mercury is one that really is excluded through sweat.