Integrative Biomedical Research
Integrative Biomedical Research (Journal of Angiotherapy) | Online ISSN 3068-6326
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Volume 8 Number 8 2024
REVIEWS (Open Access)
From Exposure to Emergency: Integrating the Exposome Framework into Acute Care and First Aid Practice
Turki Awad Alharbi 1*, Shaima Abdullah Bukhamsin 2, Auwaidh Bijad Albaqami 3, Saud Mani Hamed Al-Qahtani 4, Nawaf Rezeq Awad Al-Sulami 5, Abdullah Saleh Mohammed Alotaibi 6
Journal of Angiotherapy 8 (8) 1-8 https://doi.org/10.25163/angiotherapy.8810716
Submitted: 28 May 2024 Revised: 17 August 2024 Accepted: 24 August 2024 Published: 25 August 2024
Abstract
The understanding of acute illness is gradually shifting—almost quietly—from isolated clinical events toward something more layered and cumulative. The concept of the exposome, referring to the totality of environmental exposures across the human lifespan, offers a compelling lens through which emergency medicine may be reinterpreted. This narrative review attempts to synthesize current evidence linking chronic environmental exposures—including air pollution, heavy metals, endocrine-disrupting chemicals, and climate-related stressors—to acute clinical presentations frequently encountered in emergency departments. A structured search of major databases covering 2015–2024 literature revealed consistent associations between cumulative exposures and acute exacerbations of respiratory, cardiovascular, and heat-related conditions. Fine particulate matter (PM) and nitrogen dioxide, for instance, were repeatedly associated with increased emergency visits for asthma and acute coronary syndromes, while heavy metals such as lead and cadmium contributed to hypertensive crises and arrhythmias. Endocrine disruptors appeared to impair thermoregulation, subtly increasing susceptibility to heat-related illness. What emerges, perhaps more importantly than any single exposure, is a pattern—one where vulnerability accumulates over time and manifests abruptly in acute care settings. These risks are not evenly distributed; environmental justice communities bear a disproportionate burden. Integrating exposome-informed approaches into emergency medicine—through improved triage, risk stratification, and discharge planning—may enhance both patient outcomes and preparedness for climate-sensitive conditions. Yet, practical implementation remains limited. Bridging this gap will likely require interdisciplinary collaboration, improved data integration, and a gradual shift in how acute illness itself is conceptualized in clinical care.
Keywords: Exposome; Environmental Health; Emergency Medicine; Air Pollution; Climate-Sensitive Illness
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