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5 Scientific and Technologic Advances INTRODUCTION Obtaining reliable estimates of exposures of large populations on multiple scales of space and time requires detailed information on emissions or transfor- mation products from a source, on the locations of receptors (personal or ecosys- tem) in time and space, and on the activity levels of the receptors (as proxies for inhalation rate, ingestion potential, or dermal interaction) at the time when they are affected by a source. Additional information may be needed on how individ- ual heterogeneity influences exposures--including such susceptibility character- istics as genetics, pre-existing health conditions, and psychosocial stress-- because these factors may also influence exposure. Information on body burden, obtained by collecting exposure biomarkers, also is essential for understanding the dose from a specific source and the influence of environmental exposures on health risks. Efforts to characterize exposure have focused on ambient conditions, and an individual is typically assigned to a home address in an epidemiologic health study or a species is assigned to a region it inhabits in an ecosystem. Although those exposure assignments have revealed important health risks, reliance on proxy methods may impart large exposure-measurement error--that is, a mod- eled exposure may be an inaccurate and potentially biased estimate of the true exposure. Depending on the exposure-error type, health-effect estimates may be attenuated and biased toward a null result, and the true benefits of control meas- ures may be obscured. Obtaining more accurate estimates of internal exposure reduces exposure-measurement error and provides a more realistic understand- ing of potential health effects of environmental and occupational exposures (Carroll et al. 2006). Efforts to gather information on personal exposures have relied on special- ized equipment that is expensive and cumbersome and thus limits the wear time or number of subjects that can be monitored. Because of those limitations, many studies have used questionnaires (Wacholder et al. 1992) or simple information 106
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Scientific and Technologic Advances 107 on location, such as home address, that is related to exposures. Those techniques have well-known limitations, but they are often the only methods available, par- ticularly for reconstructing historical exposures. Innovations in science and technology provide opportunities to overcome limitations and guide exposure science in the 21st century to deliver knowledge that is effective, timely, and relevant to current and emerging environmental- health challenges. Personalized medicine1 and telemedicine will increase the pace of innovation in scientific and technologic methods that will benefit the field of exposure science. For example, many new genomic methods for moni- toring individual metabolic and exposure phenotypes will be critical for future individualized medicine. In telemedicine, cellular-telephone technologies in- creasingly contribute to improving diagnostics and patient care and hence to improving our ability to anticipate the effects of exposures (Wootton and Bon- nardot 2010). Similarly, new developments in geographic information science and technologies are leading to rapid adoption of new information obtained from satellites via remote sensing, which provides immediate access to data on poten- tial environmental threats. Improved information on physical activity and loca- tions of humans and other species obtained with global positioning systems (GPS) and related geolocation technologies is increasingly being combined with cellular-telephone technologies. Many of these advances are integrated through powerful geographic information systems (GIS)2 that operate either through stand-alone computing platforms or through the World Wide Web. Biologic monitoring and sensing increasingly offer the potential to assess internal expo- sures. The convergence of these scientific methods and technologies raises the possibility that in the near future embedded, ubiquitous, and participatory sens- ing systems will facilitate individual-level exposure assessments on large popu- lations of humans or other species. The new technologies and methods also may help to operationalize the concept of the exposome (see discussion in Chapter 1). Establishing a more complete record of exposures based on internal biomarkers as theorized in the exposome (Wild 2005) requires tools that can also assess external environmental exposures. Many important exposures lead to no internal biomarkers but can be associated with environmental health risks (Peters et al. 2012) (for example, noise, heat, and electromagnetic fields). There is also a need to continue to link sources to exposures; this is the basis of mitigation efforts to protect public health. The committee envisions that many of the new technologies discussed in this chapter will help to broaden the exposome to the "eco-exposome" concept discussed in Chapter 2, and help to quantify exposure indicators to address those concerns. 1 Personalized medicine is an emerging practice of medicine that uses information about a person's genetic profile and environmental exposures to prevent, diagnose, and treat disease (Offit 2011). 2 GIS is defined as a system for performing numerous operations involving the acquisi- tion, editing, analysis, storage, and visualization of geographic data (Longley et al. 2005).
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108 Exposure Science in the 21st Century: A Vision and A Strategy In this chapter, the committee reviews some of the newest technologies for exposure science and, in considering their strengths and limitations, identifies near-term and long-term innovations that will guide exposure science in the 21st century. The review is organized according to the framework in Chapter 1 that describes the scope of exposure science from characterizing external concentra- tions to personal exposures and finally to understanding how internal exposures affect dose. Figure 5-1 expands on the framework by identifying the technolo- gies that will be presented. The discussion begins with a review of geographic information technologies, which help in characterizing sources and concentra- tions and also can improve understanding of stressors and receptors when used in concert with other methods and information. Ubiquitous sensing systems, ecologic momentary assessment (participatory methods that are used to query subjects about their perceptions and experiences while in the exposure field us- ing cell phones or other real-time devices), and nanosensors are addressed next; these can help in characterizing personal exposures. We then discuss biomoni- toring, which can improve our understanding of internal exposures and, when combined with other technologies, can help to identify sources. Finally, models and information-management tools are addressed in the context of their ability to help in interpreting and managing the massive and often complex interactions among receptors and environmental stressors. Many of the technologies in this chapter are illustrated in connection with air pollution, inasmuch as this is one of the most developed sectors of exposure science. As shown in Figure 5-1, how- ever, the committee's framework and vision are intended to be broadly applica- ble and relevant to all media to reflect the expected needs for the technologies, and many other illustrative examples are presented. TRACKING SOURCES, CONCENTRATIONS, AND RECEPTORS WITH GEOGRAPHIC INFORMATION TECHNOLOGIES Three major technologic advances in geographic information technolo- gies--remote sensing, global positioning and related locational technologies, and GIS--have dramatically affected exposure science. As outlined by Good- child (2007), they are inspiring a new emphasis on spatial information in rela- tion to social and scientific inquiry. Over the last 10 years, the technologies have contributed to improvements in exposure science, and they will probably con- tinue to move the field toward more refined exposure assessments that are more comprehensive, more accurate, and more relevant to and valuable in policy- making and in the everyday lives of large populations. Remote Sensing for Exposure Assessment Remote sensing (RS) has emerged as a key innovation in exposure sci- ence. RS has been defined as "the acquisition and measurement of data/inform- ation on some property(ies) of a phenomenon, object, or material by a recording
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Scientific and Technologic Advances 109 device not in physical, intimate contact with the feature(s) under surveillance" (Short 2011). The field encompasses the capture, retrieval, analysis, and display of information on subsurface, surface, and atmospheric conditions that is col- lected with satellite, aircraft, or other technologies designed to sense energy, light, or optical properties at a distance (Jerrett et al. 2009). RS is an important tool for enhancing the capacity to assess human and ecologic exposures because it provides global information on the earth's surface, water, and atmosphere. It is also widely used for subsurface investigations (for example, electromagnetic imaging of karst in water resource investigations). It also provides exposure estimates in regions where sparse ground observation systems are available. With respect to air pollution, the most common aerosol characteristic measured with a satellite is the aerosol optical depth (AOD), which quantifies the extinction of electromagnetic radiation from aerosols in an atmospheric col- umn at a given wavelength (Emilli et al. 2010). Six primary satellite sensors provide information on particulate pollution (MODIS, Landsat, IKONOS, Orbview, SPOT, and GOES). Box 5-1 discusses evaluation of the reliability of AOD compared with PM2.53 mass concentrations measured on the ground. Box 5-2 and Figure 5-2 demonstrate how the results of a 1-km retrieval of the MODIS AOD substantially improve the resolution and thus the utility of remote sensing for health and ecologic studies; the current grid size has a 10-km re- trieval. FIGURE 5-1 Selected scientific and technologic advances considered in relation to the conceptual framework. 3 PM2.5 are fine particles in the ambient air that are 2.5 microns or less in diameter.
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110 Exposure Science in the 21st Century: A Vision and A Strategy BOX 5-1 Evaluating the Reliability of Aerosol Optical Depth Against Ground Observations Hoff and Christopher (2009) reviewed more than 30 papers that exam- ined the relationship between total column AOD and surface PM2.5 measure- ments on a station by station basis. Their results underscored "the range of measurements from across the globe and the range of correlations between AOD and mass". They found a wide range of uncertainty between the two measures of AOD and mass. The studies used simple linear regressions and correlations between the AOD values and the PM2.5 mass concentrations measured on the ground. In some cases the correlations were strong and the AOD served as a predictor of pollution on the ground. In other cases, either because the satellite product itself was not sufficiently accurate or because the particles observed in the total column were in layers aloft, the satellite derived AOD was a poor predictor of pollution at the earth's surface. The au- thors suggested conducting a study of the controlling extrinsic factors for each region that would aid in understanding the PM2.5AOD relationship. The litera- ture continues to grow with efforts to combine information from multiple satel- lite sensors and models (van Donkelaar et al. 2010) or to introduce auxiliary information, such as meteorologic data (Pelletier et al. 2007) or boundary layer height (Engel Cox et al. 2006). Lee et al. (2011) have hypothesized that the inherent variability in the PMAOD relationship is due to changes in parti- cle size and composition, earth surface properties, vertical distribution of par- ticle concentrations, and other factors. To account for the variability of these factors, they proposed a daily calibration technique that is based on the spa- tial variability of ground PM measurements and would make it possible to obtain quantitative estimates of PM concentrations by using AOD measure- ments. BOX 5-2 Evaluation of MODIS 1 km Product The development of the 3 km and 1 km products provides an opportunity to test the capabilities of the satellite data to provide the resolution needed for exposure assessment and health related studies. For example, the 10 km aerosol product offered by MODIS is sufficient for climate applications but insufficient for detailed exposure assessment from sources that are variable over small areas, such as traffic emissions. In that regard, Hoff and Christo- pher (2009) stressed the importance of a finer resolution product on a local urban scale. It is expected that a 3 km product will become publicly available in 2013. To attain 1km resolution AOD from MODIS, the Multi Angle Implementa- tion of Atmospheric Correction algorithm was applied (Lyapustin et al. 2011a,b). The 1 km product was generated for the New England area during 2003. Figure 5-2 compares the 10 km and 1 km retrievals. It clearly shows that considerably more detail is obtained with the 1 km product.
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Scientific and Technologic Advances 111 Kilometers 0 30 60 120 180 240 AOD at 550 nm 0 0.8 FIGURE 5-2 Aerosol optical depth (AOD) derived from MODIS data for the New Eng- land region with the standard 10-km algorithm (left) and the experimental 1-km algo- rithm (right) for June 25, 2003. Remote Sensing for Health, Exposure, and Ecologic Studies Several studies and reviews (for example, Maxwell et al. 2010) have sug- gested that higher-resolution data enhance efforts to identify timespace patterns that are the basis of many risk assessments for diseases (Wilson 2002). In many studies, remote sensing data were used to derive three variables: vegetation cover, landscape structure, and water bodies. The ability to sense vegetation remotely from space is important in that nearly all vectorborne diseases are linked to the vegetative environment during their transmission cycle. Further- more, crop-type information may be important for studying the effects of pesti- cides (for example, vector resistance and illnesses caused by exposure to toxins) (Beck et al. 2000). Ward et al. (2000, 2006) and Maxwell et al. (2010) used crop location to identify where pesticides were applied in relation to residential loca- tions (Maxwell et al. 2010). Remote sensing of vegetation cover combined with GIS has also been used to develop management strategies to reduce herbicide application (Gómez-Casero et al. 2010) and to assess potential exposure of fish and wildlife to pesticides and metals (Focardi et al. 2006). Green cover is also associated with higher levels of physical activity, and RS has been used with geolocation technologies to show associations between physical activity of children and their exposure to green cover (Almanza et al. 2012).
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112 Exposure Science in the 21st Century: A Vision and A Strategy Hyperspectral Imaging Hyperspectral imaging collects and processes information from a wide portion of the electromagnetic spectrum. It has been used to assess human health risks associated with infectious diseases or environmental hazards. Ong et al. (2003) used hyperspectral airborne techniques to quantify dust loadings on man- groves originating from mining. The authors found that they could detect and quantitatively map the distribution of iron oxide. Ferrier (1999) showed that mine tailings (which contain potentially toxic materials) had been dispersed from the mine workings extending down the Rambla del Playazo to within 600 m of the beach at El Playazo (Spain). Other researchers have used hyperspectral data that were collected over "Ground Zero" for rapid assessment of the potential asbestos hazards associated with the dust that settled over lower Manhattan after the collapse of the World Trade Center towers (Clark et al. 2001; Swayze et al. 2006). Malley et al. (1999), Winkelmann (2005), and van der Meer et al. (2002) have reported soil contamination by hydrocarbons. Wu et al. (2005) studied mercury contamina- tion in suburban agricultural soils in the Nansing region of China. Finally, Chudnovsky et al. (2009, 2011) used the Hyperion satellite data to separate the spectral features of the Saharan dust storm from the underlying surface. HI sensing has been used to examine exposures of coral reefs to stressors such as sea surface temperature, ultraviolet radiation, wind, sediment load, chlo- rophyll, acidification, salinity, and coastal development (Maina et al. 2008; Eakin et al. 2010). Sediment load/water clarity (Doran et al. 2011), stressor ex- posures in benthic ecosystems (Goetz et al. 2008), and other water quality pa- rameters (Bagheri and Yu 2008; Odermatt et al. 2012) have also been analyzed using HI techniques. More recently HI techniques were utilized to assess the extent of the Deepwater Horizon Oil Spill and possible exposures to oil in pe- lagic and nearshore ecosystems (Bradley et al. 2011; Lavrova and Kostianoy 2011; Bulgarelli and Djavidnia 2012; Mishra et al. 2012). In 2015, two new hyperspectral sensors will be launched: the National Aeronautics and Space Administration HyspIRI (NASA 2011) and European ENMAP (EnMAP 2011) missions. With their improved hyperspectral and mul- tispectral capabilities, these sensors will increase the ability to monitor the ef- fects of urbanization on the environment and to assess land-cover characteristics that could indicate the presence of or risks posed by vectorborne and animal- borne diseases on a global scale. Conclusions To improve data quality for RS and increase its utility for exposure stud- ies, technologic improvements are needed, including Breakthroughs in electro-optics technologies.
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Scientific and Technologic Advances 113 Improvement of the current AOD retrievals (to achieve near-laboratory air-quality data) by obtaining accurate and reliable atmospheric vertical profile information. Retrieval of high-resolution AOD to discern spatial patterns of pollu- tion in urban environments through frequent daily temporal coverage based on orbital sensors. Global Positioning System and Geolocation Technologies Launched in the 1980s for defense applications, the GPS offers exposure scientists a simple means of tracking the geographic position of a person or other species. GPS receivers are now embedded into many cellular telephones, vehicle navigation systems, and many other instruments (Goodchild 2007). The GPS is a utility owned by the US government, and it consists of three compo- nents: a space segment with at least 24 satellites that transmit one-way signals to the earth; a control segment that maintains ground stations to track the satellites, reset their clocks, and maintain their positions; and a user segment that consists of individual devices that users deploy to receive the signals and calculate three- dimensional positions and times (GPS 2011). GPS signals can be augmented or complemented by land-based navigation systems that use cellular-telephone triangulation to provide positions when satellite signals are unavailable because of, for example, topographic obstruction or weather conditions (Shoval and Isaacson 2006). Radiofrequency identification can also be used for local track- ing of goods, animals, or people (Goodchild 2007). Collectively, these systems are referred to here as geolocation technologies. Hundreds of studies have used geolocation technologies to improve as- sessment of environmental exposures, including exposure to infectious-disease vectors (Vazquez-Prokopec et al. 2009) and air pollution (Paulos et al. 2007); to analyze how physical activity is related to different built environments (Jones et al. 2009); and to inform simulation models of potential pesticide exposures (Leyk et al. 2009). Many other applications are found in the literature. The main contribution of geolocation technologies is to reduce exposure measurement error and to move closer to a "timegeography of exposure" (Hagerstrand 1970; Briggs 2005). That is, geolocation technologies offer the possibility to know, with a high degree of accuracy, an individual's location in time and space and to provide a window into the moment of contact between a source (that is, an environmental intensity) and a receptor. When data obtained on environmental intensities (for example, air or water quality) are combined with geolocation information and physical activity measurements (obtained with accelerometers), more detailed estimates of potential chemical, biologic, or physical exposures can be made by using data on inhalation rate, ingestion po- tential, or dermal contact. There are many examples of how geolocation technologies have improved our understanding of exposures through their use in defining a person's location
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114 Exposure Science in the 21st Century: A Vision and A Strategy in time and space. They have revealed important limitations of survey-based assessments of location. For example, a study by Elgethun et al. (2007) com- pared timeactivity diaries with actual measurements from GPS and found se- vere underreporting in the diaries regarding the amount of time spent outdoors at home. Such errors may result in substantial exposure misclassification to such pollutants as ozone that have low penetration ratios from outdoors to indoors, which make time outdoors a key determinant of exposure. The technologies provide more accurate information on geocoded locations of subjects and a bet- ter understanding of likely sources of error when points are used to represent large structures, such as schools and day-care facilities (Houston et al. 2006). They are also used in studies in which exposures are measured as study subjects walk, ride bicycles, or drive with pollution monitors. A study by McCreanor et al. (2007) demonstrated the effect of walking through polluted areas on asth- matic symptoms and biomarkers--such as exhaled nitric oxide, a marker of lung inflammation--in London, England. The study provided increased support for the hypothesis that ambient air-pollution concentrations can elicit changes in asthmatic symptoms. Geolocation technologies have already made important contributions to the understanding of exposures at the point of contact between source and receptor, and they appear poised to play an increasingly integral role in widespread population-based individual sensing (discussed below). Geographic Information Systems GIS combines topologic geometry, capable of manipulating geographic in- formation, with automated cartography and enables users to compile digital or hard-copy maps. GIS plays a central role in integrating data into coherent data- bases that connect different attribute data (for example, exposure and health at- tributes) by geographic location. Input data used to derive exposure surfaces, such as road locations and industrial land uses, also are stored and manipulated in GIS. GIS increasingly serves as the storage and integrative backbone of re- mote sensing, geolocation technologies, and sophisticated modeling outputs, such as for collecting measurements on the fate and transport of contaminants through ecosystems (Gallagher et al. 2010). Another important role of GIS in exposure assessment is the quantification of topologic relationships. For example, buffer functions that measure the dis- tance between a source, such as a roadway, and a receptor, such as a house, en- able analysts to relate the geographic position of a study subject in space and time with the subject's likely exposure on the basis of an overlay of location information (Jerrett et al. 2005). That type of buffering, which provides the dis- tance between a source and a receptor, is used to characterize proximity to roadways, factories, water bodies, and other land uses or modifications that have either potentially adverse exposures (for example, pesticide transport from agri- cultural fields) (Gunier et al. 2011) or potentially favorable exposures (for ex- ample, parks and health-food stores in cities) (Morland and Evenson 2009). GIS
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Scientific and Technologic Advances 115 can provide information that is stored by the user, both before and after a major change (for example, in land use) or a catastrophe (for example, a tsunami). Fig- ure 5-3 demonstrates a road buffer that was used to characterize human expo- sures to traffic-related air pollution in Hamilton, Canada (Jerrett et al. 2005). Ecologic studies have combined modeling results with overlay techniques to examine potential exposure exceedances of threatened and endangered species (for example, see Figure 5-4 for cadmium exposures of the Little Owl) (Lahr and Kooistra 2010). Web-Based Geographic Information Systems for Exposure Assessment Web-based GIS is becoming more common (Maclachlan et al. 2007) and can serve as a tool in policy-making and in educating and empowering commu- nities to understand and manage their environmental exposures better. (See Chapter 6 for additional discussion of community engagement.) For example, to promote active commuting, Metro Vancouver has collaborated with the Univer- sity of British Columbia to develop a cycling-route planner (Cycling Metro Vancouver 2007), which allows cyclists to select routes that have the most green vegetation, the least traffic pollution, and the least or greatest elevation, all specified by the user. That empowers cyclists to choose the routes that best suit their fitness levels, minimize exposure to traffic pollution, and reduce their car- bon dioxide output (Su et al. 2010). The Web site runs on the backdrop of Google Maps--an illustration of the potential synergies between new private- sector technologies and public-health protection. FIGURE 5-3 Example of a binary buffer overlay showing people likely to experience traffic-related air-pollution exposure. The circles represent people. People assigned a "0" are outside a prespecified distance, while people assigned a "1" are within a given dis- tance. Adapted from Jerrett et al. 2005. Reprinted with permission; copyright 2005, Jour- nal of Exposure Science and Environmental Epidemiology.
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116 Exposure Science in the 21st Century: A Vision and A Strategy FIGURE 5-4 Map of a flood plain in the Netherlands showing secondary risk of poison- ing by cadmium in Little Owls developed using a combination of measured cadmium concentrations, food web modeling, knowledge of foraging in different habitats, and probabilistic risk assessment. Source: Lahr and Kooistra 2010. Reprinted with permis- sion; copyright 2010, Science of the Total Environment. In addition to human health concerns, web-based GIS has been used to monitor ecologic exposures. For example, Google Earth and Google Fusion Ta- bles with Airborne/Visible Infared Imaging Spectrometer data (AVIRIS 2012) were used to provide public, real mapping of the Deepwater Horizon Oil Spill (Bradley et al. 2011). With the new technologies--such as cellular telephones, GPS, and com- puters that apply complex data-mining techniques--private companies are in- creasingly collecting data that are potentially useful for exposure science, such as location and mobility information, and in some cases direct measurements of exposure through sensing networks. Issues of data ownership, use, informed consent, and data-sharing remain to be addressed. Increased cooperation with private-sector entities offers great potential for enhancing the data available for exposure science.
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