Integrating the exposome framework in CBRNe risk assessment: a holistic approach to chemical, biological, radiological, nuclear, and explosive threats

This paper introduces the exposome framework as a transformative approach to improving Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNe) risk assessments. Historically, CBRNe evaluations have concentrated on acute exposures and immediate health effects, often overlooking long-term and cumulative risks. By incorporating the exposome—defined as the totality of exposures experienced throughout an individual’s life—this paper advocates for a more holistic understanding of health consequences posed by CBRNe agents. The exposome framework enhances the ability to account for low-dose, chronic exposures, residual contamination, and their synergistic interactions with other environmental and physiological factors. It is vital for assessing the health risks faced by vulnerable populations, such as first responders and communities living near CBRNe events. This paper explores emerging technological advances in biological and personal monitoring, omics technologies (genomics, proteomics, and metabolomics), and artificial intelligence (AI)-based modeling, which facilitate precise health outcome predictions. The policy implications of integrating the exposome perspective into CBRNe preparedness are also discussed, emphasizing the importance of proactive strategies that address immediate and long-term health effects of CBRNe agents.