The Exposome: What's Silently Shaping Your Health, and What to Do About It

Your home is meant to be a shelter, a place where you [and your family] feel safe. But homes are complex environments, influenced by the materials they're built with, the products we use, and the air and water inside.

The materials and products we bring into our home are meant to make them cleaner, more modern, and more comfortable. But sometimes they can have the unintended consequence of introducing or trapping chemicals that may contribute to long-term health risks, including hormone disruption, immune dysregulation, issues with the brain and nervous system, and even cancer.

History gives a useful example: For decades, lead was common in homes, especially in paint and plumbing. But as science evolved the evidence of its health impacts, including irreversible brain damage in children, became impossible to ignore, and regulations followed. We now wouldn't dream of using lead paint on our walls. Of course, not every exposure is as dangerous as lead. But it's important to keep in mind that we sometimes don't understand the full cost of an exposure until years down the line.

As the science around exposures continues to evolve, people are often left to sort through the research and misinformation themselves to make sense of their environmental exposures and decide which changes are worth prioritizing.

“There's an increasing body of literature that shows that environmental factors are just as important and sometimes more important than genetic factors in how our health is maintained or how we reach a lower disease risk,” says Manish Arora, BDS, MPH, PhD, vice chairman of the department of environmental medicine at the Icahn School of Medicine and lead exposomics advisor at ROSE.

And there's often a mismatch in how safe we expect our products to be and the safeguards that are actually in place. “People think if something can be sold to them at a store that it's definitely safe,” says Lydia Jahl, PhD, environmental scientist and a ROSE scientific advisory board member. “But that's not always the case.”

Still, let's face it: Figuring out which of these exposures, if any, is actually contributing to health risks, and whether you should make any changes to your home, can be overwhelming and anxiety-provoking (not exactly good for health, either). Rather than throwing up your hands and giving up because the problem feels too big, Jahl recommends focusing on what you can do: Learn where exposures exist, through actions like testing your home's water, then make changes on a timeline and budget that works for you.

Read on to learn more about the forces at home that could be shaping your health, and what you can do to minimize risk, from testing to avoiding certain environmental exposures to simple product swaps.

What is the exposome?

Before you can make meaningful changes to your home environment, it's important to understand how everyday exposures can affect your health over time. That's where the exposome — a person's lifetime environmental exposures (physical, chemical, biological, and social influences) and their interplay with each individual's genome to impact their health — comes in.

Think of the exposome as a bucket that collects exposures over time, says Adelina Voutchkova-Kostal, PhD, director for sustainable development at the American Chemical Society and green chemistry and toxicology advisor at ROSE. Each chemical exposure, whether from the air you breathe, the water you drink, the food you eat, or the products you put on your skin, contributes to the bucket. Some exposures add only a few drops, while others add more substantial amounts. The concern is not any single drop in isolation, but the cumulative mixture of exposures, how often they occur, and whether they happen during sensitive periods of life.

That said: Not all chemical exposure is dangerous to you. Your individual risk is strongly guided by patterns of exposure and their interplay on your own genome. Even dangerous chemicals, when encountered very rarely or in extremely small amounts, often aren't a big concern, says Voutchkova-Kostal.

Still, scientists are learning more about how long-term exposure, or exposure in vulnerable populations like immunocompromised adults, pregnant women, and children can contribute to significant health risks. “Exposures during [childhood] can often disrupt development permanently,” says Arora. “Even if the toxic exposure is later removed, the disruption will persist because it's a structural defect.”

These known risks are why, around the world, many governments place limits or bans on the use of certain chemicals. Here in the United States, some regulations around potentially harmful chemicals exist, but those protections don't often go far enough.

“There are some exceptions, but largely the United States puts chemicals in our products and then waits for science and health to catch up,” says Jahl.

Deep breaths: You don't have to overhaul your whole routine tomorrow. “We live in a universe that is filled with different kinds of chemicals, both natural and man-made, so purity isn't realistic,” says Voutchkova-Kostal.

Instead, focus on taking thoughtful, targeted steps, such as testing your home environment and making high-impact swaps over time, to minimize potentially harmful deposits in your exposome bank account. One easy place to start is the water test from ROSE.

Here are the major risk categories you should know about, how they could impact your health, and what you can do to reduce your risk.

PFAS

Per- and polyfluoroalkyl substances, or PFAS, are a family of 12,000+ synthetic chemicals built around multiple carbon-fluorine bonds, which are one of the strongest single bonds in organic chemistry. The same property that makes them useful in consumer products (they're resistant to oil, water, stains, and heat) makes them persistent and resistant to degradation: They don't easily break down in the environment or the human body. For this reason, PFAS is commonly referred to as the “forever chemical.”1

Common culprits

There are many different types of PFAS in both consumer goods and the environment. Dozens of PFAS are commonly used in personal care products or other consumer products, such as stain-resistant carpets, upholstery, and waterproof outdoor gear. PFAS are rampant in non-stick cookware and food packaging (such as microwave popcorn bags).2

PFAS can also end up in the water and food supply, especially near industrial sites, airports, military bases, and fire-training facilities where these chemicals have historically been used in manufacturing processes or firefighting foams that can contaminate soil and groundwater. Research demonstrates the rising trend of PFAS in tap water, which is now one of the primary sources of human exposure. Because of this, the EPA has recently established required PFAS water monitoring by 2027.

How they enter your body

Most commonly, PFAS enter the body through drinking affected water and eating affected food. PFAS particles can also be inhaled through particles in the air (if you have a PFAS-coated couch, for example, PFAS particles can end up in your dust, which you then breathe in).

Potential health effects

PFAS have been shown in robust studies to negatively impact many bodily systems. Exposure has been linked with developmental delays, thyroid issues, reduced immune system responses, hormone disruption, and an increased risk of kidney cancer, with emerging evidence suggesting a link with breast and testicular cancer. “Every week there are papers published on potential health impacts,” says Jahl.

How to limit harm

Given the abundance of PFAS in the water supply, testing your drinking water for PFAS, and choosing an effective filter, is one of the best ways to limit exposure. Rick Andrew, water filtration expert, former NSF employee, and ROSE scientific advisory board member, recommends looking for a filter that's certified by NSF, WQA, and/or IAPMO (and one that specifically filters out PFAS).

To limit PFAS in the air, add an air purifier with a HEPA filter to your space. Buying furniture without PFAS is a plus (look for options without stain or water repellants). Of course, it's not realistic to get rid of everything you have, so you can throw a blanket or couch protector over potential culprits in your home. It's also a great idea to swap out non-stick cookware for cast iron or stainless steel, too.

Another tip: Eat whole food rather than processed alternatives, and increase your soluble fiber intake (it's primarily found in whole grains and fruits and veggies). According to Jahl, soluble fiber, especially beta-glucans, forms a gel matrix that may prevent the digestive system from absorbing PFAS, as suggested in animal studies.

Microplastics

Microplastics are tiny particles of plastic, usually smaller than five millimeters. Because plastic doesn't biodegrade, as it fragments, it accumulates into tinier and tinier pieces that can easily enter the body. While microplastics themselves can impact health, “they're also filled with different chemicals that were already in the plastic itself, like PFAS, bisphenols, or phthalates,” says Jahl. (More on those later.)3

Common culprits

Small fragments of plastic commonly break off from larger pieces, like water bottles, plastic bags, or fishing nets in the ocean. As they break down over time, they can end up in the air, water, soil, and food supply.

Microplastics are also abundantly found in and shed from consumer products, including synthetic clothing (like nylon or polyester), interior paint, and cosmetics and personal care products (think face wash or body soap with added plastic microbeads for exfoliation).

How they enter the body

Microplastics are truly everywhere, given how ubiquitous plastic is and its inability to biodegrade. According to Jahl, they primarily enter the body through the air you breathe, food you eat, and water you drink. When microplastic sheds from objects in your home, it can end up in dust you then inhale. Dermal exposure, Jahl says, is less of a concern, except for the smallest microplastics.

Potential health effects

Research has shown that microplastics are potent carriers of known endocrine disruptors such as PFAS, BPA, and phthalates, which means they can affect hormone function. According to the U.S. Environmental Protection Agency, endocrine disruptors are associated with reproductive issues, increased cancer risk, and problems with both the nervous system and immune system.

Emerging research also suggests a link between microplastics and cardiovascular disease. For example, a 2024 paper published in The New England Journal of Medicine studied people having surgery to remove plaque from their carotid artery. Patients with higher levels of microplastics in their plaque were observed to have a higher risk of heart attack, stroke, and death than people who didn't, more than two years post-surgery. Though this single-observational study has its limitations, including risk of introduction of microplastics during analysis, this emerging research demonstrates the unknown risks from microplastics that research has yet to uncover.

How to limit harm

Given their pervasiveness, it's impossible to avoid microplastics altogether, but you can limit your exposure by choosing natural materials over plastic-ridden ones (think glass food storage containers and water bottles, and choosing natural fibers such as cotton, linen, or wool clothing over synthetic fibers like polyester). A HEPA-grade air purifier can help limit microplastics in the air.

If you do have plastic in the kitchen, never get it hot. Heating up leftovers in a plastic container or cooking with a plastic spatula, for example, can cause microplastics to leach into your food. If you're grabbing takeout, Jahl says, it's best if you can use your own glass or stainless steel containers to avoid hot food in a plastic or styrofoam container (styrofoam is a type of plastic). At minimum, transfer your takeout to regular dishware to eat, and store any leftovers in non-plastic containers. It's also best to avoid single-use plastics as much as possible.

Heavy metals

Heavy metals are naturally occurring elements found in the earth's crust. Some heavy metals, such as iron and zinc, are essential trace elements and play an important role in human health. Other heavy metals can be detrimental, even at low levels of exposure.4

Common culprits

According to Voutchkova-Kostal, lead, mercury, cadmium, and arsenic are the most common concerning heavy metal exposures. Many older homes have lead service lines, lead-soldered copper pipes, or brass fittings, which can contaminate tap water. Private wells in some regions contain arsenic, uranium, manganese, or radium. If you live in an area with an industrial site nearby, especially former mines, heavy metals may be present in your water. Lead paint is often found in homes built before 1978, and cigarette smoke is a major route for both cadmium and lead.5

Fish, especially larger types, can contain several different heavy metals. Arsenic is commonly found in rice, especially if it's grown in an area with high levels of naturally occurring arsenic in the soil like the southeastern U.S. and Italy. Certain consumer goods also contain heavy metals, including imported pottery, crystal serving items, cosmetics, toys, and spices.6

How they enter the body

Drinking water is one of the most concerning routes of heavy metal exposure. Heavy metals can enter the body through skin absorption and inhalation (for example, breathing in cigarette smoke or dust with lead paint particles). “The dust that's created by chipping that paint is a problem, especially for young children,” says Voutchkova-Kostal.

Potential health effects

Heavy metals have been shown to accumulate in organs and cause organ-specific damage. Numerous studies also link heavy metal exposure to cardiovascular, respiratory, and neurological problems, and some are classified carcinogens. For pregnant people, heavy metal exposure is especially risky, with certain exposures potentially causing miscarriage, stillbirth, or birth defects.

How to limit harm

One of the best ways to prevent heavy metal exposure is to test your water and invest in a filter. If you have lead paint in your home, the EPA recommends hiring a lead abatement professional.

Cooking rice in excess water can decrease arsenic levels. Monitoring seafood intake can also reduce dietary heavy metal exposure. The EPA recommends pregnant people and children limit seafood intake to two to three servings each week.

Flame retardants

Flame retardants are chemicals created to slow down, suppress, or prevent the spread of fire. A fire safety law passed in California in the 1970s led to flame retardants being added to furniture in CA and throughout the United States. This continued until 2014, when an update to the rule allowed furniture manufacturers to make furniture without applying these chemicals.7

Common culprits

Furniture, and some textiles, made before 2014 commonly contain flame retardant chemicals.

How they enter the body

Flame retardants can enter the body through contact with your skin (for example, if you sit on a flame retardant sofa with shorts on). Inhalation, especially of contaminated dust, is another common exposure route.

Potential health effects

These chemicals are associated with cancer risk and hormone disruption. They're also associated with neurodevelopmental impacts including reduced IQ, hyperactivity, and inattention symptoms in exposed children.

How to limit harm

Common ways of keeping a cleaner environment will reduce your exposure to flame retardants (for example, frequent vacuuming to prevent dust inhalation and adding a HEPA-grade air purifier to spaces with flame retardant furniture.

If you have furniture manufactured before 2014, slowly phase it out for pieces that don't contain flame retardants. In one study, people who swapped out their old furniture made before 2014 that contained flame retardants with new furniture without flame retardants had decreased time to excrete polybrominated diphenyl ethers, a certain type of flame retardant, from their serum compared to those who did not replace their furniture. This was not seen across all flame retardants as these chemicals can often be found in our occupational spaces.

VOCs

Volatile organic compounds, or VOCs, are a group of carbon-containing chemicals that readily evaporate into the air at room temperature. These can range from harmless scents we enjoy, such as the smell of roses, to harmful compounds that can impact our health.8

Common culprits

“Smelly” products at home like paint, nail polish, aerosol cleaning sprays, candles, air fresheners, perfumes, and permanent markers are a common source of VOC exposure, says Jahl. New furniture (including mattresses), flooring, and cabinetry can also release VOCs, as can paints, varnishes, and adhesives. Gas stoves and unvented combustion appliances are another source.

How they enter the body

VOCs primarily enter the body through inhaling the vapors in the air, though VOC particles can also end up in household dust. Exposure through your skin (for example, using nail polish remover) is another route.

Potential health effects

The health impacts from harmful VOCs can vary a lot based on what specific chemical you are considering. In the short-term, exposure to many vapors can contribute to worsening asthma, throat, eye, nose irritation, and nausea. Exposure can also lead to long-term effects, including organ damage (specifically the liver and kidneys) or neurological problems. Certain VOCs are also linked to cancer.

How to limit harm

Minimize the number of fragranced products you use to prevent VOC exposure. When you buy new furniture or mattresses, let them air out in a well-ventilated area before using them. Increasing ventilation when using products with VOCs, whether turning on a vent or opening a few windows, can also reduce potentially harmful exposure.

Quats

Quats, or quaternary ammonium compounds, are a class of positively charged chemicals commonly used as disinfectants. Bacteria and some viruses have a negative surface charge, so quats adhere to them, disrupt the cell wall or viral envelope, and destroy the organism. Common examples include benzalkonium chloride (BAC) and alkyl dimethyl benzyl ammonium chloride (ADBAC).9

Common culprits

There are a variety of quats found in household cleaners, antibacterial hand soaps, personal care products, fabric softeners, and surface treatments (like poles on public transit). In general, watch out for terms like “antimicrobial” or “antibacterial.”

How they enter the body

The most common exposure routes for quats are touch and inhaling vapors and contaminated dust.

Potential health effects

Immediately, quat exposure can trigger skin and respiratory irritation (including potentially triggering asthma), but they may also pose long-term risks, including immune system and reproductive and developmental problems, though studies have only been in animal models and have not been replicated in human studies. In lab studies, some antimicrobial products were associated with antibiotic resistance.

How to limit harm

Use antibacterial products and ingredients sparingly. “You can always just use regular soap for cleaning and washing your hands,” says Jahl. “It cleans germs just as well without all the associated risks.” If you feel you need a commercially available cleaner for your home, look for ones with active ingredients other than bleach or quats (such as ingredients like ethanol, citric acid, or hydrogen peroxide).

Pesticides

A pesticide is a substance used to prevent or destroy pests, such as insects, weeds, fungi, rodents, bacteria, and viruses. While they pose significant risks to public health and the environment, they're commonly used in agriculture (though they are regulated to some degree by the U.S. Environmental Protection Agency).10

Common culprits

The most widespread form of pesticide exposure is eating non-organic food sprayed with these harmful chemicals. Pesticide run-off into water sources can also impact tap water.

How they enter the body

Pesticides primarily enter the body through affected foods. Agricultural run-off can affect tap water, particularly in agricultural regions such as the Midwest corn belt, Central Valley, and Mississippi River basin.

Potential health effects

Years of scientific research have identified significant health risks associated with pesticides (especially through direct exposure, such as working on a farm that uses pesticides), including an increased risk of allergic diseases, autoimmune conditions, thyroid disease, kidney cancer, and thyroid cancer.

Additional research highlights long-term health risks from consuming pesticides, including neurological disorders and certain types of cancer.

How to limit harm

Test your water, especially if you live in an agricultural area, and use an appropriate filtration system. Kahl recommends buying organic when you can, too, to reduce pesticide exposure (and support farms that don't expose workers to the worst pesticides).

Phthalates

Phthalates are a group of chemicals used to make plastic products, especially PVC, more flexible and durable. They don't bind well to plastic, so they commonly leach out into consumer goods packaged in them.11

Common culprits

Phthalates are frequently used to help fragrances last longer, so they're often in detergents, fabric softener, air fresheners, and perfumes. They're also abundant in personal care products like shampoo, lotion, makeup, and sunscreen to improve product texture. They're also found in building materials (especially vinyl), furniture, and other plastic goods.

How they enter the body

These chemicals can enter the body through skin contact (as with cosmetic and personal care items), contaminated foods (think processed foods packaged in plastic), and in dust (if you have vinyl floors or other phthalate-ridden items in your home).

Potential health effects

Phthalates are known endocrine disruptors that emerging evidence has suggested may be associated with breast cancer. Children may also be at higher risk of exposure and risk impaired development.

How to limit harm

Less processed food is less likely to contain phthalates, according to Jahl, so eat whole, organic foods whenever you can. Limit your purchases of flexible plastic products, and don't buy products with synthetic fragrances. Swapping out personal care products can make a big difference. A review of more than 20 studies found that practical changes, like swapping out products known to contain endocrine-disrupting chemicals and limiting exposure to certain plastics and packaged foods, can reduce the amount of these chemicals in the body.

Bisphenols (BPA/BPS)

Bisphenols are a group of industrial chemicals used to manufacture certain plastics and resins. The most well-known is bisphenol A (BPA), but related compounds such as BPS and BPF are also commonly used in consumer products and have not been established as safer than BPA.12

Common culprits

The most common sources of bisphenols are thermal paper receipts, can linings, and plastics.

How they enter the body

Dermal contact (touching receipts) and ingestion (eating canned food lined with bisphenol or drinking out of plastic bottles that contain it).

Potential health effects

Bisphenols have been linked in research to endocrine disruption and may contribute to metabolic disorders, including obesity, insulin resistance, and type 2 diabetes. Researchers have also investigated potential connections between bisphenol exposure and cardiovascular health outcomes.

How to limit harm

Don't accept receipts, and don't let your kids handle them if you do. “BPA rubs off on the skin, so I don't let my children touch them,” says Voutchkova-Kostal. When you touch a receipt, wash your hands right after (don't use hand sanitizer, this could increase BPA dermal absorption). Limit processed food and limit plastics in contact with your food and water.

The takeaway

Learning about the potential risks of chemical exposures can be anxiety-inducing, especially when you realize how prevalent they are, and how little regulatory bodies are doing to prevent them. Remember: Knowledge is power. When you understand the risks affecting your family, you can take a strategic approach to reduce them.

Not sure where to begin? Jahl recommends taking one step at a time and focusing on manageable high-impact swaps most likely to impact those in your home, such as using a HEPA-grade air purifier, vacuuming dust regularly, swapping chemical cleaners for soap, minimizing plastic in your home, and buying organic, whole foods whenever possible.

Another high-impact way to mitigate risk is testing your water and investing in a filtration system that addresses the contaminants affecting your water supply. “If you don't know what to treat, the odds of coming up with the right solution or a good solution are much lower,” says Andrew.

With a thoughtful approach tailored to your home's specific risks, you can focus on the changes that matter most and feel confident that your efforts are making a meaningful difference for your family.