Southern Environmental Health Study

SUMMARY Approximately 80% of human cancers are caused by adverse environmental exposures, unhealthy lifestyles and/or their interactions with host susceptibility factors. Previous studies have mostly focused on evaluating behavioral risk factors, such as tobacco smoking, physical inactivity, unhealthy diets and obesity. While more than 80,000 chemicals have been registered by the EPA, very

few of them have been adequately investigated in relation to human cancers in epidemiologic studies. There are considerable challenges in studying environmental exposures in epidemiologic studies. Humans are exposed to large numbers of chemical and physical substances and their mixtures, typically at low levels over extended periods of time. Previous environmental epidemiologic studies

have mostly evaluated exposures one at a time. However, because of a typically weak association of a given exposure with disease risk, coupled with limited tools and biomarkers for environmental assessments, most studies have failed to provide convincing evidence to link environmental exposures to cancer risk. To overcome these challenges, we propose to establish a large cohort study including

~50,000 participants with an extensive collection of survey and geospatial exposure data, as well as biological and environmental samples, to address critical issues in the environmental etiology of cancer. Utilizing a framework of community-engagement to help inform research, enhance recruitment and

retention efforts, and disseminate results, we will focus on recruiting low-income and minority populations who are more likely to live in resource deprived and heavily polluted communities. We propose to include 1,500 of the study participants in a deep-exposome study to comprehensively assess the exposome, identify key biomarkers of external exposures, examine associations of external

and internal metrics with cancer-related biological responses, and develop cumulative exposome risk scores. The proposed study will enable direct evaluation of associations of environmental exposures with cancer outcomes in the long term, and associations with cancer intermediate biomarkers in the short term. By integrating environmental exposure data from multiple sources, including personal

exposure assessments and biologic markers of environmental exposure and responses, this proposed study will allow us to systematically and rigorously investigate environmental exposures in relation to cancer risk and provide substantial novel data to improve the understanding of both external and internal exposomes, which will pave the way for future remediation of environmentally induced cancer.