Improving our understanding of chronic disease risk will thus require more cross-disciplinary partnerships like the NIH's GEI. "Most geneticists think of the environment as a confounder to their genetic studies," Butte says. But he proffers the altered adage: "One researcher's confounder is another researcher's signal."
The work will also require a boost in technology, similar to that which has come to speed along the genomic field with high-throughput genetic sequencing. Fast, affordable and comprehensive chemical analyses could go a long way toward collecting the immense quantity of data needed to start better parsing environment's role in disease risk. Butte hopes that study subjects and even willing hospital patients will start to be screened as a matter of course to help amass the vast quantities of data needed to start making sound disease-exposure connections.
And ultimately that data could start paying dividends. "These are things you could eventually see in a doctor's office," Rappaport says. "It wouldn't take a great stretch of the imagination" to expect physicians to regularly screen patients for 100 or so of the most implicated chemicals to assess disease risk, much the way blood work today can reveal high cholesterol or other red flags. Such a practical application, he notes, would fit in well with the vision of "the future of medicine being more predictive and more personalized."