Exposure means different things to different people, so we conveniently packaged TEH into a simple brand. We revealed TEH as a catalyst to move exposure health away from animal data and population models to individual personalized effects of exposure. We also found TEH fosters innovations in research and technology development through programmatic support and can promote economic development, particularly in science, technology, engineering and mathematics (STEM).

1. TOTAL EXPOSURE HEALTH
INITIATIVE
Col Kirk Phillips, MS
Richard Hartman, Ph.D, CIH, CSP

2. Disclosure Informa>on
Kirk Phillips, Col, MS
Richard Hartman, PhD, MS, CIH, CSP
We have the following financial rela>onships to
disclose:
→ Consultant and Employee for: US Air Force Surgeon
General
→ We will not discuss off-label use and/or
inves>ga>onal use in my presenta>on
→ We have no financial rela>onships to disclose.
→ We will not discuss off-label use and/or
inves>ga>onal use in my presenta>on

3. 3
Total Exposure Health
What is it?

4. → Exci>ng and bold ini>a>ve to improve delivery of care
& health outcomes providing pa>ent centric exposure
monitoring
• Increase use of genomic knowledge/research
• Improve exposure monitoring through sensors and
wearables
• Be<er understand monitored exposure to individual
health outcomes
• Advance clinical decision support with digital
biodata bank, Big Data analyAcs, & expert sys
4
Total Exposure Health…

5. 5
Total Health (TH)
Industrial Hygiene
Safety
Health Promotion
Clinical Health
Mental Health
Behavioral
Occupational Health
Public Health
Nutritional Health
Financial Health
Environmental Health
Providing Proper Interventions Requires an Understanding of Health Effects and
their Root Cause – the “Exposure”
Total Worker
Health
“Comptox”
Total Exposure
Health
Environmental
Workplace Environment
Lifestyles
Total Exposure Health…Origins

6. 6
Total Exposure Health…Basics

7. Total Exposure Health…
Improved Information Flow

8. 8
Total Exposure Health
Why Now?

9. Healthcare is Changing

10. Current State…
EOSH/Preventive Medicine

12. Total Exposure Health…
Takes Us There
* SEG – Similarly Exposure Group

13. Total Exposure Health Example
(Today)
→ Enhance preven>on through “Total awareness”
– Noise – AF member
• DebilitaAve, highly compensable - not job centric
• By issuing ported form fit hearing protecAon we cover Total Air Force
member exposure - work, hobby/lifestyle, and environment
– Noise – All PopulaAons
• One in eight people in the United States aged 12 years or older has
hearing loss in both ears
– Affects accessions and beneficiary costs
• Sound level locking kiosk in clinics provided to prevent hearing loss in
children & members
• Known geneAc variance
13

14. Total Exposure Health
(Near Future)
→ Capturing and displaying root cause “Exposure” enhances Clinical
Decision Support
– Adding known exposure science and biomarkers allows more effecAve
clinical tesAng, e.g., prompts:
• Order/compare cholinesterase test to baseline when exposed to pesAcides
• lab test when exposed to emerging exposures
→ Sensor development ongoing to capture total cumula>ve env,
lifestyle & work exposures for individual enhancing clinical
experience, e.g.,
• All organic vapor and rad exposures on hang tags
• Wearable data integraAon for locaAon/env data
14

15. Total Exposure Health
“not so” Distant Future
→ TEH will drive the development of medical expert systems,
sensors and R&D
– Through TEH we will advance the science and understand the effects of
currently undetectable exposures and what we clinically know about
exposure, gene expression and disease
– Through TEH genomic data will be transparently incorporated into the
clinical decision process
– PaAents/Providers afforded TEH data real-Ame into healthcare enhancing
the Dr/PaAent experience
→ TEH will incrementally maximize human performance to not
only retain personal health aXributes but enhance
15
“The Distant Future is Really not that Distant”

16. Total Exposure Health
Tying It Together

17. Total Exposure Health –
the Promise of Big Data

19. Total Exposure Health
Conclusion
19
→ As Exposure Scien>st we are posi>oned to:
– We are posiAoned to effecAvely contribute to this fundamental change
in our health care system as “exposure scienAsts”
– Linking our EOSH experAse not only to the occupaAonal and
environmental health of individuals but also to their overall well-being.
→ Collec>vely We Can:
– Improve the delivery of care and health outcomes providing paAent
centric exposure monitoring
– Advance science and technology through the development of
biosensors and area Sensors
– Increase the knowledge/research base through exposomics
– Become a criAcal touch point to the paAent and provider

20. Questions?