Nature, nurture and exposure

Abstract

In 1854, the Soho area of London was ravaged by cholera, with more than 600 people dying of the disease in less than a month. John Snow's maps of the cholera outbreak helped confirm the theory behind the most famous intervention in the history of public health—the removal of the handle of the Broad Street pump—and so demonstrated the utility of disease mapping. Over the past decade, scientists have developed more powerful systems that link geographical information with data on disease prevalence or severity to analyse the sources, distribution, spread and risk of diseases. Now, the combination of population biobanks with Geographic Information Systems (GIS) could take disease mapping to the next level by connecting a person's biological and health data with environmental exposure. This could expedite biomedical and public health research, but it could expose participants and the public to ethical and societal hazards. Population biobanks hold great potential for population‐based studies into the genetic and environmental causes of common complex diseases. A participant's health data, lifestyle data and family medical history are collected at enrolment, at repeat assessments and through web‐based questionnaires. Genetic data are derived from blood samples, and clinical data are collected from medical and other health‐related records, such as cancer registries and primary care records. What is missing in population biobanks to date, however, is data on a participant's environmental exposure, including data on air pollution from traffic or industrial sources, noise pollution from transport, climate data, or exposure to contaminated soils or water. To study associations between phenotype, genotype and environment, the biobank data must somehow be linked to environmental data, which requires the analysis of spatial information and context [1]. The missing link here could be the use of Geographic Information Systems or GIS. > … the combination of population biobanks with …