Page 6 - March ARB Beacon 4-8-16

6 April 8, 2016
Total Exposure Health: an innovation in precision health
by Prerana Korpe
Air Force Surgeon General Public Affairs
FALLS CHURCH, Va. -- Walking in sunlight, be-
ing stuck in traffic, painting in a studio, listening to of warfighters to perform missions, TEH is different
music, washing a car … What do these things have
in common? Each illustrates a form of “exposure”
through our environment and lifestyle.
Health is not independent of environment and
lifestyle. Our environment and lifestyle present a
variety of factors which directly and indirectly af-
fect our health and wellbeing. Each time we step out
into the sunlight, we are exposed to UV rays. When
we sit in traffic, we are exposed to vehicle emis-
sions and pollutants. As we tend to our gardens, we
are most likely exposed to some form of pesticide
or herbicide. Physical exposure and chemical pro-
cesses cause the body to change the way it performs,
much like stress causes a change in the chemical
makeup of the body. External exposures can impact
the way organs perform and can lead to long-term
health consequences.
Factors known as “exposures,” are critical to the
development of preventive medicine, as we take
into account the role of our environment and life-
style in our total health assessment –through preci-
sion health.
Precision health is an outcome of the Precision
Medicine Initiative, launched by President Obama
in his 2015 State of the Union address. While preci-
sion medicine focuses on treatment of disease, pre-
cision health considers lifestyle and environment as
factors in both disease treatment and prevention.
“To provide proper interventions requires an un-
derstanding of health effects and their root cause –the are of critical concern. The Air Force recognizes the
exposure,” said Col. Kirk Phillips, Associate Chief
for Bioenvironmental Engineering, consultant to the
Air Force Surgeon General for Bioenvironmental En-
gineering. “Our medicine is not the only pathway to
health. The food we eat, the choices we make, etc., all on nutrition and the effects of smoking and alco-
contribute to our wellbeing,” said Phillips.
Precision health involves patient empowerment
through research, innovations in technology and
policy implementation. Understanding health im-
pacts from exposures will help the total force make
more informed choices during daily activities, to
help reduce harmful exposures so they do not lead
to future adverse health impacts. People will be bet-
ter positioned to reduce certain exposures or avoid
some harmful exposures altogether. This new era of
medicine lays the foundation for patients and pro-
viders to work together to develop individualized
care –putting patients at the helm.
Precision health has already begun to make ad-
vances. New discoveries and treatments to improve
chances of survival and reduction of exposure to ad-
verse effects are underway.
Bioenvironmental engineer Colonel Phillips de-
veloped the concept of Total Exposure Health to
support the Air Force Surgeon General’s commit-
ment to the healthiest and highest performing seg-
ment of the population.
“In order to be the healthiest population, it will
take something extraordinary,” explained Phillips.
TEH is an embodiment of precision health. Con-
sidering human performance issues and the readiness
because it looks at prevention. While restoring health
is important, restoration does not transform a popula-
tion into the state of “healthiest.” It is important to
consider the role of primary prevention –the facet of
medicine through which people are kept in the healthy
state. Keeping people healthy is the foundation for
progression towards the healthiest population.
While treating illness is an important part of preci- rienced hearing loss in both ears.
sion medicine, Total Exposure Health would provide
the total force with information that allows people to
keep themselves healthy and become active partici-
pants in protection of their individual health.
Air Force Medical Service provides resources for
protection, medical intervention, as well as health
and medical testing. Through TEH, this would in-
clude advice on protective equipment that acknowl-
edges exposures outside of the workplace. TEH
would educate the total force on how to protect
themselves from exposures, not just at work, but
outside of work as well.
“Total Exposure Health will provide our popu-
lation an opportunity to have their exposures com-
bined from work, the environment and their life
style [everyday life choices like hobbies, diet and
household chemical use] to receive proactive advice
on health and other every day decisions along with
information on how to protect them from exposure
and thereby protect their health,” Phillips said.
“Within the military, human performance issues
value of its beneficiaries and partnering with their
health,” Phillips said.
While health care delivery currently offers advice
hol consumption, Total Exposure Health seeks to
expand to other exposures and provide more clear
advice on protecting health.
Take for example, hearing and the different sound
exposures which affect the status of our hearing.
Based on the decibels, an activity such as listening
to music through headphones can have compound-
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ing effects on the quality of our hearing over time.
According to the National Institute on Deafness
and Other Communications Disorders, noise expo-
sure at work or during leisure activities can lead to
high frequency hearing loss. Of Americans between
the ages of 20 and 69, an estimated 15 percent have
experienced high frequency hearing loss as a result
of this noise exposure. The NIDCD reports that of
Americans age 12 and older, one in eight has expe-
“The infrastructure of health care is changing,
just like the world around us,” said Richard Hart-
man, Ph.D., Chief Health Strategist, Total Exposure
Health, Air Force Medical Support Agency. “This is
an incredibly exciting time in our history with the
advances in science, technology, and information
and especially medicine. What makes Total Expo-
sure Health bold is that TEH bridges all those in-
novations into one common solution.”
Across the Air Force, bioenvironmental engineers
are developing innovations to monitor, control and
document exposures. Sometimes referred to as “ex-
posure scientists,” BEEs have already been in the
process of collecting exposure information on work-
er and community health. Using their expertise in
occupational health of individuals along with indi-
vidual wellbeing, BEEs have the capability to make
significant contributions to the fundamental change
in health care required for precision health. Accord-
ing to Hartman, the natural development in health
care is to move into precision health.
“TEH is at the intersection of healthcare and
technology … Specifically, it takes advantage of
the advances [within] science, medicine, technol-
ogy and IT to better collect, analyze and understand
--workplace, environment and lifestyle-- exposures
to better inform the individual but also create a rich-
er clinical experience with all the AFMS providers
to create healthier lives,” said Hartman.
Total Exposure Health is an AFMS strategic pri-
ority, in the early stages of development and will be
evaluated through ongoing studies.