The understanding of disease etiology and pathogenesis has radically changed as a consequence of the new challenges posed by climate change, environmental degradation and emerging infectious diseases. The awareness of the influence of distal causes (e.g. planetary changes at the roots of new pandemics), of the social environment and of early life exposures calls for innovative models of disease onset. Here we propose a scheme for the practice of epidemiology and toxicology that incorporates new recent advancements in both disciplines, under the general umbrella of the “exposome”. The exposome approach to disease encompasses a lifecourse perspective from conception onwards, and the investigation of the role played by all exposures individuals undergo in their lives. These include social inequalities and psychosocial influences, in addition to chemical, biological and physical exposures. We stress the role played by social differences and inequalities in the course of life as an overarching factor that influences downstream layers (including behaviours). We show that the idea of “lifecourse exposome” is compatible with the current interpretation of Adverse Outcome Pathways in toxicology, and in fact we propose an extension of the concept towards “lifecourse Adverse Outcome Pathways”. We propose to merge different research perspectives and promote an encounter between the sociological perspective of “biography” (using Pierre Bourdieu’s conceptual framework) and biology, according to the idea of accumulated biological capital of individuals. We also propose to treat social capital (including inequalities) no longer as a confounding factor but as an overarching determinant, perhaps the most important of all because it is the one that influences all other exposures downstream. The importance of early exposures in a lifecourse perspective leads to policy implications, i.e. investing more in the various forms of capital (social, economic, cultural) in early life.

由于气候变化、环境退化和新出现的传染病带来的新挑战，对疾病病因学和发病机制的理解发生了根本性的变化。对远端原因（例如新流行病根源的行星变化）、社会环境和早期生命暴露的影响的认识需要创新的疾病发作模型。在这里，我们提出了一个流行病学和毒理学实践方案，该方案在“暴露组”的总保护伞下结合了这两个学科的最新进展。疾病的暴露组方法包括从受孕开始的生命历程观点，以及对个体在其生活中经历的所有暴露所扮演的角色的调查。这些包括社会不平等和社会心理影响，除了化学、生物和物理接触。我们强调社会差异和不平等在生活过程中所扮演的角色是影响下游层级（包括行为）的首要因素。我们表明，“生命历程暴露组”的概念与当前毒理学中对不良结果途径的解释是相容的，事实上，我们建议将该概念扩展到“生命历程不良结果途径”。根据个人积累的生物资本的理念，我们建议融合不同的研究视角，促进“传记”（使用皮埃尔布迪厄的概念框架）的社会学视角与生物学的相遇。我们还建议不再将社会资本（包括不平等）视为混杂因素，而是视为首要决定因素，也许是最重要的，因为它会影响下游所有其他风险敞口。从生命历程的角度来看，早期接触的重要性会产生政策影响，即在早期生命中对各种形式的资本（社会、经济、文化）进行更多投资。