Living beings are biochemical systems in action. Millions of bodies’ own chemicals meet millions of substances in the environment, in its totality forming the Human Exposome. Some of them such as nutrients are essential, some are beneficial such pharmaceuticals and remedies, many inert and some are detrimental as toxicants – and for most we simply do not know. Even for those where we believe to know, we often have to revise our judgments or it simply depends on circumstances, the individual and most important the amount. Coffee is a good example, where our critical views had to be revised lately. For nutrients such as cholesterol and sugar, our assessments are shifting in opposite directions. Scientific advise is remarkably difficult, also because commercial interests interfere.

After 40 years of the Human Genome Project we can explain about 5% of diseases as caused by genetics and 40% having a genetic component. However, an estimated 70-80% of diseases are caused or aggravated by exposures. This shows the potential of a Human Exposome Project, which would bring toxicology to another level.

In the meantime, we have to take decisions based on imperfect tools, applied to far too few chemicals. Artificial intelligence is emerging as a tool to integrate existing evidence and extrapolate to chemicals, where we miss data. This allows focusing resources, but the integration of such information into politics and public health action has not even started. On top of this, lifestyle, cultural and value decisions have to be taken into account. Public Health focuses on longevity and health, but struggles with personal choices such as drug abuse, alcohol and tobacco. Cannabis legalization, the weighing of positive vs. negative effects of alcohol and the steering of smoking toward much less damaging non-combustion products are challenging debates. These debates are already difficulty in the transatlantic divergence of political, legal and regulatory systems. They cannot be simply exported to other parts of the world, which are unique in cultural choices, economic opportunities and exposure challenges. However, the novel tools promise strongly broadened risk characterization as the basis for informed risk management tailored to the needs of different individuals and nations.

A number of disruptive technologies are changing the way we discover, innovate, produce and live. This is most evident in information technologies, artificial intelligence, or sensor technologies. These are mostly democratizing technologies, which are giving more and more people access to their benefits. Biotechnology often is different as bioengineering and its products are costly. Their benefits come with a price and have the potential to increase inequality within and between nations. The open access movement of information technologies applies here if at all to sharing of knowledge through open access publishing. The enormous acceleration of innovation with an abundance of new technologies raises questions for example whether we have to revise the patent system. The first mover advantage already often outweighs legal protections, which too often hinder the field and the spread of knowledge.

Biotechnologies currently revolutionize biomedical research with microphysiological systems allowing to produce more and more human-relevant information faster and faster. They allow the production of novel foods and drugs. However, they also play enormous roles identifying environmental threats, mitigating contaminations or cleaning waste water. Social justice requires equality and equity in benefiting from these technologies. Often these innovations are driven by the entrepreneurial state, i.e., the investment of public money with a long-term vision as contrasted by the short-term shareholder value-driven perspective of industry. This allows coupling such development programs with goals of social justice. If all are paying for it, all should benefit from it. Open access to knowledge on innovation plays a key role here. However, engagement, participation and collaboration are needed to allow all to keep pace with the accelerated generation of disruptive technologies.