Research Appraisalother

The Digital Exposome: A Life Course Framework for Health in the Digital Age

Journal of medical Internet researchPetit, Pascal, Vuillerme, Nicolas8 May 2026DOI

Clinical Snapshot

75CEBM
Evidence: Moderateother

PICO Framework

P — PopulationHuman populations across the lifespan exposed to digital technologies
I — InterventionDigital technology exposures (smartphones, wearables, digital health tools, social media)
C — ComparatorTraditional non-digital environments or varying levels of digital exposure
O — OutcomesHealth outcomes including mental health, cognitive function, circadian rhythms, physical activity, health equity, and biological markers

Bottom Line

This viewpoint proposes integrating digital technology exposures into exposome science as a measurable environmental determinant of health. The authors define the 'digital exposome' as the full spectrum of exposures from digital technology interactions affecting health across the lifespan. While conceptually valuable for understanding how ubiquitous digital technologies influence population health, the framework lacks empirical validation. The approach could inform clinical practice by systematically assessing patients' digital environments alongside traditional risk factors. For Australian clinicians, this framework is particularly relevant given widespread digital health adoption and could guide development of evidence-based recommendations for healthy digital technology use. However, practical implementation requires validated measurement tools, longitudinal studies, and integration with existing clinical workflows. The emphasis on equity considerations is important for addressing digital divides in healthcare access and outcomes.

Evidence: Moderate

Key Findings

  • Effect Size: Not applicable - conceptual framework

  • Primary Outcome: Conceptual framework defining digital exposome as spectrum of digital technology exposures affecting health across lifespan

  • Nnt Or Sensitivity: Framework sensitivity to capture diverse digital exposures across sociotechnical, behavioral, and biological pathways

Clinical Application

Moderate - requires new measurement tools and interdisciplinary collaboration, but builds on existing digital health infrastructure Highly relevant given Australia's advanced digital health ecosystem, My Health Record implementation, and TGA regulation of digital therapeutics. Aligns with RACGP digital health guidelines and PBS digital health initiatives All populations with digital technology exposure, particularly relevant for Australian healthcare given high smartphone penetration and digital health initiatives

Abstract

Digital technologies are reshaping human behavior, health care delivery, and population health; however, their cumulative effects across the lifespan remain underexplored. This viewpoint argues that exposures arising from interactions with digital technologies should be formally integrated into exposome science as a distinct, measurable component of the human environment. Our aims are to (1) redefine the digital component of the exposome (the digital exposome) within the broader exposome framework, (2) examine its life course implications for health and equity, and (3) outline a research and policy agenda to enable its systematic measurement and integration into clinical and public health practice. Digital technology-related exposures can confer benefits such as enhanced health monitoring, personalized interventions, improved access to care, and the promotion of healthy behaviors. However, they may also introduce potential risks, including mental health challenges, cognitive and circadian disruptions, sedentary lifestyles, exposure to misinformation, and widening inequities among vulnerable populations. Despite their ubiquity, digital technology-related exposures remain poorly integrated into clinical medicine, epidemiology, or public and global health policies. Drawing on interdisciplinary evidence from exposure science, epidemiology, and digital phenotyping research, we propose a refined conceptual definition of the digital exposome grounded in the classical exposome domains. We propose redefining the digital exposome as the full spectrum of exposures resulting from interactions or proximities with digital technologies and their combined influence on health across the lifespan. This framework conceptualizes digital technology-related exposures as a dynamic set of environmental influences operating through sociotechnical, behavioral, and biological pathways over the life course. To operationalize this framework, we discuss practical approaches using validated behavioral instruments, objective device use logs, ecological momentary assessments, smartphone-based digital phenotyping, and wearable sensing technologies. Systematic measurement, large-scale longitudinal studies, and harmonized exposure metrics are needed to characterize the cumulative health impacts of digital environments more accurately. Emerging tools such as digital markers or biomarkers and digital phenotypes offer promising opportunities to link real-world technology use with physiological and biological outcomes, thereby supporting precision medicine and population health strategies. Ethical governance, privacy safeguards, and equity considerations must be embedded from the start, drawing on emerging exposomethics frameworks. Recognizing the digital exposome as a modifiable determinant of health offers a foundation for evidence-based guidance, prevention strategies, and policy interventions suited to increasingly digital societies. By integrating digital technology-related exposures into exposome science, clinical practice, and public health research, this viewpoint seeks to foster interdisciplinary dialogue, guide future empirical work, and support the development of safer and more equitable digital environments across the lifespan.

References

  1. 1.Petit, P., & Vuillerme, N. (2026). The Digital Exposome: A Life Course Framework for Health in the Digital Age. Journal of Medical Internet Research, 28(5), e90153. https://doi.org/10.2196/90153
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