A human sentinel surveillance framework for comprehensive exposure assessment in occupational and environmental health

Abstract

Environmental and occupational exposures are increasingly recognized as major determinants of population health, contributing to the rising burden of chronic diseases and adverse health outcomes, yet traditional surveillance systems are often inadequate for capturing the complex and evolving nature of human exposures across diverse settings. In response, we propose the Human Sentinel Surveillance Platform (HSSP), a new digital infrastructure based on sentinel surveillance framework, to monitor exposures and health effects in real-time and via trained and motivated health professionals in order to identify emerging exposure trends. This perspective paper defines the foundational pillars, data governance principles, and operational workflows of the HSSP, while critically examining its potential impact on health policy, practice, and exposome research. The platform integrates biomarker-based monitoring, validated questionnaires, and adaptive protocols that can be updated in response to new threats, ensuring methodological relevance over time. Its four foundational pillars include: (1) a structured network of health care professionals, (2) targeted training and capacity building, (3) harmonized data collection using standardized tools, and (4) secure data repository and management aligned with ethical and regulatory standards. By incorporating multidisciplinary data from epidemiology, toxicology, genetics, and exposure science, HSSP enables comprehensive exposure characterization, longitudinal analysis of exposure-health relationships, early warning and timely public health regulatory and preventive interventions. This scalable and adaptable platform bridges critical data gaps in exposome research by capturing dynamic human-environment interactions and generating actionable insights to inform targeted interventions and provide evidence-based foundations for public health policy.