{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:04:49Z","timestamp":1789045489785,"version":"build-2803163510"},"reference-count":10,"publisher":"Korean Society for Preventive Medicine","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["jpmph.org"],"crossmark-restriction":true},"short-container-title":["JPMPH"],"published-print":{"date-parts":[[2026,7,31]]},"abstract":"<jats:p>Fine particulate matter (PM&lt;sub&gt;2.5&lt;\/sub&gt;; aerodynamic diameter \u22642.5 \u03bcm) is a leading contributor to the global burden of disease and is associated with substantial morbidity and mortality. However, its health effects are often evaluated within single-exposure frameworks, limiting causal inference and reducing the translational relevance of evidence for policy development. In this study, we reconceptualise PM&lt;sub&gt;2.5&lt;\/sub&gt; within the exposome framework by integrating external exposures, internal biological responses, and structural determinants of health across the life course. PM&lt;sub&gt;2.5&lt;\/sub&gt; comprises a complex and dynamic mixture of pollutants from ambient and household sources, including biomass combustion, traffic emissions, and industrial activities. After inhalation, PM&lt;sub&gt;2.5&lt;\/sub&gt; particles can penetrate the respiratory tract, and finer fractions may enter the systemic circulation, where they induce oxidative stress, inflammation, epigenetic dysregulation, and endocrine disruption. These mechanisms contribute to a broad spectrum of adverse health outcomes, including cardiovascular, respiratory, metabolic, and neurodegenerative diseases as well as cancers. The multi-level and temporally accumulated nature of these effects highlights the limitations of reductionist exposure assessment and underscores the need for integrative, systems-based approaches. Integrating cumulative impact assessment with exposome-wide approaches that leverage satellite, clinical, land-use, urban planning, and socioeconomic data can improve the characterization of context-specific cumulative health effects. Positioning PM&lt;sub&gt;2.5&lt;\/sub&gt; as a sentinel indicator of cumulative environmental risk provides a unifying framework for exposome-informed science and supports the development of more precise, equitable, and policy-relevant interventions.<\/jats:p>","DOI":"10.3961\/jpmph.26.219","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T23:55:07Z","timestamp":1783986907000},"page":"432-436","update-policy":"https:\/\/doi.org\/10.3961\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Fine Particulate Matter (PM2.5), the Exposome, and Cumulative Health Risk: A Life-course Perspective"],"prefix":"10.3961","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0507-0177","authenticated-orcid":true,"given":"Sarawut","family":"Sangkham","sequence":"first","affiliation":[{"name":"Department of Environmental Health, School of Public Health, University of Phayao, Phayao, 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