Advancing Breathomics through Accurate Discrimination of Endogenous from Exogenous Volatiles in Breath

Breathomics, a growing field in exposure monitoring and clinical diagnostics, has faced accuracy challenges due to unclear contributing factors. This study aims to enhance the potential of breathomics in various frontiers by categorizing exhaled volatile organic compounds (VOCs) as endogenous or exogenous. Analyzing ambient air and breath samples from 271 volunteers via TD-GC × GC-TOF MS/FID, we identify and quantify 50 common VOCs in exhaled breath. Advanced quantitative structure–property relationships and compartment models are employed to obtain VOCs kinetic parameters. This in-depth approach allows us to accurately determine the alveolar concentration of VOCs and further discern their origins, facilitating personalized application of breathomics in exposure assessment and disease diagnosis. Our findings demonstrate that prolonged external exposure turns humans into secondary pollutant sources. Analysis of endogenous VOCs reveals that internal exposure poses more significant health risks than external. Moreover, by correcting environmental backgrounds, we improve the accuracy of gastrointestinal disease diagnostic models by 15–25%. This advancement in identifying VOC origins via compartmental models promises to elevate the clinical relevance of breathomics, marking a leap forward in exposure assessment and precision medicine.