The Toxicity of Diesel Exhaust: Implications for Primary Care

Irina N. Krivoshto, BA; John R. Richards, MD; Timothy E. Albertson, MD, MPH, PhD; Robert W. Derlet, MD


J Am Board Fam Med. 2008;21(1):55-62. 

In This Article


In 1989, the International Agency for Research on Cancer concluded that there is sufficient evidence for the carcinogenicity of diesel exhaust in experimental animals but limited evidence for carcinogenicity in humans. In 1990, California identified diesel exhaust as a substance known to cause cancer. Diesel exhaust particles have been shown to directly damage DNA and result in carcinogenesis in several animal lung studies.[46] Diesel exhaust particles have been shown to generate reactive oxygen species, which lead to oxidative stress and DNA damage. PAH associated with diesel exhaust are genotoxic, forming PAH-DNA adducts and resulting in mutation and DNA strand breakage.[47] Occupational studies of railroad workers, heavy equipment operators, and truck drivers have demonstrated a significantly higher-than-normal incidence of death from lung cancer.[48,49] A more recent case-control study of occupational diesel exhaust exposure in Montreal, Quebec, Canada found a limited association with lung cancer in both smokers and nonsmokers.[50] Gustavsson et al reported that workers exposed to combustion products had a higher incidence of esophageal cancer.[51] In a study by Guo et al, human exposure to DEPs was associated with a higher risk of ovarian cancer but not with esophageal, testicular, or urinary tract cancers or leukemia.[52] A possible causal relationship between DEPs and multiple myeloma was reported by Lee et al.[53]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.