Skip to main content
Environmental Health Perspectives logoLink to Environmental Health Perspectives
. 1995 Sep;103(9):812–818. doi: 10.1289/ehp.95103812

Diesel engine exhaust and lung cancer: an unproven association.

J E Muscat 1, E L Wynder 1
PMCID: PMC1519219  PMID: 7498093

Abstract

The risk of lung cancer associated with diesel exhaust has been calculated from 14 case-control or cohort studies. We evaluated the findings from these studies to determine whether there is sufficient evidence to implicate diesel exhaust as a human lung carcinogen. Four studies found increased risks associated with long-term exposure, although two of the four studies were based on the same cohort of railroad workers. Six studies were inconclusive due to missing information on smoking habits, internal inconsistencies, or inadequate characterization of diesel exposure. Four studies found no statistically significant associations. It can be concluded that short-term exposure to diesel engine exhaust (< 20 years) does not have a causative role in human lung cancer. There is statistical but not causal evidence that long-term exposure to diesel exhaust (> 20 years) increases the risk of lung cancer for locomotive engineers, brakemen, and diesel engine mechanics. There is inconsistent evidence on the effects of long-term exposure to diesel exhaust in the trucking industry. There is no evidence for a joint effect of diesel exhaust and cigarette smoking on lung cancer risk. Using common criteria for determining causal associations, the epidemiologic evidence is insufficient to establish diesel engine exhaust as a human lung carcinogen.

Full text

PDF
812

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alavanja M. C., Brown C. C., Swanson C., Brownson R. C. Saturated fat intake and lung cancer risk among nonsmoking women in Missouri. J Natl Cancer Inst. 1993 Dec 1;85(23):1906–1916. doi: 10.1093/jnci/85.23.1906. [DOI] [PubMed] [Google Scholar]
  2. Beems R. B., van Beek L. Modifying effect of dietary fat on benzo[a]pyrene-induced respiratory tract tumours in hamsters. Carcinogenesis. 1984 Mar;5(3):413–417. doi: 10.1093/carcin/5.3.413. [DOI] [PubMed] [Google Scholar]
  3. Benhamou S., Benhamou E., Flamant R. Occupational risk factors of lung cancer in a French case-control study. Br J Ind Med. 1988 Apr;45(4):231–233. doi: 10.1136/oem.45.4.231. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Berger J., Wynder E. L. The correlation of epidemiological variables. J Clin Epidemiol. 1994 Aug;47(8):941–952. doi: 10.1016/0895-4356(94)90198-8. [DOI] [PubMed] [Google Scholar]
  5. Blair A., Walrath J., Rogot E. Mortality patterns among U.S. veterans by occupation. I. Cancer. J Natl Cancer Inst. 1985 Dec;75(6):1039–1047. [PubMed] [Google Scholar]
  6. Boffetta P., Harris R. E., Wynder E. L. Diesel exhaust exposure and lung cancer risk. Exp Pathol. 1989;37(1-4):32–38. doi: 10.1016/s0232-1513(89)80007-6. [DOI] [PubMed] [Google Scholar]
  7. Boffetta P., Stellman S. D., Garfinkel L. Diesel exhaust exposure and mortality among males in the American Cancer Society prospective study. Am J Ind Med. 1988;14(4):403–415. doi: 10.1002/ajim.4700140405. [DOI] [PubMed] [Google Scholar]
  8. Burns P. B., Swanson G. M. The Occupational Cancer Incidence Surveillance Study (OCISS): risk of lung cancer by usual occupation and industry in the Detroit metropolitan area. Am J Ind Med. 1991;19(5):655–671. doi: 10.1002/ajim.4700190510. [DOI] [PubMed] [Google Scholar]
  9. Byers T. E., Graham S., Haughey B. P., Marshall J. R., Swanson M. K. Diet and lung cancer risk: findings from the Western New York Diet Study. Am J Epidemiol. 1987 Mar;125(3):351–363. doi: 10.1093/oxfordjournals.aje.a114542. [DOI] [PubMed] [Google Scholar]
  10. Calisti R., Sgarzi A., Ardissone S., Bernardi P., Di Federico E., De Ruggiero N. Asbestosi in un autotrasportatore: caso clinico e analisi della esposizione. Med Lav. 1991 Jan-Feb;82(1):30–37. [PubMed] [Google Scholar]
  11. Costellati L., Guglielmin A. M., Calisti R., Sgarzi A., Ghelli C. Dispersione di fibre di asbesto e di fibre minerali artificiali (MMMF) all'interno della cabina di guida di autocarri: una possibile esposizione degli autotrasportatori. Med Lav. 1991 Nov-Dec;82(6):510–514. [PubMed] [Google Scholar]
  12. DOLL R. Occupational lung cancer: a review. Br J Ind Med. 1959 Jul;16:181–190. doi: 10.1136/oem.16.3.181. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Damber L., Larsson L. G. Professional driving, smoking, and lung cancer: a case referent study. Br J Ind Med. 1985 Apr;42(4):246–252. doi: 10.1136/oem.42.4.246. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Doll R. Occupational cancer: a hazard for epidemiologists. Int J Epidemiol. 1985 Mar;14(1):22–31. doi: 10.1093/ije/14.1.22. [DOI] [PubMed] [Google Scholar]
  15. Dubrow R., Wegman D. H. Cancer and occupation in Massachusetts: a death certificate study. Am J Ind Med. 1984;6(3):207–230. doi: 10.1002/ajim.4700060305. [DOI] [PubMed] [Google Scholar]
  16. Emmelin A., Nyström L., Wall S. Diesel exhaust exposure and smoking: a case-referent study of lung cancer among Swedish dock workers. Epidemiology. 1993 May;4(3):237–244. [PubMed] [Google Scholar]
  17. Garshick E., Schenker M. B., Muñoz A., Segal M., Smith T. J., Woskie S. R., Hammond S. K., Speizer F. E. A case-control study of lung cancer and diesel exhaust exposure in railroad workers. Am Rev Respir Dis. 1987 Jun;135(6):1242–1248. doi: 10.1164/arrd.1987.135.6.1242. [DOI] [PubMed] [Google Scholar]
  18. Garshick E., Schenker M. B., Muñoz A., Segal M., Smith T. J., Woskie S. R., Hammond S. K., Speizer F. E. A retrospective cohort study of lung cancer and diesel exhaust exposure in railroad workers. Am Rev Respir Dis. 1988 Apr;137(4):820–825. doi: 10.1164/ajrccm/137.4.820. [DOI] [PubMed] [Google Scholar]
  19. Gustafsson L., Wall S., Larsson L. G., Skog B. Mortality and cancer incidence among Swedish dock workers--a retrospective cohort study. Scand J Work Environ Health. 1986 Feb;12(1):22–26. doi: 10.5271/sjweh.2178. [DOI] [PubMed] [Google Scholar]
  20. Gustavsson P., Plato N., Lidström E. B., Hogstedt C. Lung cancer and exposure to diesel exhaust among bus garage workers. Scand J Work Environ Health. 1990 Oct;16(5):348–354. doi: 10.5271/sjweh.1780. [DOI] [PubMed] [Google Scholar]
  21. Hall N. E., Wynder E. L. Diesel exhaust exposure and lung cancer: a case--control study. Environ Res. 1984 Jun;34(1):77–86. doi: 10.1016/0013-9351(84)90077-x. [DOI] [PubMed] [Google Scholar]
  22. Hansen E. S. A follow-up study on the mortality of truck drivers. Am J Ind Med. 1993 May;23(5):811–821. doi: 10.1002/ajim.4700230514. [DOI] [PubMed] [Google Scholar]
  23. Hayes R. B., Thomas T., Silverman D. T., Vineis P., Blot W. J., Mason T. J., Pickle L. W., Correa P., Fontham E. T., Schoenberg J. B. Lung cancer in motor exhaust-related occupations. Am J Ind Med. 1989;16(6):685–695. doi: 10.1002/ajim.4700160608. [DOI] [PubMed] [Google Scholar]
  24. Higgins I. T. Air pollution and lung cancer: diesel exhaust, coal combustion. Prev Med. 1984 Mar;13(2):207–218. doi: 10.1016/0091-7435(84)90052-5. [DOI] [PubMed] [Google Scholar]
  25. Howe G. R., Fraser D., Lindsay J., Presnal B., Yu S. Z. Cancer mortality (1965-77) in relation to diesel fume and coal exposure in a cohort of retired railway workers. J Natl Cancer Inst. 1983 Jun;70(6):1015–1019. [PubMed] [Google Scholar]
  26. Howe G. R., Nair R. C., Newcombe H. B., Miller A. B., Abbatt J. D. Lung cancer mortality (1950-80) in relation to radon daughter exposure in a cohort of workers at the Eldorado Beaverlodge uranium mine. J Natl Cancer Inst. 1986 Aug;77(2):357–362. [PubMed] [Google Scholar]
  27. Jain M., Burch J. D., Howe G. R., Risch H. A., Miller A. B. Dietary factors and risk of lung cancer: results from a case-control study, Toronto, 1981-1985. Int J Cancer. 1990 Feb 15;45(2):287–293. doi: 10.1002/ijc.2910450214. [DOI] [PubMed] [Google Scholar]
  28. KAPLAN I. Relationship of noxious gases to carcinoma of the lung in railroad workers. J Am Med Assoc. 1959 Dec 12;171:2039–2043. doi: 10.1001/jama.1959.03010330001001. [DOI] [PubMed] [Google Scholar]
  29. Kabat G. C., Wynder E. L. Body mass index and lung cancer risk. Am J Epidemiol. 1992 Apr 1;135(7):769–774. doi: 10.1093/oxfordjournals.aje.a116363. [DOI] [PubMed] [Google Scholar]
  30. Knekt P., Heliövaara M., Rissanen A., Aromaa A., Seppänen R., Teppo L., Pukkala E. Leanness and lung-cancer risk. Int J Cancer. 1991 Sep 9;49(2):208–213. doi: 10.1002/ijc.2910490211. [DOI] [PubMed] [Google Scholar]
  31. Knekt P., Seppänen R., Järvinen R., Virtamo J., Hyvönen L., Pukkala E., Teppo L. Dietary cholesterol, fatty acids, and the risk of lung cancer among men. Nutr Cancer. 1991;16(3-4):267–275. doi: 10.1080/01635589109514165. [DOI] [PubMed] [Google Scholar]
  32. Kolonel L. N. Lung cancer: another consequence of a high-fat diet? J Natl Cancer Inst. 1993 Dec 1;85(23):1886–1887. doi: 10.1093/jnci/85.23.1886. [DOI] [PubMed] [Google Scholar]
  33. Kroes R., Beems R. B., Bosland M. C., Bunnik G. S., Sinkeldam E. J. Nutritional factors in lung, colon, and prostate carcinogenesis in animal models. Fed Proc. 1986 Feb;45(2):136–141. [PubMed] [Google Scholar]
  34. Lawler A. B., Mandel J. S., Schuman L. M., Lubin J. H. A retrospective cohort mortality study of iron ore (hematite) miners in Minnesota. J Occup Med. 1985 Jul;27(7):507–517. [PubMed] [Google Scholar]
  35. Lerchen M. L., Samet J. M. An assessment of the validity of questionnaire responses provided by a surviving spouse. Am J Epidemiol. 1986 Mar;123(3):481–489. doi: 10.1093/oxfordjournals.aje.a114263. [DOI] [PubMed] [Google Scholar]
  36. Lindsay J. P., Stavraky K. M., Howe G. R. The Canadian Labour Force Ten Percent Sample Study. Cancer mortality among men, 1965-1979. J Occup Med. 1993 Apr;35(4):408–414. [PubMed] [Google Scholar]
  37. Luepker R. V., Smith M. L. Mortality in unionized truck drivers. J Occup Med. 1978 Oct;20(10):677–682. [PubMed] [Google Scholar]
  38. Mallin K., Rubin M., Joo E. Occupational cancer mortality in Illinois white and black males, 1979-1984, for seven cancer sites. Am J Ind Med. 1989;15(6):699–717. doi: 10.1002/ajim.4700150609. [DOI] [PubMed] [Google Scholar]
  39. Mauderly J. L., Jones R. K., Griffith W. C., Henderson R. F., McClellan R. O. Diesel exhaust is a pulmonary carcinogen in rats exposed chronically by inhalation. Fundam Appl Toxicol. 1987 Aug;9(2):208–221. doi: 10.1016/0272-0590(87)90044-3. [DOI] [PubMed] [Google Scholar]
  40. McLaughlin J. K., Mandel J. S., Mehl E. S., Blot W. J. Comparison of next-of-kin with self-respondents regarding questions on cigarette, coffee, and alcohol consumption. Epidemiology. 1990 Sep;1(5):408–412. doi: 10.1097/00001648-199009000-00013. [DOI] [PubMed] [Google Scholar]
  41. Menck H. R., Henderson B. E. Occupational differences in rates of lung cancer. J Occup Med. 1976 Dec;18(12):797–801. doi: 10.1097/00043764-197612000-00005. [DOI] [PubMed] [Google Scholar]
  42. Milne K. L., Sandler D. P., Everson R. B., Brown S. M. Lung cancer and occupation in Alameda County: a death certificate case-control study. Am J Ind Med. 1983;4(4):565–575. doi: 10.1002/ajim.4700040410. [DOI] [PubMed] [Google Scholar]
  43. RAFFLE P. A. The health of the worker. Br J Ind Med. 1957 Apr;14(2):73–80. doi: 10.1136/oem.14.2.73. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Rafnsson V., Gunnarsdóttir H. Mortality among professional drivers. Scand J Work Environ Health. 1991 Oct;17(5):312–317. doi: 10.5271/sjweh.1697. [DOI] [PubMed] [Google Scholar]
  45. Rosenkranz H. S. Revisiting the role of mutagenesis in the induction of lung cancers in rats by diesel emissions. Mutat Res. 1993 Oct;303(2):91–95. doi: 10.1016/0165-7992(93)90100-a. [DOI] [PubMed] [Google Scholar]
  46. Rushton L., Alderson M. R., Nagarajah C. R. Epidemiological survey of maintenance workers in London Transport Executive bus garages and Chiswick Works. Br J Ind Med. 1983 Aug;40(3):340–345. doi: 10.1136/oem.40.3.340. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Saracci R. The interactions of tobacco smoking and other agents in cancer etiology. Epidemiol Rev. 1987;9:175–193. doi: 10.1093/oxfordjournals.epirev.a036301. [DOI] [PubMed] [Google Scholar]
  48. Schenker M. B. Diesel exhaust - an occupational carcinogen? J Occup Med. 1980 Jan;22(1):41–46. [PubMed] [Google Scholar]
  49. Schenker M. B., Kado N. Y., Hammond S. K., Samuels S. J., Woskie S. R., Smith T. J. Urinary mutagenic activity in workers exposed to diesel exhaust. Environ Res. 1992 Apr;57(2):133–148. doi: 10.1016/s0013-9351(05)80074-x. [DOI] [PubMed] [Google Scholar]
  50. Siemiatycki J., Gérin M., Stewart P., Nadon L., Dewar R., Richardson L. Associations between several sites of cancer and ten types of exhaust and combustion products. Results from a case-referent study in Montreal. Scand J Work Environ Health. 1988 Apr;14(2):79–90. doi: 10.5271/sjweh.1949. [DOI] [PubMed] [Google Scholar]
  51. Steenland K. Lung cancer and diesel exhaust: a review. Am J Ind Med. 1986;10(2):177–189. doi: 10.1002/ajim.4700100208. [DOI] [PubMed] [Google Scholar]
  52. Steenland K., Silverman D., Zaebst D. Exposure to diesel exhaust in the trucking industry and possible relationships with lung cancer. Am J Ind Med. 1992;21(6):887–890. doi: 10.1002/ajim.4700210612. [DOI] [PubMed] [Google Scholar]
  53. Steenland N. K., Silverman D. T., Hornung R. W. Case-control study of lung cancer and truck driving in the Teamsters Union. Am J Public Health. 1990 Jun;80(6):670–674. doi: 10.2105/ajph.80.6.670. [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Swanson G. M., Lin C. S., Burns P. B. Diversity in the association between occupation and lung cancer among black and white men. Cancer Epidemiol Biomarkers Prev. 1993 Jul-Aug;2(4):313–320. [PubMed] [Google Scholar]
  55. Wegman D. H., Peters J. M. Oat cell lung cancer in selected occupations: a case-control study. J Occup Med. 1978 Dec;20(12):793–796. [PubMed] [Google Scholar]
  56. Wegman D. H., Peters J. M. Oat cell lung cancer in selected occupations: a case-control study. J Occup Med. 1978 Dec;20(12):793–796. [PubMed] [Google Scholar]
  57. Williams R. R., Stegens N. L., Goldsmith J. R. Associations of cancer site and type with occupation and industry from the Third National Cancer Survey Interview. J Natl Cancer Inst. 1977 Oct;59(4):1147–1185. doi: 10.1093/jnci/59.4.1147. [DOI] [PubMed] [Google Scholar]
  58. Wong O., Morgan R. W., Kheifets L., Larson S. R., Whorton M. D. Mortality among members of a heavy construction equipment operators union with potential exposure to diesel exhaust emissions. Br J Ind Med. 1985 Jul;42(7):435–448. doi: 10.1136/oem.42.7.435. [DOI] [PMC free article] [PubMed] [Google Scholar]
  59. Woskie S. R., Smith T. J., Hammond S. K., Schenker M. B., Garshick E., Speizer F. E. Estimation of the diesel exhaust exposures of railroad workers: I. Current exposures. Am J Ind Med. 1988;13(3):381–394. doi: 10.1002/ajim.4700130307. [DOI] [PubMed] [Google Scholar]
  60. Wynder E. L., Hebert J. R., Kabat G. C. Association of dietary fat and lung cancer. J Natl Cancer Inst. 1987 Oct;79(4):631–637. [PubMed] [Google Scholar]
  61. Wynder E. L., Miller S. Motor exhaust-related occupations and bladder cancer. Cancer Res. 1988 Apr 1;48(7):1989–1990. [PubMed] [Google Scholar]
  62. Zaebst D. D., Clapp D. E., Blade L. M., Marlow D. A., Steenland K., Hornung R. W., Scheutzle D., Butler J. Quantitative determination of trucking industry workers' exposures to diesel exhaust particles. Am Ind Hyg Assoc J. 1991 Dec;52(12):529–541. doi: 10.1080/15298669191365162. [DOI] [PubMed] [Google Scholar]
  63. Zang E. A., Wynder E. L. Cumulative tar exposure. A new index for estimating lung cancer risk among cigarette smokers. Cancer. 1992 Jul 1;70(1):69–76. doi: 10.1002/1097-0142(19920701)70:1<69::aid-cncr2820700112>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]

Articles from Environmental Health Perspectives are provided here courtesy of National Institute of Environmental Health Sciences

RESOURCES