Drivers exposed to diesel exhaust face increased lung cancer risk

Researchers are calling for engineering and administrative controls to reduce the incidence of lung cancer among professional drivers. The authors of a new study also say the government and researchers should step in and help.

"An 18 percent excess risk of lung cancer was linked to professional drivers who are potentially exposed to diesel exhaust, after taking into consideration the confounding effect of smoking," the report states. "There was a tendency towards a positive lung cancer gradient with increasing years of employment as a professional driver."

Vehicles such as trucks, buses, and taxis are often powered by diesel engines. While previous studies have suggested a positive association between occupational exposure to diesel exhaust and the risk of lung cancer, many have been ruled not statistically significant for various reasons.

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The researchers conducted a systematic review of studies examining the association between professional driving and lung cancer between 1996 and 2011. Their findings are published in Occupational and Environmental Medicine.

Professional drivers potentially exposed to diesel exhaust will become a crucial public health issue if a positive association between diesel exhaust and lung cancer is shown, given the large number of professional drivers in the general population, especially in developing countries, they said.

Some 20 studies were analyzed involving employees in the trucking industry, national transport companies, private transport companies, and the construction industry. Most were male.

"Work as a professional driver with potential exposure to diesel exhaust and other known and/or suspected occupational carcinogens is a common occupation in developed and developing countries," the report says. "There are far-reaching public health implications if the association between professional drivers and diesel exhaust and lung cancer is confirmed."

For example, government and health agencies should regulate public transport vehicle engines through legislation, they suggest. "Buses should be equipped with petrol, liquefied petroleum gas or hybrid engines instead of diesel engines."

Also, governments could subsidize bus companies to modify diesel engines or replace buses. The study noted a policy in Hong Kong called Early Replacement of Old Vehicles.

More research is needed on the feasibility of alternative fuels and power sources for vehicles, such as electricity. The researchers say government and private industry should work to raise worker awareness of the health risks of diesel exhaust.

"Given the prevalence of professional drivers worldwide and the great impact of lung cancer on public health, policymakers should implement effective measures to protect professional drivers from lung cancer through engineering and administrative control," the study said.

Read more at the WorkersComp Forum homepage.

August 20, 2012

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