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Diesel Exhaust Linked to Cancer
Jon
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Diesel Exhaust Linked to Cancer

Occupational Exposure

The International  Agency for Research on Cancer (IARC), which is part of the World Health Organization (WHO), has classified diesel engine exhaust as carcinogenic to humans (Group 1), based on sufficient evidence that exposure is associated with an increased risk for lung cancer.

Causally Linked to Heart Conditions

Exposure to diesel exhaust has previously been held to be a causative factor in contributing to a compensable occupational heart condition. Recognizing that the Workers' Compensation Act required an occupational exposure to be “characteristic” of and peculiar to a particular employment, that there be restricted compensability for disability due to “deterioration of a tissue, organ or part of the body in which the function of the tissue, organ or part of the body is diminished due to the natural aging process,” and that the disease be “due in a material degree to causes or conditions” peculiar to the place of employment, the court concluded that a truck driver might suffer cardiovascular disability as a result of exposure to carbon monoxide even though the employee had other pre-disposing risk factors including smoking, obesity, and a genetic predisposition.

The court referred to the example of a teacher who developed asbestosis from working in a classroom with a flaking asbestos ceiling where the disability arising from the asbestos exposure was recognized as being compensable under the New Jersey Workers' Compensation Act. Fiore v. Consolidated Freightways, 140 N.J. 452, 659 A.2d 436 (1995).

Background

In 1988, IARC classified diesel exhaust as probably carcinogenic to humans (Group 2A). An Advisory Group which reviews and recommends future priorities for the IARC Monographs Program has recommended diesel exhaust as a high priority for re-evaluation since 1998. 

There has been mounting concern about the cancer-causing potential of diesel exhaust, particularly based on findings in epidemiological studies of workers exposed in various settings. This was re-emphasized by the publication in March 2012 of the results of a large US National Cancer Institute/National Institute for  Occupational Safety and Health study of occupational exposure to such emissions in underground miners,  which showed an increased risk of death from lung cancer in exposed workers.

Cancer-Causing Agent

The scientific evidence was reviewed thoroughly by the Working Group. and overall, it was concluded that there was sufficient evidence in humans for the carcinogenicity of diesel exhaust. The Working Group found that diesel exhaust is a cause of lung cancer (sufficient evidence) and also noted a positive association (limited evidence) with an increased risk of bladder cancer (Group 1).  The Working Group concluded that gasoline exhaust was possibly carcinogenic to humans (Group 2B), a  finding unchanged from the previous evaluation in 1989.

Public health

Large populations are exposed to diesel exhaust in everyday life, whether through their occupation or the ambient air. People are exposed not only to motor vehicle exhausts but also to exhausts from other diesel engines, including from other modes of transport (e.g., diesel trains and ships) and power generators.

Given the Working Group’s rigorous, independent assessment of the science, governments and other decision-makers have a valuable evidence base on which to consider environmental standards for diesel exhaust emissions and to continue to work with the engine and fuel manufacturers towards those goals.  Increasing environmental concerns over the past two decades have resulted in regulatory action in North  America, Europe, and elsewhere with successively tighter emission standards for both diesel and gasoline engines. There is a strong interplay between standards and technology – standards drive technology, and new technology enables more stringent standards. For diesel engines, this required changes in the fuel, such as marked decreases in sulfur content, changes in engine design to burn diesel fuel more efficiently, and reductions in emissions through exhaust control technology.

However, while the number of particulates and chemicals are reduced with these changes, it is not yet clear how the quantitative and qualitative changes may translate into altered health effects; research into this question is needed. In addition, existing fuels and vehicles without these modifications will take many years to be replaced, particularly in less developed countries, where regulatory measures are currently also less stringent. Notably, many parts of the developing world lack regulatory standards, and data on the occurrence and impact of diesel exhaust are limited.

Conclusions

Dr. Christopher Portier, Chairman of the IARC working Group, stated that “The scientific evidence was compelling, and the Working Group’s conclusion was unanimous: diesel engine exhaust causes lung cancer in humans.” Dr. Portier  continued: “Given the additional health impacts from diesel  particulates, exposure to this mixture of chemicals should be reduced worldwide.“ Dr. Kurt Straif, Head of the IARC Monographs Program, indicated that “The main studies that led to this conclusion were in highly exposed workers. However, we have learned from other carcinogens, such as radon, that initial studies showing a risk in heavily exposed occupational groups were followed by positive findings for the general population. Therefore actions to reduce exposures should encompass workers  and the general population.”

Dr. Christopher Wild, Director of IARC, said that “while IARC’s remit is to establish the evidence-base for regulatory decisions at the national and international level, today’s conclusion sends a strong signal that public health action is warranted. This emphasis is needed globally, including among the more vulnerable  populations in developing countries where new technology and protective measures may otherwise take many years to be adopted.”

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Jon L. Gelman of Wayne, NJ, is the author of NJ Workers’ Compensation Law (Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (Thomson-Reuters). For over 4 decades, the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com have represented injured workers and their families who have suffered occupational accidents and illnesses.

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