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Study estimates 6% of lung cancer deaths in US and UK attributable to diesel exhaust

In 2012, the International Agency for Research on Cancer (IARC), which is part of the World Health Organization (WHO), classified diesel engine exhaust (DEE) as carcinogenic to humans (Group 1). (Earlier post.)

Now, a study by researchers from the Netherlands, the US, and France estimates that approximately 6% of annual lung cancer deaths in the US and UK—combining both environmental and occupational exposures—may be due to DEE exposure. This translates to about 9,000 annual lung cancer deaths in the US and about 2,000 annual lung cancer deaths in the UK that may be attributable to DEE.

An open access paper describing their study is in the journal Environmental Health Perspectives, which is published with support from the US National Institute of Environmental Health Sciences, US National Institutes of Health, and US Department of Health and Human Services.

To derive a meta-exposure-response curve (ERC) for DEE and lung cancer mortality and to estimate lifetime excess risks (ELRs) of lung cancer mortality based on assumed occupational and environmental exposure scenarios, the researchers conducted a meta-regression of lung cancer mortality and cumulative exposure to elemental carbon (EC), a proxy measure of DEE, based on relative risk (RR) estimates reported by three large occupational cohort studies (including two studies of workers in the trucking industry and one study of miners).

Based on the derived risk function, they calculated ELRs for several lifetime occupational and environmental exposure scenarios, and also calculated the fractions of annual lung cancer deaths attributable to DEE.

They estimated that approximately 1.3% and 4.8% of annual lung cancer deaths at age 70 in the US and the UK are due to past occupational and environmental DEE exposures, respectively.

In their paper, the researchers note that the estimates are far from precise, and depend on broad assumptions about proportions exposed to different levels of DEE, and the duration of occupational exposures. However, their attributable fraction AF estimates for occupational and environmental DEE exposure is generally consistent with some previous estimates for traffic-related air pollution and lung cancer mortality and incidence.

Our estimates suggest that stringent occupational and environmental standards for DEE should be set. Fortunately, increasingly stringent on-road emission standards for diesel engines have been introduced in the United States and the European Union (US2010 and Euro 6 standards) with other countries (e.g., China, India, Brazil) following with a delay of about 5 to 10 years. These regulations have resulted in the recent introduction of new diesel engine technologies (integration of wall-flow diesel particulate filter and diesel oxidation catalyst) that on a per-km basis achieve a more than 95% reduction of particulate mass and nitrogen oxides emissions.

However, emission standards for offroad vehicles and industrial applications are generally introduced after those for on-road vehicles and therefore many offroad applications were still largely uncontrolled in 2000. It should also be noted that although new diesel engines are available, it will take still many years before they have a significant penetration into the diesel engine fleet, especially in less developed countries.

—Vermeulen et al.


  • Roel Vermeulen, Debra T. Silverman, Eric Garshick, Jelle Vlaanderen, Ltzen Portengen, and Kyle Steenland (2013) “Exposure-Response Estimates for Diesel Engine Exhaust and Lung Cancer Mortality Based on Data from Three Occupational Cohorts,” Environ Health Perspect doi: 10.1289/ehp.1306880



Wonder how many premature lung cancer deaths are directly and indirectly attributable to ALL ICE vehicles + refineries + oil & Gas transport + exploitation (including shales and tar sands)?

The grand total and all associated cost to society is certainly scary.

The savings (in lives and health care cost and climate changes cost) by going to FCEVs and BEVs and clean energy sources would pay for all the new infrastructures required within one or two decades.

What is more appalling is that the majority does not (yet) understand the positive implications of the essential changes.


Pollution and junk food created health problems are still ignored by posters? How much more data is required before we realize that it is a huge industrial growing problem that will not disappear unless something is done to fight it?


That total calculated for this study was just for lung cancers. Diesel has also been implicated in heart damage, and frequency of attacks. Another cause of disability and premature dearths in people who do not smoke, is COPD caused by diesel particulate. So yes, your sweet mother, who never smoked, fed you fresh veggies and saw you got plenty of love, exercise and good foods may herself suffer years of debilitation because she happens to live in an area where infilling, and redevelopment eventually placed your lovely childhood home too near a freeway, down wind from a port, next-door to a guy who loves his diesel trucks, or otherwise right in harms way.


Actually, HarveyD has a good point. Particulate emissions from ALL sources need to be studied, not just diesel PM emissions. IARC has classified PM IN GENERAL as a Class 1 carcinogen ("carcinogenic to humans").

According to Argonne National Laboratory (ANL), the total PM emissions ("well-to-wheel") from the baseline gasoline engine technology is about the same as OLD technology diesel; new diesel engine technology has FAR lower PM emissions overall.

A 2009 study by the National Academy of Sciences ("Hidden Cost of Energy: Unpriced Consequences of Energy Production and Use") concluded that new technology diesel was one of the lowest in terms of health and environmental damages (roughly tied with CNG) of all the technologies considered when taking emissions from vehicle manufacturing, vehicle operations, fuel production, and fuel feedstock acquisition into account.


Air quality is generally better in Sweden than in continental Europe or in the USA. This is mainly due to less dense population. We do have some problems in the wintertime but this is mainly due to studded tires, not vehicle exhaust. Where I live, in a rural area, air quality is much better than in the cities. To give you some perspective, I would like to mention that I have measured particle mass and number emissions from my own diesel car. These levels are lower (factor 2-4) than in ambient air. When I drive into the city, I am literally cleaning the air. For that, I pay a penalty called “congestion charge”. Often, “upstream” emissions of BEV can be higher than for the fuels used in ICEs. Besides that, BEVs cannot clean the air while driving.


Fine particle emissions should be considered much more of an issue for modern gasoline cars than diesel cars. Have a look at this report and bear in mind that the T&E organisation has been lobbying very much against diesel cars in the past. The report does not specifically compare emissions from GDI cars with diesel cars but knowing (from other studies) that the actual levels from diesel are far lower than the limit, you get the picture. I would not agree with the report on all aspects, e.g. how well GPFs would work and the low cost of the whole system but I could agree with the conclusions that GPFs are needed. In that context, I am stunned to find that US EPA still does not grasp this problem and do not bother to do anything about it. On the contrary, they have even worked against Cal ARB, who wanted to adopt similar regulations as the EU.


@Peter XX,

I submitted comments to USEPA regarding high PM/PN emissions from GDI vehicles for the Proposed Rule, "Control of Air Pollution From New Motor Vehicles: Tier 3 Motor Vehicle Emission and Fuel Standards", EPA Docket ID: EPA-HQ-OAR-2011-0135. EPA has not yet finalized the Rule and has not yet responded to comments.

However, based on the EPA response to my comments in a previous Proposed Rule on the 2025 CAFE ("Proposed Rule to Extend the National Program to Reduce Greenhouse Gases and Improve Fuel Economy for Cars and Trucks"), I'm not optimistic that anything will be done to address the high particle emissions from GDI. Here is the EPA response from the 2025 CAFE Rule...

"...EPA agrees with the commenter that testing on initial GDI technology, primarily wall-guided systems, has shown an increase in PM emissions over the FTP as compared to conventional PFI gasoline engines. However as noted above, the technology is still evolving, making it difficult to predict future PM emission performance of GDI vehicles. Testing on initial spray-guided GDI systems has shown less of a PM increase over the FTP, and even reduced PM emissions over the US06 compared to PFI vehicles. Due to the improved fuel economy and reduced emissions offered by spray-guided GDI technology, it is anticipated that spray-guided GDI will replace wall-guided systems in the 2017 to 2025 timeframe. As a result, in the technical assessment conducted by the agencies as part of this rulemaking, the agencies assessed the emissions and fuel consumption improvements associated with spray-guided GDI systems and assumed that their overall in-use PM emission performance was comparable to that of PFI vehicles...."


With almost 200,000 long cancer deaths in USA & UK every year; 6% x 200,000 = 12,000/year from diesel exhaust is significant.

Wonder what is the total (medical and other) associated cost per year. It is certainly enough to install a large number of H2 and battery charging stations over a 10 to 20 year period.


We both know that the statements from US EPA are totally wrong. Manufacturers are not using wall-guided GDI systems any more (EPA should update themselves regarding technology). Yet, the PN emissions from GDI cars are much higher than from old MPI cars. For sure, older GDI cars were even worse but they were not produced in large numbers and that technology is now obsolete. We have enough tests in the EU to prove that the newest GDI cars have high PN emissions; much higher than diesels with DPF and much higher than old MPI cars. For example, all the three cars tested in the German study were modern (Euro 5). You must do something about the US EPA! They are now in a process of conducting a large-scale experiment on the health of US citizens. Why not use GPF if this technology is readily available (with emission limits that would enforce this to happen)? Why would it be so difficult? Is it about industrial politics, i.e. to give US manufacturers some advantage over imports? Is it the “not invented here” syndrome, due to that this problem was first recognized in Europe? I am stunned with EPA!

Why not concentrate on the pollution that causes the remaining 94% of cancer cases, since we know that modern diesel vehicles are so much better than older generations. From the ACES2 study: “…emissions of fine particles were also 92% lower than the 2010 standard, 99% lower than 2004 emissions” and: “hydrocarbons were also significantly below required 2010 levels… 99.9%, respectively. If we use these numbers, we see that the 6% you refer to would be 0,06% and 0,006% for new engines respectively, i.e. the problem remaining from other sources would be 99,94% and 99,994%. Why not concentrate on the other sources, e.g. electricity generation?


@Peter XX

Thank you for your comments. I'm not an engineer, so I wasn't sure if EPA's response to my comments were valid regarding "wall-guided" vs. "spray-guided" GDI technology.

It appears to me that USEPA is proposing to (artificially) set PM (mass) limits at a level where GDI vehicle will BARELY meet them without filters.

A criticism of USEPA has always been too much politics involved with the promulgation of its regulations since I've been involved since the early 1980s.

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