Diesel engines are widely used in transport and power supply, making occupational exposure to diesel exhaust common. Both human and animal studies associate exposure to diesel exhaust with inflammatory lung effects, cardiovascular effects, and an increased risk of lung cancer. The International Agency for Research on Cancer has evaluated diesel exhaust as carcinogenic to humans. Yet national or regional limit values for controlling occupational exposure to diesel exhaust are rare. In recent decades, stricter emission regulations have led to diesel technologies evolving significantly, resulting in changes in exhaust emissions and composition. These changes are also expected to influence the health effects of diesel exhaust. This review provides an overview of the current knowledge on the health effects of diesel exhaust and the influence of new diesel technologies on the health risk. It discusses the relevant exposure indicators and perspectives for setting occupational exposure limit values for diesel exhaust, and outlines directions for future research. The review is based on a collaborative evaluation report by the Nordic Expert Group for Criteria Documentation of Health Risks from Chemicals and the Dutch Expert Committee on Occupational Safety.
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