Diesel exhaust and heart disease

Question:
I am a retired fireman who has developed heart problems. In the fire station, there were a lot of diesel fumes. Are these diesel fumes responsible for my heart problems? Could they have affected my health?

Response:
Diesel exhaust exposures have been linked to heart (and lung) problems in many research studies. These studies show fairly consistently that higher levels of diesel pollution in the outdoor air is related to higher number of deaths, hospital admissions, heart attacks, and other bad health outcomes. Since these studies base their results on populations (and not individuals), their results say that on average an increase in bad health outcomes may occur for the group that they studied, often a group of people living in a particular city or a group of elderly people.

What this means for you is not that clear. Even though these studies show that inhaling diesel fumes is bad, they don't necessarily say anything about whether diesel fumes in your firehouse are responsible for your specific heart problems. You (with some help and guidance) could estimate your risk of heart problems from diesel exposures in the fire house, given your family, diet, exercise, smoking and work history; scientists and consultants do this all the time. However, to do so properly, you would need to make many assumptions and factor in your exposures from fighting fires, when you probably inhaled soot and other pollutants that can also damage the heart. Without doing the calculations, I would guess that breathing diesel exhaust in the fire house does create additional risks of heart problems for you, but these risks are likely to be small, especially relative to those from fighting fires.

For more related information and more detailed explanations, I liked the following links: http://www.healthfinder.gov/news/newsstory.asp?docID=532393 (news article that talks about heart attacks and firefighters);
www.arb.ca.gov/research/health/fs/PM-03fs.pdf (a review that talks generally about the impacts of air pollution in California)
http://erj.ersjournals.com/cgi/content/abstract/17/4/733 (a scientific review article about the health impacts of breathing in diesel exhaust)