A large retrospective study analyzing over five decades of data has reported higher mortality risks among London transport workers, particularly those employed in bus and underground rail services. The analysis included more than 117,000 employees followed between 1960 and 2021 and compared health outcomes across different occupational roles. Findings showed that bus drivers and underground workers experienced significantly higher rates of all-cause, respiratory, and cardiovascular mortality compared with office-based staff. Notably, lung cancer mortality was more than twice as high in transport workers, raising concerns about long-term exposure to occupational and environmental hazards in urban transport systems.

      The study suggests that a combination of factors such as prolonged exposure to traffic-related air pollution, sedentary work patterns, shift schedules, and occupational stress may contribute to these increased risks, although specific causal mechanisms were not definitively established. Researchers also observed elevated cancer mortality across several transport roles, with particularly high risks among underground workers. Despite these findings, the authors emphasized that limitations such as incomplete exposure data and potential confounders warrant cautious interpretation. Nevertheless, the results highlight the importance of targeted occupational health strategies, including improved ventilation, reduced pollutant exposure, stress management, and routine health screening for transport personnel. These findings underscore the broader public health relevance of workplace conditions and the need for preventive interventions to protect long-term cardiovascular and respiratory health in high-risk occupational groups.