Cover Page

Key Concepts
  • Because of combustion of fossil fuels and organic waste, PAHs are ubiquitous in the environment
  • Studies show that certain PAH metabolites interact with DNA and are genotoxic, causing malignancies and heritable genetic damage in humans.
  • In humans, heavy occupational exposure to mixtures of PAHs entails a substantial risk of lung, skin, or bladder cancer.
About This and Other Case Studies in Environmental Medicine

This educational case study document is one in a series of self-instructional modules designed to increase the primary care provider’s knowledge of hazardous substances in the environment and to promote the adoption of medical practices that aid in the evaluation and care of potentially exposed patients. The complete series of Case Studies in Environmental Medicine is located on the ATSDR Web site at In addition, the downloadable PDF [546 KB] version of this educational series and other environmental medicine materials provides content in an electronic, printable format, especially for those who may lack adequate Internet service.


ATSDR Authors: Kim Gehle, MD, MPH

CDC/ATSDR Planners: Charlton Coles, Ph.D.; John Doyle, MPA; Bruce Fowler, PhD.; Kimberly Gehle, MD; Sharon L. Hall, Ph.D.; Michael Hatcher, DrPH; Kimberly Jenkins, BA; Ronald T. Jolly; Barbara M. Riley, RN; Delene Roberts, MSA; Oscar Tarrago, MD, MPH, CHES; Brian Tencza

CDC/ATSDR Commenters: Moiz Mumtaz, Ph.D.; Frank C. Schnell, PhD, DABT

NIOSH commenter: David Trout MD, MPH

External Peer Reviewers: Scott Phillips, MD, FACP, FACMT; Gary R. Krieger, MD, MPH, DABT; Janet Kester, PhD, DABT; Ellen Remenchik, MD, MPH

Disclaimer and Disclosure


The state of knowledge regarding the treatment of patients potentially exposed to hazardous substances in the environment is constantly evolving and is often uncertain. In developing its educational products ATSDR has made a diligent effort to ensure the accuracy and the currency of the presented information. ATSDR, however, makes no claim that the environmental medicine and health education resources discussed in these products comprehensively address all possible situations related to various substances. The products are intended for educational use to build the knowledge of physicians and other health professionals in assessing the conditions and managing the treatment of patients potentially exposed to hazardous substances. The products are not a substitute for a health-care provider’s professional judgment. Please interpret the environmental medicine and the health education resources in light of specific information regarding the patient and in conjunction with other medical authorities. Use of trade names in ATSDR products is for identification purposes only and does not imply endorsement by the Agency for Toxic Substances and Disease Registry or the U.S. Department of Health and Human Services.

department of health and human services logo

U.S. Department of Health and Human Services
Agency for Toxic Substances and Disease Registry
Division of Toxicology and Environmental Medicine
Environmental Medicine Branch