The history, genotoxicity, and carcinogenicity of carbon-based fuels and their emissions: part 5. Summary, comparisons, and conclusions.

As seen through the previous reviews, each carbonaceous source of energy is associated with genotoxic and carcinogenic health risks; however, energy use is central to human society and provides many health benefits. These reviews examined the genotoxicity of carbonaceous sources of energy, focusing on the impacts due to the combustion of fuels and biomass. In previous reviews, information and data were used to examine occupational, industrial, household, and general environmental pollution as well as laboratory research. In this final summation, the effort is not only to summarize the previous reviews but to provide additional information to support any final conclusions. Included in the final observations are: (1) emissions from combusted carbonaceous fuels are very likely to include genotoxicants and/or carcinogens, and, as such, they can considerably increase the risk of adverse health effects in exposed humans, (2) environmental transformation is likely to increase genotoxicity of emissions, and (3) the world's poor households have an increased health risk because they have limited access to clean fuels and electricity. Because carbonaceous fuel emissions are highly complex, risk assessments are difficult; however, decision makers have many toxicological approaches for evaluating emissions. Although energy efficiency brings many benefits, it also involves health risks, as do renewable energy systems, if not managed carefully. The reviews do not examine climate change or non-carbonaceous fuels (e.g., nuclear fuels). Because these are not papers about the risk assessment or regulation of pollutants from carbon-based fuels, the discussions of regulations were to place research, concerns, and actions into a historical reference for the reader.