Objectives: vehicle exhaust consists of many toxic components and professional drivers are occupationally exposed to vehicle exhaust during their routine daily work. Hence, the aim of the present study is to evaluate genotoxic and nephrotoxic risk of vehicle exhaust in professional drivers in Zagazig city, Al-Sharkia Governorate, Egypt.Subjects and Methods: A comparative cross sectional study was carried out on 33 professional drivers and 34 control office workers as non-exposed control group. A structured questionnaire was offered for all subjects through personal interview.
Peripheral blood samples were collected from all participants for detection of chromosomal aberrations and measurement of blood lead level. Urine samples also were obtained from all participants for laboratory analysis to detect levels of B2 –
microglobulin, microalbumin and trans,trans- muconic acid. Results: A significant increase was observed in the  ercentage of chromosomal aberrations in non smoker and smoker professional drivers when compared to their respective control groups. Also a significant increase in the mean values of B2 microglobulin and microalbumin was observed in studied professional drivers when compared to their control. The results showed that professional drivers have significant
higher blood lead level and urinary trans,trans- muconic acid level as compared to control group, with positive correlation to the duration of exposure. Conclusion: Thus the present study suggests that the induction of cytogenetic changes
and renal damage might be due to the cumulative effect of smoking, lead toxicity, benzene toxicity, leaded gasoline and prolonged duration of exposure to vehicle exhaust.