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In 2012, the World Health Organization's International Agency for Research on Cancer (IARC) reclassified diesel engine exhaust and related ambient air pollution to be carcinogenic and associated with increased mortality from lung cancer. This could have critical consequences for both public and occupational health in enclosed railway stations where ventilation is often inadequate. Recent policies encouraging a shift to public transport, along with increasing passenger and train numbers, have led to a variety of co-benefits, including improved health and well-being from increased walking and cycling. This paper considers the unintended consequences of a reduction of air quality in crowded enclosed railway stations and concludes with a number of possible interventions to ensure that public health is not affected, especially by air pollution from stationary diesel trains. Pollution from electric trains can also lead to poor air quality due to the production of metal-rich ultrafine particles from brake linings, friction between wheel and rail, and from overhead pantographs. Current occupational health standards are not suitable for enclosed railway stations and need to be reconsidered in the light of the IARC findings. More measurements of the levels of particulates and nitrogen dioxide in enclosed railway stations need to be undertaken and published.

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