The authors investigated the health effects of occupational exposures to vehicle emissions in 745 bus drivers, conductors, and taxi drivers, compared with 532 unexposed controls, in Shanghai. Logistic regression and general linear models were used to examine the relationship between exposure and respiratory illness. Results showed that the prevalences of some respiratory symptoms and chronic respiratory diseases were significantly higher (p < 0.05) in the exposed group than in the controls. The adjusted odds ratios for throat pain, phlegm, chronic rhinitis, and chronic pharyngitis were 1.95 (95% CI 1.55-2.46), 3.90 (95% CI 2.61-5.81), 1.96 (95% CI 1.11-3.46), and 4.19 (95% CI 2.49-7.06), respectively. Also, there were exposure time response relationships for the prevalences of phlegm and chronic respiratory disease. Pulmonary function and blood lead levels were not significantly correlated with exposure status. The results suggest that occupational exposure to vehicle emissions may induce detectable adverse health effects.