Longstanding occupational health challenges of the underground hard-rock mining sector require both an analysis of historical data to assess evidence of linkages between the source of the problem and subsequent illnesses, as well as investigating the means by which health risks to workers can be eliminated or minimised. This paper refers briefly to a recently established National Health and Medical Research Council (NHMRC) sponsored Epidemiological Study into the incidence of Lung Cancer, contracted by mineworkers in Western Australia (WA) due to the inhalation of diesel exhaust fumes from 1996 to 2012. Thereafter it reviews current knowledge of the nature of the challenges facing those responsible for the health and wellbeing of underground hard-rock miners in WA, commencing with the recent categorisation of diesel exhaust as Carcinogenic to Humans, Group 1', by the World Health Organisation's (WHO) International Agency for Research on Cancer (IARC). An attempt is also made to explore how the challenge has changed with the adoption of more advanced engine technologies, including the increased generation of ultra-fine volatile organic and other nucleates, submicron carbonaceous agglomerates and toxic gases.The compounding effect of using the mine decline access entry as both the primary ventilation intake and haulage-way is also discussed, as is the need to develop a more appropriate metric for regulating diesel engine emissions. Finally the paper refers to ongoing in-mine research pursued by the National Institute for Occupational Safety and Health (NIOSH) at its Diesel Laboratory in an underground limestone mine near Morgantown in the USA.CITATION:Jones, O, 2015. Diesel exhaust and the underground miner in Western Australia, in Proceedings The Australian Mine Ventilation Conference, pp 167-172 (The Australasian Institute of Mining and Metallurgy: Melbourne).