U.S. water infrastructure is in need of widespread repair due to age-related deterioration. Currently, the cured-in-place (CIPP) procedure is the most common method for water pipe repair. This method involves the on-site manufacture of a new polymer composite plastic liner within the damaged pipe. The CIPP process can release materials resulting in occupational and public health concerns. To understand hazards associated with CIPP-related emission exposures, an in vitro toxicity assessment was performed utilizing mouse alveolar epithelial and alveolar macrophage cell lines and condensates collected at 3 worksites utilizing styrene-based resins. All samples were normalized based on the major emission component, styrene. Further, a styrene-only exposure group was used as a control to determine mixture related toxicity. Cytotoxicity differences were observed between worksite samples, with the CIPP worksite 4 sample inducing the most cell death. A proteomic evaluation was performed, which demonstrated styrene-, worksite-, and cellspecific alterations. This examination of protein expression changes determined potential biomarkers of exposure including transglutaminase 2, advillin, collagen type 1, perlipin-2 and others. Pathway analysis of exposure-induced proteomic alterations identified MYC and p53 to be regulators of cellular responses. Protein changes were also related to pathways involved in cell damage, immune response, and cancer. Together these findings demonstrate potential risks associated with the CIPP procedure as well as variations between worksites regarding emissions and toxicity. Our evaluation identified biological pathways that require future evaluation and also demonstrates that exposure assessment of CIPP worksites should examine multiple chemical components beyond styrene, as many cellular responses were styrene-independent.