How does exposure to jet fuels (JP-4, JP-5, JP-8), aviation gasoline, diesel fumes, and aircraft-engine exhaust during Military Occupational Specialty (MOS) duties between [DATE] and [DATE] contribute to the development of gastro-oesophageal reflux disease (GERD)?

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Last updated: October 23, 2026 • View editorial policy

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No Direct Causal Link Between Jet Fuel Exposure and GERD Development

Based on current evidence, there is no established causal relationship between occupational exposure to jet fuels (JP-4, JP-5, JP-8), aviation gasoline, diesel fumes, and aircraft engine exhaust and the development of gastroesophageal reflux disease (GERD). The available systematic reviews and epidemiologic studies do not identify gastrointestinal or esophageal disorders as outcomes associated with jet fuel exposure.

Evidence Analysis

What We Know About Jet Fuel Health Effects

The most comprehensive systematic review of jet fuel exposure 1 evaluated epidemiologic evidence through 2024 and found only slight evidence for associations with:

  • Neurologic outcomes
  • Cognitive and behavioral effects
  • Respiratory conditions
  • Cancer

Critically, gastrointestinal disorders, including GERD, were not identified as outcomes with even indeterminate evidence in this systematic assessment of 28 studies across military and non-military settings 1.

The Long-Term Impact of Fuel Exposure (LIFE) Study 2, involving over 1.3 million Veterans, is currently evaluating multiple body systems for adverse health outcomes from jet fuel exposure, but published results have not established GERD as an associated condition.

GERD Pathophysiology Does Not Align With Jet Fuel Toxicity

GERD develops through specific mechanical and physiologic mechanisms 3:

  • Lower esophageal sphincter dysfunction
  • Inadequate crural diaphragm support
  • Disruption of the His angle and gastroesophageal flap valve
  • Postprandial acid pocket formation
  • Delayed gastric emptying

None of these mechanisms are documented consequences of hydrocarbon exposure. While jet fuels contain potentially toxic compounds including benzene, n-hexane, toluene, and polycyclic aromatic hydrocarbons 4, their known toxicity profiles target the nervous system, respiratory tract, and hematopoietic system—not the gastroesophageal junction or its regulatory mechanisms.

Clinical Implications

Approach to the Veteran With GERD and Jet Fuel Exposure History

If a veteran presents with GERD symptoms and occupational jet fuel exposure history:

  1. Evaluate and treat GERD according to standard clinical guidelines 5:

    • Provide 4-8 week trial of single-dose PPI for typical reflux symptoms without alarm features
    • Escalate to twice-daily dosing if inadequate response
    • Offer objective testing (endoscopy and prolonged wireless pH monitoring off PPI) if long-term therapy is planned

  2. Do not attribute GERD causation to jet fuel exposure based on current evidence, as this connection lacks scientific support

  3. Assess for documented jet fuel-related conditions if the veteran has additional symptoms:

    • Neurologic complaints (peripheral neuropathy, cognitive changes)
    • Respiratory symptoms (chronic bronchitis, asthma exacerbation)
    • Dermatologic issues from direct fuel contact 6

Important Caveats

  • Self-reported health complaints are common in fuel-exposed worker cohorts 4, but epidemiologic evidence for serious organic disease remains limited
  • The exposure assessment itself is complex: personnel may have been exposed through dermal absorption, inhalation of vapor/aerosol, or combustion exhaust 6, with exposures typically below permissible exposure limits
  • Absence of evidence is not evidence of absence: ongoing research 2 may eventually identify associations not yet documented, but clinical decision-making must be based on current evidence

What to Document

For veterans seeking service connection, document:

  • Standard GERD diagnostic workup results (endoscopy findings, pH monitoring if performed, response to PPI therapy)
  • Temporal relationship between exposure period and symptom onset (though this alone does not establish causation)
  • Alternative risk factors for GERD (obesity, dietary habits, smoking, alcohol use, medications)
  • Presence or absence of conditions with established jet fuel associations (neurologic, respiratory, dermatologic)

The burden of proof for service connection involves regulatory and legal standards beyond pure medical causation, but from a medical-scientific standpoint, current evidence does not support jet fuel exposure as a causative factor for GERD development.

References

4
Research

Biological and health effects of exposure to kerosene-based jet fuels and performance additives.

Journal of toxicology and environmental health. Part B, Critical reviews, 2003

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.