Can exposure to distillates (petroleum), molybdenum sulfide, kerosene, isopropanol, aromatic naphtha, tricresyl phosphate, cryogenic liquid, oils, and Jet-A (jet fuel) aircraft fuels cause valvular heart disease?

Exposure to Petroleum Distillates and Related Chemicals and Valvular Heart Disease

There is no established causal relationship between exposure to petroleum distillates, molybdenum sulfide, kerosene, isopropanol, aromatic naphtha, tricresyl phosphate, cryogenic liquid, oils, or Jet-A aircraft fuels and the development of valvular heart disease. While these substances have known toxicity profiles, current medical guidelines and research do not identify them as specific causes of valvular heart disease.

Known Causes of Valvular Heart Disease

According to the ACC/AHA guidelines, the established causes of valvular heart disease include:

1. Common causes:

   • Age-related degenerative changes
   • Congenital abnormalities
   • Rheumatic heart disease
   • Infective endocarditis
   • Myxomatous degeneration

2. Uncommon causes related to systemic diseases: 1

   • Rheumatoid arthritis
   • Systemic lupus erythematosus
   • Anti-phospholipid antibody syndrome
   • Ankylosing spondylitis

3. Drug-related causes: 1

   • Ergotamine
   • Methysergide
   • Anorexiant medications (fenfluramine, dexfenfluramine)
   • Pergolide (dopamine-receptor agonist)

4. Other established causes:

   • Mediastinal radiation (causing calcification of valve leaflets) 1
   • Carcinoid syndrome

Petroleum Products and Valvular Disease

The comprehensive ACC/AHA guidelines on valvular heart disease do not list petroleum distillates, kerosene, jet fuels, or the other chemicals mentioned in your question as known causes of valvular heart disease 1. These guidelines specifically detail uncommon causes of valvular disease but do not include these industrial chemicals.

Research on jet fuels and related chemicals has primarily focused on:

1. Respiratory effects: Pulmonary inflammation, reduced lung function
2. Neurological effects: Headaches, dizziness, cognitive changes
3. Dermatological effects: Skin irritation and sensitization
4. General toxicity: Liver and kidney effects 2, 3

A comprehensive review of biological and health effects of exposure to kerosene-based jet fuels did not identify valvular heart disease as a known consequence of exposure 2. Similarly, studies on aircraft maintenance technicians exposed to organophosphates (including tricresyl phosphate) have focused on neurological and respiratory outcomes rather than cardiac valve effects 4.

Risk Assessment and Clinical Approach

For individuals with history of exposure to these chemicals who present with cardiac symptoms:

1. Standard cardiac evaluation should be performed based on symptoms
2. Echocardiography remains the primary diagnostic tool for valvular disease
3. Risk factor assessment should focus on established causes of valvular disease
4. Treatment decisions should follow standard guidelines for valvular heart disease management 1

Clinical Perspective

While these chemicals may have various health effects, the current medical evidence does not support routine cardiac valve screening specifically due to exposure to petroleum distillates, kerosene, jet fuels, or the other chemicals mentioned. If valvular disease is detected in exposed individuals, standard treatment protocols should be followed based on the type and severity of the valve lesion.

If a patient with such exposures develops valvular heart disease, the clinician should consider other more established etiologies before attributing it to chemical exposure, as the scientific evidence for such a connection is currently lacking.