Can exposure to industrial solvents such as glutaraldehyde, desflurane (inhalation anesthetic), isoflurane (inhalation anesthetic), and 2-butoxyethanol cause Hypertension (HTN)?

Occupational Solvent Exposure and Hypertension Risk

Based on available evidence, exposure to certain industrial solvents—particularly benzene and xylene—is associated with increased hypertension risk, but there is no documented evidence linking glutaraldehyde, desflurane, isoflurane, or 2-butoxyethanol specifically to chronic hypertension.

Evidence for Solvent-Related Hypertension

The strongest evidence for solvent-induced hypertension comes from benzene and xylene exposure:

• Workers exposed to benzene demonstrated a significantly elevated prevalence of arterial hypertension at 30.51% (OR = 2.44; 95% CI 1.24-4.85) compared to unexposed controls 1

• Xylene and benzene co-exposure resulted in 27.92% hypertension prevalence (OR = 2.00; 95% CI 1.11-3.61), with a significant correlation between length of service and both systolic and diastolic blood pressure after controlling for cardiovascular risk factors 1

• Phenol exposure showed elevated but non-significant hypertension rates (23.29%) compared to controls 1

Specific Agents Listed in Your ILER Report

Glutaraldehyde (Ingestion and Inhalation)

Glutaraldehyde does not cause hypertension based on documented toxicity profiles. The British Society of Gastroenterology guidelines comprehensively detail glutaraldehyde's health effects:

• Primary effects include respiratory irritation (cough, bronchospasm), allergic sensitization (asthma, dermatitis), and systemic symptoms (headache, dizziness, nausea, metallic taste, skin discoloration) 2

• Acute toxicity studies confirm irritant and allergenic properties affecting mucous membranes, skin, and respiratory tract, with no mention of cardiovascular or blood pressure effects 3

• Hypertension is notably absent from the extensive list of documented adverse effects despite high prevalence of symptoms (65-79% of exposed workers) in endoscopy units 2

Desflurane and Isoflurane (Inhalation Anesthetics)

These volatile anesthetics cause transient, acute hemodynamic changes during administration but not chronic hypertension:

• Desflurane produces acute sympathetic hyperactivity with transient hypertension (peak mean arterial pressure 114 mmHg) and tachycardia (peak heart rate 102 beats/min) during induction and when increasing from 1.0 to 1.5 MAC 4

• This represents a 2.5-fold increase in sympathetic nerve activity with facial flushing and tearing, but these are acute pharmacologic effects during anesthetic administration, not chronic occupational exposure consequences 4

• Isoflurane does not produce these acute sympathetic responses 4

• Neither agent has documented association with chronic hypertension from occupational exposure—the cardiovascular effects are immediate, reversible, and related to direct pharmacologic action rather than toxic exposure

2-Butoxyethanol (Inhalation)

No specific evidence links 2-butoxyethanol to hypertension. General solvent literature indicates:

• Organic solvents primarily cause respiratory irritation (eyes, nose, throat), with inconsistent evidence for pulmonary impairment 5

• Systematic research on cardiovascular effects of industrial chemicals remains limited, with no consistent documentation that most solvents cause hypertension 6

Clinical Implications and Caveats

Important considerations for your assessment:

• The documented hypertension risk from solvents applies primarily to aromatic hydrocarbons (benzene, xylene), not the specific agents in your ILER report 1

• Glutaraldehyde's extensive occupational health literature focuses on respiratory and allergic manifestations without cardiovascular effects 2

• Desflurane and isoflurane cause acute, transient blood pressure changes during anesthetic use, not chronic hypertension from occupational exposure 4

• The general solvent literature suggests cardiovascular effects remain controversial and inconsistent, with lead and cadmium showing more consistent (though still debated) blood pressure effects than organic solvents 6

For occupational medicine purposes: If hypertension is present in a worker with these exposures, alternative etiologies (essential hypertension, other cardiovascular risk factors) should be prioritized over attributing causation to glutaraldehyde, desflurane, isoflurane, or 2-butoxyethanol exposure, as the evidence does not support this association.