The Respiratory Effects of Jet Fuel Exposure: A Fit-for-Purpose Systematic Literature Review and Evidence Synthesis

Abstract Objective Jet fuel inhalation represents one of the most significant exposures among service members; however, health outcomes are unclear, and the processes linking exposures and respiratory effects are undefined. Methods A systematic literature review of human, animal, and mechanistic studies was conducted to assess and synthesize the scientific evidence on the adverse respiratory effects of jet fuel exposure. Results Animal studies provided moderate evidence that jet fuel inhalation resulted in adverse effects through cytotoxicity, tissue damage, inflammation, airway remodeling, and lung function changes, which was corroborated by mechanistic data. This was further supported by slight epidemiologic evidence that jet fuel exposure is associated with increased respiratory symptoms and disease. Conclusions Evidence indicates that jet fuel exposure is likely to produce adverse respiratory effects, which may have important implications for exposed service members and veterans.