Nitrogen dioxide-induced pulmonary disease: five new cases and a review of the leterature

J Occup Med. 1978 Feb;20(2):103-10.


Twenty-three patients exposed to nitrogen dioxide in agriculture or industry were referred to the University of Wisconsin Medical Center. Eighteen experienced a transient upper respiratory tract syndrome; five developed pulmonary edema or bronchiolitis obliterans. This latter group responded to steroid therapy but all demonstrated evidence of persistent pulmonary dysfunction on follow-up studies. Combining our findings with those in the literature we concluded: (1) exposure to NO2 is more common than generally appreciated; (2) case fatality is high--29% for silo-filler's disease; (3) steroids are effective therapy and should be continued for at least eight weeks; (4) although the majority recover without significant sequelae, some individuals may develop persistent functional abnormalities; (5) there is no evidence that long-term exposure to low concentrations of NO2 leads to chronic airway obstruction; and, (6) NO2-induced pulmonary disease could be elminated with appropriate preventive measures.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Female
  • Humans
  • Lung Diseases / chemically induced*
  • Lung Diseases / diagnostic imaging
  • Lung Diseases / drug therapy
  • Male
  • Middle Aged
  • Nitrogen Dioxide / adverse effects*
  • Occupational Diseases / chemically induced*
  • Occupational Diseases / diagnostic imaging
  • Occupational Diseases / drug therapy
  • Pneumonia / chemically induced
  • Pneumonia / diagnostic imaging
  • Pneumonia / drug therapy
  • Prednisone / therapeutic use
  • Pulmonary Edema / chemically induced
  • Pulmonary Edema / diagnostic imaging
  • Pulmonary Edema / drug therapy
  • Radiography
  • Syndrome


  • Nitrogen Dioxide
  • Prednisone