Annals of Occupational and Environmental Medicine

Case Report

A Case of Bronchiolitis Obliterans after Exposure to Nitrogen Dioxide: Su Yeon Cheon, Yu Jin Kim, Sun Young Kyung, Sang Pyo Lee, Jeong Woong Park, Sung Hwan Jeong; Korean Journal of Occupational and Environmental Medicine 2010;22(1):64-68. Published online March 31, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.1.64

INTRODUCTION: Irritant gases and aerosols are capable of inducing acute, irritant lung injury. Lung injury caused by the inhaling nitrogen dioxide (NO2) has been known as silo-filler's disease in western countries. In Korea, acute pulmonary edema after NO2 inhalation in an industrial environment has been reported. We report here on a case of bronchiolitis obliterans after inhalation of NO2.
CASE
REPORT: A 54-year-old male was admitted to the hospital with dyspnea and fever. Three weeks perviously, he was diagnosed with acute pulmonary edema after occupational exposure of NO2 and he was treated with corticosteroid for 2 weeks. After cessation of the corticosteroid, he developed dyspnea and fever. High resolution computed tomography (HRCT) showed ill-defined centrilobular nodules and patterns of mosaic perfusion; this all suggested air-trapping due to bronchiolitis obliterans. We diagnosed the patient as having bronchiolitis obliterans after acute pulmonary edema due to NO2 inhalation. The corticosteroid treatment was restarted and continued for 8 weeks.
CONCLUSION
NO2 induced lung injuries have variable clinical features. Close observation is needed for 6 to 8 weeks because recurrence with bronchiolitis obliterans may be seen several weeks later.

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Analysis of NO2over the Korean Peninsula from Ozone Monitoring Instrument Satellite Measurements
Deok-Rae Kim, Won-Jun Choi, Joon-Suk Lee, Seung-Yeon Kim, Jun-Suk Hong, Chang-Keun Song, Jae-Bum Lee, You-Deog Hong, Suk-Jo Lee
Journal of Korean Society for Atmospheric Environment.2012; 28(3): 249. CrossRef

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Case Report

A Case of Nitrogen Dioxide-Induced Pulmonary Edema in Oxygen Torch: Jong Joon Ahn, Yangjin Jegal, Kwang Won Seo, Woon Jung Kwon, Nari Choy, Yangho Kim; Korean Journal of Occupational and Environmental Medicine 2007;19(3):244-249. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.244

Abstract PDF

BACKGROUND
Welders tend to be exposed to a variety of hazards including metal fumes, toxic gases, electricity, heat, noise, and radiation such as ultraviolet and infrared light. Noxious gases generated during welding include carbon monoxide, ozone, and nitrogen oxide. Although the effects of metal fumes have been well studied, few reports have investigated the influence of noxious gas exposure in welders.
CASE
REPORT: We encountered a patient who developed non-cardiogenic pulmonary edema within a day after fairing up a steel plate with an oxygen/LPG torch. The patient was a 43-year-old female who complained of dyspnea which became exacerbated the following morning. Her chest X-ray and chest CT scan showed an extensive ground glass opacity which was more prominent in the both upper lungs. Both her symptoms and chest X-ray findings improved. We attributed the patient's symptoms to non-cardiogenic pulmonary edema caused by nitrogen dioxide exposure, by reasoning that: 1) the patient's clinical course and radiologic findings suggested pulmonary edema 2) the event happened following fairing work with oxygen/LPG torch that usually induces a high concentration of nitrogen dioxide, and 3) the other possible causes of pulmonary edema could be excluded.
CONCLUSION
Nitrogen dioxide-induced pulmonary edema should be considered in oxygen torch contrary to arc welding.

Citations

Citations to this article as recorded by

Acute Occupational Poisoning in Korea
Hyunjoo Kim, Jia Ryu
The Ewha Medical Journal.2016; 39(4): 99. CrossRef

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