![]() This situation typically prompts exposed individuals to remove themselves from the exposure early on. In contrast, highly water-soluble gases generally deposit in the upper airways causing relatively quick onset upper airway and mucous membrane irritation. Nitrogen oxides are irritant gases with low water solubility. Exposure occurs when a worker enters a silo or opens the hatch without proper respiratory protection. It is worth noting that silo filler's disease is an entirely preventable illness with proper workplace controls and personal protective equipment. As such, a case of silo filler's disease may require reporting to local public health authorities in some jurisdictions. The most significant risk of overexposure occurs within the first month after the silos are filled. Oxides of nitrogen are heavier than air and gather on top of the silage. Nitrogen oxides form when filling agricultural grain silos with organic matter, typically corn or other grains. Silo filler's disease is an occupational disease that occurs due to the inhalation of nitrogen oxides. Longer exposures allow a higher concentration of nitrogen oxides to reach the lower airways, leading to delayed lower respiratory tract injury. They may be unaware of ongoing exposures. Employees with occupations that expose them to nitrogen oxides are most commonly at risk for toxicity. workers to be at risk for pulmonary irritants each year. Inhalation of numerous gases, aerosols, fumes, or dust may cause lung injury, asphyxiation, or systemic effects. The use of industrial chemicals that could be sources of toxicity is on the rise. The National Occupational Exposure Survey (NOES) estimates that more than one million U.S. However, symptoms of nitrogen dioxide toxicity may occur remotely from the work site due to its delayed presentation. If a patient has a significant exposure initially, they may present with shortness of breath, cough, or even symptoms consistent with acute respiratory distress syndrome (ARDS). Patients may experience various symptoms depending on the duration of exposure and the concentration of nitrogen dioxide. The classic example of nitrogen dioxide toxicity is known as “silo filler’s disease.” Silo filler's disease occurs when a patient inhales nitrogen dioxide that forms during the decomposition of silage. In 1987, 116 people attending an ice hockey game in Minnesota reported various symptoms from cough to hemoptysis due to significant nitrogen dioxide exposure. It can be significant exposure for an indoor ice-skating rink with poor ventilation. Oxides of nitrogen can be produced by ice resurfacing machines (so-called "Zamboni machines") during the combustion of their fuel source, propane.
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