Lung injuries due to exposure to nitrogen oxides can occur in various process in industry. We experienced a case of chemical pneumonitis induced by accidental inhalation of nitrogen oxides emitted from the bath in an acid dipping operation.

Dyspnea, cough and blood-tinged sputum production, cyanosis, and tachypnea occurred after exposure to oxides of nitrogen. There were bilateral diffuse ground glass opacities in simple chest radiography and high resolutional computed tomography, hypoxemia in arterial blood gas analysis, mixed ventilation defect and reduced diffusion capacity in spirometry. As an oxygen and supportive therapy, after hospitalization, was given, the patient recovered completely from the lung injury on the 8th day after admission. There was no evidence of delayed onset of bronchiolitis obliterance or pulmonary edema in a follow-up for about 6 months.

Acid dip operation require more efficient hooding and exhausting system for the prevention of lung injuries caused by inhalation of nitrogen oxides. Also health education for worker need.