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Int Forum Allergy Rhinol. 2016 Dec;6(12):1245-1252. doi: 10.1002/alr.21829. Epub 2016 Sep 13.

Nitrogen dioxide pollution exposure is associated with olfactory dysfunction in older U.S. adults.

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Pritzker School of Medicine, The University of Chicago, Chicago, IL.
Department of Health Sciences, Bouve College of Health Sciences, Northeastern University, Boston, MA.
Department of Public Health Sciences, The University of Chicago, Chicago, IL.
Department of Psychology, Northeastern Illinois University, Chicago, IL.
Department of Comparative Human Development and the Institute for Mind and Biology, The University of Chicago, Chicago, IL.
Section of Otolaryngology-Head and Neck Surgery, The University of Chicago, Chicago, IL.



Olfactory dysfunction has profound effects on quality of life, physical and social function, and mortality itself. Nitrogen dioxide (NO2 ) is a pervasive air pollutant that is associated with respiratory diseases. Given the olfactory nerve's anatomic exposure to airborne pollutants, we investigated the relationship between NO2 exposure and olfactory dysfunction.


The ability to identify odors was evaluated using a validated test in respondents from the National Social Life, Health, and Aging Project (NSHAP), a representative probability sample of home-dwelling, older U.S. adults age 57 to 85 years. Exposure to NO2 pollution was assessed using measurements obtained from the U.S. Environmental Protection Agency (EPA) Aerometric Information Retrieval System (AIRS) ambient monitoring site closest to each respondent's home. We tested the association between NO2 exposure and olfactory dysfunction using multivariate logistic regression.


Among older adults in the United States, 22.6% had impaired olfactory function, defined as ≤3 correct (out of 5) on the odor identification test. Median NO2 exposure during the 365 days prior to the interview date was 14.7 ppb (interquartile range [IQR], 10.8 to 19.7 ppb). An IQR increase in NO2 exposure was associated with increased odds of olfactory dysfunction (OR, 1.35; 95% CI, 1.07 to 1.72), adjusting for age, gender, race/ethnicity, education, cognition, comorbidity, smoking, and season of the home interview (n = 1823).


We show for the first time that NO2 exposure is associated with olfactory dysfunction in older U.S. adults. These results suggest an important role for NO2 exposure on olfactory dysfunction, and, potentially, nasal disease more broadly.


aged; air pollutants; air pollution; cross-sectional studies; nitrogen dioxide; olfaction disorders; smell

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