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Incidence of Asymptomatic Pneumothorax in University Students

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A4217 - Incidence of Asymptomatic Pneumothorax in University Students
Author Block: S. Takanashi1, R. Uruma2, The Japanese National University Council of HealthAdministration Facilities (JNUHA); 1Health Administration Center, Hirosaki University, Hirosaki, Japan, 2Safety and Health Organization, Chiba Univerisity, Chiba, Japan.
Introduction: Primary spontaneous pneumothorax (PSP) may be undiagnosed in many cases, wherein symptoms are mild or non-existent, and the patient does not undergo hospital examination. In a real-life clinical scenario, an asymptomatic pneumothorax (AP) may be detected incidentally when a patient undergoes thoracic imaging; its incidence is unclear. In the early 20th century, tuberculosis (TB) was a heavy burden in Japan. Therefore, the thoracic imaging for TB check is still a mandatory medical examination when the student enter the university. In this thoracic imaging, AS is rare, but is recognized. Method: JNUHA Health White Paper Review Panel collected the data of thoracic imaging in 2005, 2010 and 2015. The respective total of male and female students targeted for evaluation were 184,274 and 116,348 for 2005, 192,995 and 121,531 for 2010, and 183,041 and 116,937 for 2015. All students were at least 18 years old and 90% of the students were between 18 and 22 years old. Results: The incidence of AP showed marked difference in sex. AP was detected at the following respective incidence rates in male and female students per 100,000 students of the target population: 31.47 (58/184,274) and 1.72 (2/116,348) in 2005, 33.68 (65/192,995) and 1.65 (2/121,531) in 2010, and 35.51 (65/183,041) and 4.28 (5/116,937) in 2015. The secondary survey targeted subjective symptoms present at the time of the detection of the AP, including body mass index (BMI) as a marker of physical constitution. The surveys revealed that not all cases of detected AP had been completely asymptomatic; some diagnosed students recalled sensations of chest discomfort. The characteristics of students who developed an AP were skewed towards a lower BMI. Conclusions: Based on the annual thoracic imaging of university students and triplicate surveys, we found the incidences of AP to be 33 to 36 and 2 to 4 per 100,000 students in the population of male and female students, respectively. Whereas PSP is four-times more common in men than women, our surveys revealed a greater gender disparity for AP, projecting this condition to be 10-times more common in male than female students.
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