Occupational and Environmental Lung Diseases |

Lung Injury in Asymptomatic Firefighters: Breath Sound Frequency Analysis May Find What Spirometry May Not FREE TO VIEW

Ilina Krishen; Mary Zaremba, APRN-BC; Kristn Elliott; Sridhar Reddy, MD
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St. Clair Pulmonary & Critical Care, Ira Township, MI

Chest. 2015;148(4_MeetingAbstracts):762A. doi:10.1378/chest.2271267
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SESSION TITLE: Occupational and Environmental Lung Diseases Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: This study investigates the utility of breath sound frequency analysis (BSFA) in detecting early lung damage in asymptomatic firefighters. It also seeks to determine asymmetry in lung injury due to air pollutants.

METHODS: Frequency patterns of recorded breath sounds were analyzed in 10 asymptomatic never-smokers and 11 age matched, asymptomatic firefighters. Fast Fourier transformation was performed using MATLAB software. Using an electronic stethoscope right and left lung sounds were recorded separately to analyze regional differences. Frequency peaks with amplitude values between 50 and 100% of the tallest peak (high energy peaks, HEP) were analyzed. Spirometry results were obtained and subgroup analysis was performed in subjects with normal FEV1/FVC. Statistical analysis was performed using a Student t-test.

RESULTS: Firefighters (n=11) had a significantly greater average maximum high energy peak (HEP) of 186.21 Hz compared to never-smokers (n=10) with average maximum HEP of 148.14 Hz with a (p-value of 0.0019). In the subgroup with a normal FEV1/FVC ratio, 10 firefighters were compared to 5 never-smokers. Firefighters had a significantly greater maximum HEP (187.06 vs 151.54) with a p value of 0.04. In addition, the difference in the maximum frequencies between the right and left lungs were greater in firefighters (35.95 Hz) compared to never-smokers (20.78 Hz) with a p-value 0.036.

CONCLUSIONS: This study suggests that breath sound frequency analysis (BSFA) may detect early lung injury despite a normal spirometry in firefighters prior to development of symptoms. More importantly, unlike spirometry, BSFA can detect regional variations in lung injury. This may be the hallmark of early lung damage from air pollutants.

CLINICAL IMPLICATIONS: Early detection of lung damage is key to prevention of progressive lung injury. BSFA is a simple and inexpensive method of detecting early lung changes. These findings may be important in establishing standards that reflect early lung damage. Asymmetry of breath sound frequencies may be useful in detecting early lung damage in vulnerable populations. Further investigation into the heterogeneity of breath sounds and its relationship to particle deposition due to bronchial asymmetry is needed.

DISCLOSURE: The following authors have nothing to disclose: Ilina Krishen, Mary Zaremba, Kristn Elliott, Sridhar Reddy

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