Federal Register/Vol. 85, No. 31/Friday, February 14, 2020

Total Page:16

File Type:pdf, Size:1020Kb

Load more

Federal Register / Vol. 85, No. 31 / Friday, February 14, 2020 / Proposed Rules 8521 make. The EPA will generally not Dated: January 30, 2020. Identifier Number (0920–AA68) for this consider comments or comment Dennis Deziel, rulemaking. All relevant comments, contents located outside of the primary Regional Administrator, EPA Region 1. including any personal information submission (i.e. on the web, cloud, or [FR Doc. 2020–02226 Filed 2–13–20; 8:45 am] provided, will be posted without change other file sharing system). For BILLING CODE 6560–50–P to http://www.regulations.gov. For additional submission methods, please detailed instructions on submitting contact the person identified in the FOR public comments, see the ‘‘Public Participation’’ heading of the FURTHER INFORMATION CONTACT section. DEPARTMENT OF HEALTH AND SUPPLEMENTARY INFORMATION section of For the full EPA public comment policy, HUMAN SERVICES information about CBI or multimedia this document. submissions, and general guidance on 42 CFR Part 37 FOR FURTHER INFORMATION CONTACT: making effective comments, please visit Rachel Weiss, Program Analyst; 1090 https://www.epa.gov/dockets/ [Docket No. CDC–2019–0088; NIOSH–330] Tusculum Ave., MS: C–48, Cincinnati, OH 45226; telephone (855) 818–1629 commenting-epa-dockets. Publicly RIN 0920–AA68 available docket materials are available (this is a toll-free number); email at https://www.regulations.gov or at the Coal Workers’ Health Surveillance [email protected]. U.S. Environmental Protection Agency, Program: B Reader Decertification and SUPPLEMENTARY INFORMATION: EPA Region 1 Regional Office, Air and Autopsy Payment I. Public Participation Radiation Division, 5 Post Office AGENCY: Centers for Disease Control and Interested parties may participate in Square—Suite 100, Boston, MA. EPA Prevention, HHS. this rulemaking by submitting written requests that if at all possible, you views, opinions, recommendations, and contact the contact listed in the FOR ACTION: Notice of proposed rulemaking. data. Comments received, including FURTHER INFORMATION CONTACT section to SUMMARY: HHS proposes to revise the attachments and other supporting schedule your inspection. The Regional National Institute for Occupational materials, are part of the public record Office’s official hours of business are Safety and Health (NIOSH), Coal and subject to public disclosure. Do not Monday through Friday, 8:30 a.m. to Workers’ Health Surveillance Program include any information in your 4:30 p.m., excluding legal holidays. (Program) regulations by adding a comment or supporting materials that FOR FURTHER INFORMATION CONTACT: Bob provision to allow NIOSH to suspend or you do not wish to be disclosed. You McConnell, Environmental Engineer, revoke B Reader certification. may submit comments on any topic Air and Radiation Division (Mail Code Certification may be revoked for any B related to this notice of proposed 05–2), U.S. Environmental Protection Reader found by NIOSH to have rulemaking. engaged in a pattern of providing Agency, Region 1, 5 Post Office Square, II. Statutory Authority Suite 100, Boston, Massachusetts unreasonably inaccurate chest The Federal Mine Safety and Health 02109–3912; (617) 918–1046. radiograph classifications in practice— Act of 1977 (Pub. L. 91–173, 30 U.S.C. [email protected]. those that are found by the Program to diverge substantially from a competent 801 et seq.) (Mine Act), authorizes the SUPPLEMENTARY INFORMATION: In the interpretation of the radiographs, as HHS Secretary (Secretary) to work with Final Rules Section of this Federal determined by a panel of practicing, coal mine operators to make available to Register, EPA is approving the State’s certified B Readers selected by NIOSH. coal miners the opportunity to have SIP submittal as a direct final rule In addition to the B Reader provisions, regular and routine chest radiographs without prior proposal because the HHS would also amend existing (X-rays) in order to detect coal workers’ Agency views this as a noncontroversial regulatory text to allow compensation pneumoconiosis (i.e., black lung) and submittal and anticipates no adverse for pathologists who perform autopsies prevent its progression in individual comments. A detailed rationale for the on coal miners at a market rate, on a miners. The Mine Act grants the approval is set forth in the direct final discretionary basis as needed for public Secretary general authority to issue rule. If no adverse comments are health purposes. regulations as is deemed appropriate to carry out provisions of the Act and received in response to this action rule, DATES: Comments must be received by no further activity is contemplated. If specifically directs that medical May 14, 2020. Comments on the examination of coal miners shall be EPA receives adverse comments, the information collection approval request direct final rule will be withdrawn and given in accordance with specifications sought under the Paperwork Reduction prescribed by the Secretary (30 U.S.C. all public comments received will be Act must be received by April 14, 2020. addressed in a subsequent final rule 843(a), 957). The Mine Act also ADDRESSES: Written comments: based on this proposed rule. EPA will authorizes the Secretary to establish Comments may be submitted by any of specifications for the reading of not institute a second comment period. the following methods: Any parties interested in commenting radiographs and to pay for autopsies • Federal eRulemaking Portal: http:// submitted to the Program. on this action should do so at this time. www.regulations.gov. Follow the Please note that if EPA receives adverse instructions for submitting comments to III. Background and Need for comment on an amendment, paragraph, the docket. Rulemaking or section of this rule and if that • Mail: NIOSH Docket Office, Robert All mining work generates fine provision may be severed from the A. Taft Laboratories, MS–C34, 1090 particles of dust in the air. Coal miners remainder of the rule, EPA may adopt Tusculum Avenue, Cincinnati, OH who inhale excessive dust are known to as final those provisions of the rule that 45226. develop a group of diseases of the lungs are not the subject of an adverse Instructions: All submissions received and airways, including dust-induced comment. must include the agency name (Centers fibrotic lung disease (pneumoconiosis) For additional information, see the for Disease Control and Prevention, and chronic obstructive pulmonary direct final rule which is located in the HHS) and docket number (CDC–2019– disease, including chronic bronchitis Rules Section of this Federal Register. 0088; NIOSH–330) or Regulation and emphysema. To address such VerDate Sep<11>2014 16:35 Feb 13, 2020 Jkt 250001 PO 00000 Frm 00040 Fmt 4702 Sfmt 4702 E:\FR\FM\14FEP1.SGM 14FEP1 khammond on DSKJM1Z7X2PROD with PROPOSALS 8522 Federal Register / Vol. 85, No. 31 / Friday, February 14, 2020 / Proposed Rules threats to the U.S. coal mining classifications in accordance with ILO has occasionally learned of B Readers workforce, the Mine Act was enacted in standards. The B Reader examination found to provide unreasonably 1969 and amended in 1977, authorizing currently offered by NIOSH consists of inaccurate radiograph classifications in the NIOSH Coal Workers’ Health the classification of 125 chest formal litigation and compensation Surveillance Program, within the radiographs over the course of 6 hours; proceedings relative to the actual Respiratory Health Division, to detect the test addresses proficiency in features of the chest radiographs in pneumoconiosis and prevent its classification of small opacities, large question. ‘‘Unreasonably inaccurate’’ progression in individual miners, while opacities, pleural abnormalities, and classifications are those that diverge at the same time providing information certain other abnormalities that may substantially from a competent for evaluation of temporal and appear in the lung radiographs. In order interpretation of the radiographs and are geographic trends in pneumoconiosis. to maintain B Reader status, B Readers unsupported by the chest radiographs in To inform each miner of his or her must take and pass the B Reader question, as determined by a panel of health status, the Act requires that coal recertification exam every 5 years. practicing, certified B Readers selected mine operators provide each miner who B Readers participate in the NIOSH by NIOSH. For example, one B Reader begins work at a coal mine for the first Coal Workers’ Health Surveillance was accused of ‘‘under-reading’’ chest time a chest radiograph (X-ray) through Program, as well as other national and radiographs, frequently not identifying an approved facility as soon as possible state programs addressing dust-related severe cases of pneumoconiosis that after employment starts. Three years illnesses,2 and are also involved with may have been indicated by the later a miner must be offered a second epidemiologic evaluations, surveillance, radiographs; 4 another was accused of chest radiograph. If this second and worker monitoring programs ‘‘over-reading,’’ frequently identifying examination reveals evidence of involving many types of asbestosis where the radiographs were pneumoconiosis, the miner is entitled to pneumoconioses. In applying the ILO subsequently found not to support that a third chest radiograph 2 years after the Classification, B Readers compare sets determination.5 The Program second. Further, all miners working in of standard images, which
Recommended publications
  • WORKSHOP on ILO INTERNATIONAL CLASSIFICATION of RADIOGRAPHS of PNEUMOCONIOSES 9 – 13 NOVEMBER 2020 TURIN, ITALY Information Note INTRODUCTION

    WORKSHOP on ILO INTERNATIONAL CLASSIFICATION of RADIOGRAPHS of PNEUMOCONIOSES 9 – 13 NOVEMBER 2020 TURIN, ITALY Information Note INTRODUCTION

    OCCUPATIONAL SAFETY AND HEALTH WORKSHOP ON ILO INTERNATIONAL CLASSIFICATION OF RADIOGRAPHS OF PNEUMOCONIOSES 9 – 13 NOVEMBER 2020 TURIN, ITALY Information Note INTRODUCTION The prevention of occupational respiratory diseases has a high priority in the ILO. Despite all international and national efforts to prevent them, they continue to be the leading occupational illnesses in many countries that may amount to as many as 30% of all registered work-related diseases. Pneumoconiosis cause significant numbers of cases of disabilities and premature deaths because they are highly disabling and incurable. They also represent a huge burden on national economies and compensation systems in terms of sickness, absenteeism, lost working days, disabilities, compensatory payments and loss of qualified labour. The ILO International Classification of Radiographs of Pneumoconiosis provides a means for describing and recording systematically the radiographic abnormalities in the chest provoked by the inhalation of dusts. The purpose of the ILO Classification is to describe and codify radiographic abnormalities of the pneumoconiosis in a simple, systematic, and reproducible manner. The ILO Classification of Radiographs of Pneumoconiosis is an important international standard which is widely used around the world in early detection of pneumoconiosis, medical screening and health surveillance of workers exposed to noxious dusts, as well as epidemiological evaluations. The use of the Classification is mandatory in many countries. Use of the ILO Classification may lead to better international comparability of data concerning the pneumoconiosis. Some countries have established legal requirements for use of the ILO Classification in the assessment of compensation claims, although the Classification was not originally designed for this purpose.
  • Readers' Interpretations of Chest Radiographs for Asbestos Related

    Readers' Interpretations of Chest Radiographs for Asbestos Related

    Original Investigations Comparison of “B” Readers’ Interpretations of Chest Radiographs for Asbestos Related Changes1 Joseph N. Gitlin, DPH, Leroy L. Cook, BA, Otha W. Linton, MSJ, Elizabeth Garrett-Mayer, PhD Rationale and Objectives. The purpose of this study was to determine if chest radiographic interpretations by physicians retained by attorneys representing persons alleging respiratory changes from occupational exposure to asbestos would be confirmed by independent consultant readers. Materials and Methods. For 551 chest radiographs read as positive for lung changes by initial “B” readers retained by plain- tiffs’ attorneys, 492 matching interpretative reports were made available to the authors. Six consultants in chest radiology, also B readers, agreed to reinterpret the radiographs independently without knowledge of their provenance. The film source, patient name, and other identifiers on each film were masked. The International Labor Office 1980 Classification of Chest Radiographs (ILO 80) was used with forms designed by the US National Institute of Occupational Safety and Health to record the consult- ants’ findings. The results were compared with initial readings for film quality, complete negativity, parenchymal abnormalities, small opacities profusion, and pleural abnormalities using chi-square tests and kappa statistics. Results. Initial readers interpreted study radiographs as positive for parenchymal abnormalities (ILO small opacity profu- sion category of 1/0 or higher) in 95.9% of 492 cases. Six consultants classified the films as 1/0 or higher in 4.5% of 2,952 readings. Statistical tests of these and other comparable data from the study showed highly significant differences between the interpretations of the initial readers and the findings of the consultants.
  • Brief Overview of the ILO System for Classifying Chest Radiographs

    Brief Overview of the ILO System for Classifying Chest Radiographs

    Brief Overview of the ILO System for Classifying Chest Radiographs David N. Weissman, MD Director, Division of Respiratory Disease Studies National Institute for Occupational Safety and Health Morgantown, WV The findings and conclusions in this report are those of the author and do not necessarily represent the views of the National Institute for Occupational Safety and Health. The ILO Classification • International Conference on Silicosis, Johannesburg, 1930 – Modifications/revisions 1950, 1959, 1970, 1980, 2002 – Most recent revision 2011 for digital radiography • “A means for describing and recording systematically the radiographic abnormalities in the chest provoked by the inhalation of dusts.” NIOSH “B” Reader Program • Certifies licensed physicians as proficient in the classification of chest x-rays of the pneumoconioses using the International Labour Office (ILO) Classification System • Developed in response to large inter-reader variability early in the Coal Worker’s X-ray Surveillance Program. • Fully operational since 1978. • Self-study syllabus available • “B” Reader: passed the B-reader certification examination. • Information – https://www.cdc.gov/niosh/topics/chestradiography/breader.html – https://www.cdc.gov/niosh/topics/chestradiography/breader-info.html NIOSH Form for ILO Classification Of Chest X-rays Classified items: • Film quality • Abnormalities • Parenchymal • Pleural • Other Film quality: “1”: good, free of technical imperfections or artifacts “2”: acceptable, no technical defects or artifacts likely to impair
  • Guidelines for the Use of the Ilo International Classification of Radiographs of Pneumoconioses

    Guidelines for the Use of the Ilo International Classification of Radiographs of Pneumoconioses

    OCCUPATIONAL SAFETY AND HEALTH SERIES No. 22 (Rev. 2000) GUIDELINES FOR THE USE OF THE ILO INTERNATIONAL CLASSIFICATION OF RADIOGRAPHS OF PNEUMOCONIOSES Revised edition 2000 INTERNATIONAL LABOUR OFFICE · GENEVA Copyright © International Labour Organization 2002 First published 2002 Publications of the International Labour Office enjoy copyright under Protocol 2 of the Universal Copy r i g h t Convention. Nevertheless, short excerpts from them may be reproduced without authorization, on condition that the source is indicated. For rights of reproduction or translation, application should be made to the Publications Bureau (Rights and Permissions), International Labour Office, CH-1211 Geneva 22, Switzerland. The Inter- national Labour Office welcomes such applications. Libraries, institutions and other users registered in the United Kingdom with the Copyright Licensing Agency, 90 Tottenham Court Road, London W1T 4LP [Fax (+44) (0)20 7631 5500; email: [email protected]], in the United States with the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923 [Fax (+1) (978) 750 4 4 7 0; email: [email protected]] or in other countries with associated Reproduction Rights Orga n i z a t i o n s , may make photocopies in accordance with the licences issued to them for this purpose. ILO Guidelines for the use of the ILO International Classification of Radiographs of Pneumoconioses 2000 edition Geneva, International Labour Office, 2002 (Occupational Safety and Health Series, No. 22 (rev. 2000)) Pneumoconiosis, medical examination, standardization. 15.04.2 ISBN 92-2-110832-5 ISSN 0078-3129 ILO Cataloguing in Publication Data The designations employed in ILO publications, which are in conformity with United Nations practice, and the presentation of material therein do not imply the expression of any opinion whatsoever on the part of the Inter- national Labour Office concerning the legal status of any country, area or territory or of its authorities, or concern- ing the delimitation of its frontiers.
  • Standards for Acquiring Digital Chest Radiography Images for Coal Mine

    Standards for Acquiring Digital Chest Radiography Images for Coal Mine

    This publication has been compiled by Coal Mine Workers’ Health Scheme of Minerals and Energy Resources Division, Department of Natural Resources and Mines. © State of Queensland, 2017 The Queensland Government supports and encourages the dissemination and exchange of its information. The copyright in this publication is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) licence. Under this licence you are free, without having to seek our permission, to use this publication in accordance with the licence terms. You must keep intact the copyright notice and attribute the State of Queensland as the source of the publication. Note: Some content in this publication may have different licence terms as indicated. For more information on this licence, visit https://creativecommons.org/licenses/by/4.0/. The information contained herein is subject to change without notice. The Queensland Government shall not be liable for technical or other errors or omissions contained herein. The reader/user accepts all risks and responsibility for losses, damages, costs and other consequences resulting directly or indirectly from using this information. Department of Natural Resources and Mines i Table of contents Acknowledgement ................................................................................................................................ 1 Introduction ........................................................................................................................................... 1 Background ..........................................................................................................................................
  • Imaging of Occupational Lung Disease

    Imaging of Occupational Lung Disease

    Imaging of Occupational Lung Disease The Royal Australian and New Zealand College of Radiologists® Imaging of Occupational Lung Disease Clinical Radiology Position Statement Name of document and version: Imaging of Occupational Lung Disease, Version 1 Approved by: Faculty of Clinical Radiology Council Date of approval: 04 October 2019 ABN 37 000 029 863 Copyright for this publication rests with The Royal Australian and New Zealand College of Radiologists ® The Royal Australian and New Zealand College of Radiologists Level 9, 51 Druitt Street Sydney NSW 2000 Australia New Zealand Office: Floor 6, 142 Lambton Quay, Wellington 6011, New Zealand Email: [email protected] Website: www.ranzcr.com Telephone: +61 2 9268 9777 Disclaimer: The information provided in this document is of a general nature only and is not intended as a substitute for medical or legal advice. It is designed to support, not replace, the relationship that exists between a patient and his/her doctor. TABLE OF CONTENTS 1. Introduction 4 2. Role of Radiologists 4 3. Role of chest x-ray versus high resolution CT chest 4 4. Recommendations 5 5. Appendices 8 Imaging Imaging 6. References 12 of O ccupational ccupational L ung ung D isease, Version 1 Version isease, | © The Royal Australian and New Zealand College of Radiologists® | | Radiologists® of College Zealand New and Australian Royal The © | October 2019 October Page 2 of 12 About the College The Royal Australian and New Zealand College of Radiologists (RANZCR) is a not-for-profit association of members who deliver skills, knowledge, insight, time and commit to promoting the science and practice of the medical specialties of clinical radiology (diagnostic and interventional) and radiation oncology in Australia and New Zealand.
  • (ILO) Readings Predict Arterial Oxygen Desaturation During Exercise in Subjects with Asbestosis Y C G Lee, B Singh, S C Pang,Nhdeklerk, D R Hillman, a W Musk

    201 Occup Environ Med: first published as 10.1136/oem.60.3.201 on 1 March 2003. Downloaded from ORIGINAL ARTICLE Radiographic (ILO) readings predict arterial oxygen desaturation during exercise in subjects with asbestosis Y C G Lee, B Singh, S C Pang,NHdeKlerk, D R Hillman, A W Musk ............................................................................................................................. Occup Environ Med 2003;60:201–206 Background: Exercise impairment is common in subjects with asbestosis. Arterial oxygen desaturation during exercise is an important contributor to exercise limitation. The International Labour Office (ILO) classification of plain chest radiographs correlates with resting pulmonary function, but its value in pre- dicting abnormal ventilatory responses to exercise, including desaturation, has not been explored. Aims: To determine in subjects with asbestosis (1) if radiographic profusion scores and the extent of small irregular shadows on plain chest radiographs correlate with resting lung function and abnormal ventilatory responses to exercise; and (2) if radiographic scores add value to resting lung function tests in predicting abnormal ventilatory responses to exercise. Methods: Thirty eight male subjects with asbestosis were included. Plain chest radiographs were read according to the ILO classification independently by three observers. All subjects underwent assessment of lung function and an incremental exercise test. Results: Profusion scores and number of affected zones correlated significantly
  • Chapter 6 ILO International Classifications of Radiographs of Pneumoconioses - Past, Present and Future

    Chapter 6 ILO International Classifications of Radiographs of Pneumoconioses - Past, Present and Future

    Chapter 6 ILO International Classifications of Radiographs of Pneumoconioses - Past, Present and Future - Yutaka Hosoda Consultant, Radiation Effects Research Foundation, Hijiyama Park 5-2, Minami-ku, Hiroshima, 732-0815, Japan The ILO International Classification of Pneumoconioses is an internationally used system to identify and record radiographic changes provoked by industrial dusts. The preliminary classification was first proposed at the 1930 International Con­ ference on Silicosis held in Johanesburg South Africa and the prototype of the present classification was made in 1950 for pulmonary abnormalities due to min­ eral dust exposures. Since then, the scope has been expanded to exposures to all other dusts to keep pace with the industrial changes. This chapter is concemed with the guidelines and standard radiographs of the 1950, 1958, 1968, 1971, 1980 and 2000 versions. A look to the future is also included. Initial or Pioneering Classifications : Profusion or Size/Type Before use of radiographs, pneumoconiosis was evaluated by working capacity. When radiographs came to wide use, various radiological classifications were de­ veloped in industrial countries such as Britain, France, Germany, South Africa, United States, and former USSR in 1930s and 1940s (1-8), mostly combined with clinical findings, as seen in the recommendation by the 1930 International Con­ ference on Silicosis held in Johannesburg. In radiographical classifications, there were two major schools. One is the classification with emphasis of profusion of discrete small shadows as represented by the Welsh National Memorial Associa­ tion (1931) and British Medical Research Council Pneumoconiosis Research Unit (PRU, 1945) and the other that stressing the dominant morphological size/type of such shadows as represented by French and Belgian groups (6).
  • Study on Definition of Radiographic Patterns of the Silicosis in Mongolia

    Study on Definition of Radiographic Patterns of the Silicosis in Mongolia

    STUDY ON DEFINITION OF RADIOGRAPHIC PATTERNS OF THE SILICOSIS IN MONGOLIA Definition of radiographic patterns of the silicosis in Mongolia according to the ILO International classification L.Munkhtsetseg1, D.Khishigtogtokh1 1 Occupational physician of the National Center for Labor Conditions and Occupational diseases study, Ulaanbaatar, Mongolia Abstract We involved in this study 247 patients who worked at the “Bor-Undur” underground spar mining and were diagnosed as having occupational lung diseases; and their 30 chest radiographs with evidence of silicosis. The mining employs 1500 employees, 350 of that work at underground mining. There are totally 247 patients from “Bor-Undur” spar mining and processing plant, who have been diagnosed as having occupational lung diseases and compensated during 1995-2010, and these 247 patients are under medical follow-up of the National Center for Labor Conditions and Occupational Diseases study. Silicosis is a type of pneumoconiosis and caused by inhalation of crystalline silica dust. When small silica (also known as silicon dioxide (SiO2)) dust particles are inhaled, they can embed themselves deeply into the tiny alveolar sacs and ducts in the lungs. When fine particles of silica dust are deposited in the lungs, macrophages that ingest the dust particles will set off an inflammation response by releasing inflammatory factors, in turn, these stimulate fibroblasts to proliferate and produce collagen around the silica particle, thus resulting in fibrosis and the formation of the nodular lesions; and further respiratory-heart failure and lung cancer [1]. For this reason, the silicosis still attracts attention in many countries of the world among the occupational health issues.
  • Chest X-Rays Chest X-Ray

    Chest X-Rays Chest X-Ray

    Chest X-rays Chest x-ray 2 Types of Views Superimposed images PA – posterior-anterior Also: AP, lateral, oblique, lordotic Lateral decubitus 3 Introduction to Chest Radiology 4 Mediastinum Thymus Heart Trachea Esophagus Aorta Lymph nodes Anterior – sternum Posterior – vertebrae 5 Opacities, Infiltrates 6 Effusions 7 Chest X-ray Terms Nodule – discrete opacity (usually small) Granuloma – nodule due to inflammation (e.g. past infection or foreign body/antigen); Can become fibrosed/calcified Caseating/Non – Cells necrotic/not; TB/sarcoid-CBD Calcified Granuloma – usually benign Bulla – bubble, round, hollow air filled cavity Bleb – bulla on pleura Atelectasis – area of collapsed lung Reticular – cris-crossing lines Honeycombing – fibrous walled cysts – e.g. asbestosis Ground glass - refers to the presence of increased hazy opacity within the lungs - CBD 8 International Labour Organization (ILO) Classification Pneumoconiosis Pulmonary medicine ILO Classification – System for recording abnormalities in Chest X-Rays resulting from the inhalation of dusts. (Pneumoconioses) 9 ILO Classification Standardizes Quantifies “B” Readers - certified 10 ILO Classification Quality – Contrast Parenchyma Pleura 11 “Profusion” Categories 0, 1, 2, 3 (4 levels) 12-point scale (continuous scale) 0/- 0/0 0/1 1/0 1/1 1/2 2/1 2/2 2/3 3/2 3/3 3/+ shape, size, location s,t,u, (irregular) p,q,r (regular) 1/0 presumptive but not unequivocal 12 ILO Chest x-ray 0/0 13 ILO 3/3 r/r 14 Chest X-Ray Interpretation is an inexact science Inter-reader variability Intra-reader variability 15 ILO 3/3 t/t 16 ILO Summary 17 What We have Covered The general findings in a normal chest x-ray.
  • Guidelines for the Use of the Ilo International Classification of Radiographs of Pneumoconioses

    Guidelines for the Use of the Ilo International Classification of Radiographs of Pneumoconioses

    GUIDELINES FOR THE USE GUIDELINES FOR THE USE OF THE ILO INTERNATIONAL OF THE ILO INTERNATIONAL CLASSIFICATION OF RADIOGRAPHS CLASSIFICATION OF RADIOGRAPHS OF PNEUMOCONIOSES OF PNEUMOCONIOSES (REVISED EDITION 2011) In the continuing struggle to protect the health of workers occupationally exposed to airborne dusts, the ILO has for many (REVISED EDITION 2011) years sought to improve the understanding of pneumoconiosis problems. The Guidelines for the use of the ILO International Classifi cation of Radiographs of Pneumoconioses is the latest version of a well-established publication designed to standardize classifi cation methods and facilitate international comparisons of pneumoconiosis statistics and research reports. This revised edition of the Guidelines supplements the preceding 2000 edition with an entirely new Chapter 6. This chapter extends the applicability of the ILO scheme to classifi cations of results from digital radiographic images of the chest. The ILO Standard Digital Images (ILO 2011-D), which derive from the ILO (2000) standard radiographs, have been produced for this purpose. The new text in Chapter 6 identifi es principles for viewing digitally acquired images of the chest and covers effective acquisition, display and storage of digital images. The Foreword to this revised edition defi nes the nomenclature used to distinguish different types of chest images. The earlier (2000) Guidelines for classifi cation of conventionally Occupational acquired “fi lm-screen” radiography remain applicable. The relevant text from the earlier edition is reproduced in this edition, Safety and Health and the associated sets of standard radiographs remain available from the ILO. Series 22 ISBN 978-92-2-124541-4 9 789221 245414 OCCUPATIONAL SAFETY AND HEALTH SERIES No.
  • 3.2 ILO Classification

    3.2 ILO Classification

    ILO Classifi cation 93 3.2 ILO Classification Vinicius C. S. Antao and John E. Parker CONTENTS dust diseases. It is not designed to define patho- logical entities, and it does not take into account 3.2.1 Introduction 93 working capacity or compensation for disability 3.2.2 The 2000 Revision 93 Jacobsen 3.2.2.1 Parenchymal Abnormalities 94 ( 1991). The initial version of the Classifi- 3.2.2.2 Pleural Abnormalities 94 cation was issued in 1930, with subsequent revisions 3.2.2.3 Symbols and Comments 94 published in 1950, 1958, 1968, 1971, 1980, and 2000. 3.2.2.4 The Quad Set 95 The first editions were focused on silicosis. In 1958, 3.2.3 Proficiency in the Use of the ILO Classification 95 a single category was included to cover all types 3.2.4 Correlation with Other Tests 95 3.2.5 Assessment of Disease Progression 96 and profusions of linear markings. In the 1960s, the 3.2.6 Limitations of the Classification 96 International Union Against Cancer (UICC) evolved 3.2.6.1 Reader Variability 96 a parallel system for linear (now called irregular) 3.2.6.2 Insensitivity of Radiographs to Pneumoconiosis 96 opacities, mainly spurred by asbestos exposure. 3.2.6.3 Lack of Specificity to Pneumoconiotic Lesions 97 In 1968, the UICC and ILO systems were merged 3.2.6.4 Importance of Film Quality 97 for all dust-induced pneumoconioses, with the ILO 3.2.6.5 Additional Limitations of the Classification 97 Henry ILO 3.2.7 Other Classifications 97 embracing the UICC ideas ( 2002; 2002; 3.2.8 Future Trends in Digital Radiography and Shipley 1992).