What to know
The NIOSH B Reader program trains and certifies physicians in the International Labour Organization (ILO) International Classification of Radiographs of Pneumoconioses. In the U.S., B Readers classify chest radiographic images of workers participating in health surveillance programs. This is due to jobs involving exposure to mineral dusts such as coal mine dust, crystalline silica, and asbestos. B Readers also perform classifications in a range of other settings, including research, legal, and evaluation for benefits.
Being a B Reader
B Readers use demonstrated proficiency in classifying chest radiographs to participate in research and health surveillance activities. Additionally, B Readers participate in legal and administrative activities such as compensation programs. Physicians who classify chest radiographs for certain federal surveillance programs may be required to be B Readers. For example, federal regulations for the NIOSH Coal Workers' Health Surveillance Program require B readers to classify chest radiographs.
Programs using B Reader classifications must trust that they are accurate and based solely on the appearances of chest radiographic images. Therefore, B Readers must adhere to the B Reader Code of Ethics. B Readers should also recognize issues that can affect reading accuracy and ensure accurate classifications to the degree possible. B Readers providing classifications to the Black Lung Benefits Program operated by the Office of Workers' Compensation Programs, U.S. Department of Labor, might undergo quality assurance reviews if they provide classifications that are identified as possibly inaccurate.
Maintaining B Reader status
Readers must retest every five years to maintain their B Reader status. Testing can be done any time within the fifth year. There are no limits to the number of times examinees can take the exam.
A reader who fails the retest must retake and pass it before their five-year approval period expires to retain their status. Examinees that are not B Readers and do not achieve a passing score must wait 90 days before retaking the exam.
Current B Readers who are taking the exam for recertification may retake the exam once with no waiting period. If a B Reader fails a second recertification attempt, the reader must wait 90 days before retaking the exam.
B Readers who do not retest and pass before their expiration date will lose their certification. They will also not be able to provide B readings until they pass the exam.
B Reader state medical licensure
The NIOSH B Reader certification is granted after successful completion of a competency examination. Certification through NIOSH's B Reader program indicates proficiency in classifying posteroanterior chest radiographs using the ILO system. However, it is not a type of licensure to practice medicine. Therefore, physicians must perform duties in accordance with medical licensure laws of States and Territories.
Requirements may vary depending on the State or Territory and the nature of the work. To ensure all medical licensure requirements of States and Territories are followed, NIOSH recommends that facilities or other organizations obtaining ILO classifications and their respective B Readers consult with relevant State Boards of Medicine to determine licensing requirements.
Classification of chest radiographs using the ILO system is not typically performed for clinical diagnostic purposes. This is why the B Reader Code of Ethics states that "When a contemporary chest radiograph is classified, the B Reader shall either take responsibility for assuring to the extent feasible that the examined individual is promptly notified of all clinically important findings or must be assured that another appropriate party is taking that responsibility." This requirement is satisfied when a chest radiograph is interpreted by an appropriate clinician at the examining facility and the examinee is notified of the results in accordance with the requirements of the jurisdiction. After the clinical interpretation has been obtained, a chest radiograph may then be classified by a NIOSH-certified B Reader for public health or other legal or administrative purposes.
Physicians requiring licensure in more than one state should be aware of the Interstate Medical Licensure Compact, which provides a streamlined process for physicians to obtain licensure in more than one state. Currently, 37 states participate: Physician License | Interstate Medical Licensure Compact.
List search of B Readers
This list will be updated continuously. Listing does not imply medical licensure.
Use this search form to select the criteria for your search. Leaving the Last Name and State fields blank will produce a complete list of B Readers.
Listed by State of Residence
Successful international examinees
Use this search form to obtain a listing of physicians from outside the United States who have demonstrated competence in applying the ILO classification by successfully completing the NIOSH B Reader examination. Leaving the Last Name field blank will produce a complete list of examinees.
Contact information
Please contact us if you have questions or need further information.
- Call (888) 480-4042
- Email cwhsp@cdc.gov
Complaints about a specific B Reader should be referred to the appropriate State medical licensing board. These boards are responsible for assuring competence and integrity of licensed physicians.