NIOSH Guideline: Application of Digital Radiography for the Detection and Classification of Pneumoconiosis

March 2011

NIOSH Docket Number 215

Monitoring the health of individuals involved in dusty work is intended to provide assurance to the worker that ongoing exposure controls are adequate. Recognition of minor health abnormalities serves as an early warning to both workers and managers when there is need for more effective measures to prevent work-related impairment and disability. Since 1970, NIOSH and other organizations have successfully applied traditional film screen chest radiography, interpreted using the ILO International Classification of Radiographs of Pneumoconiosis, toward these objectives. Imaging of interstitial lung diseases such as the pneumoconiosis represents one of the most difficult challenges in diagnostic radiology, and comprehensive attention to technological, methodological, and human factors is required to assure that the image quality and interpretation are satisfactory for achieving early disease detection. The draft NIOSH Guideline: “Application of Digital Radiography for the Detection and Classification of Pneumoconiosis” is based upon accepted contemporary professional recommendations, and provides technical and operational guidance for radiographic facilities and physician readers who obtain digital chest radiographs for the evaluation of pneumoconiosis. The intent of the Guideline is to assure that the recognition of pneumoconiosis using digitally-acquired chest radiographs is at least as safe and effective as traditional film screen radiography. The Guideline should not be considered a mandate for medical practice; however participating practitioners and facilities who deviate from the specifications should have a sound medical rationale for alternative approaches. NIOSH intends to review the comments that have been submitted by the public and, to the extent necessary, make revisions to the draft Guideline. It will then be re-posted to our digital radiography web pages. As digital technology advances, and research findings emerge, further revisions may be made so as to maintain it as a state-of-the-art reference document.