Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to page options Skip directly to site content

Priority Knowledge and Competency Items to Address in Training and Testing of Certified B Readers

June 2013
NIOSH Docket Number 234, CDC-2013-0008

The National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention announces the availability of a draft Request for Information entitled "Priority Knowledge and Competency Items to Address in Training and Testing of National Institute for Occupational Health (NIOSH)-Certified B Readers" now available for public comment. To view the notice and related materials, visit and enter CDC-2013-0008 in the search field and click "Search."

Federal Register Notice:
Notice of draft publication available for public comment [PDF - 197 KB]

Public Comment Period

Comments will be accepted until 5:00 p.m. EST on August 13, 2013.

Written comments, identified by CDC-2013-0008 and docket number NIOSH-234, may be submitted by any of the following methods:

  • Federal rulemaking portal: Follow the instructions for submitting comments.

    Instructions: All information received in response to this notice must include the agency name and docket number (CDC-2013-0008; NIOSH-234). All relevant comments received will be posted without change to , including any personal information provided. All electronic comments should be formatted as Microsoft Word. Please make reference to CDC-2013-0008 and Docket Number NIOSH-234.

  • Mail: NIOSH Docket Office
    Robert A. Taft Laboratories
    4676 Columbia Parkway
    Cincinnati, OH 45226

Supplementary Information

The National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC) is requesting information from stakeholders and the general public to identify and prioritize knowledge and competencies currently needed by B Readers. The information obtained will be used in the development of the new digital B Reader program, including training and examinations.


The B Reader Program aims to ensure competency in radiographic reading by evaluating the ability of readers to classify a test set of radiographs, thereby creating and maintaining a pool of qualified readers having the skills and competencies to provide accurate and precise International Labour Office (ILO) classifications. B Reader certification is granted to licensed physicians who demonstrate proficiency in the classification of chest radiographs for pneumoconioses using the ILO Classification System. Proficiency is evaluated via the NIOSH B Reader Examination, which was developed in response to the mandates of the Federal Coal Mine Health and Safety Act of 1969, amended 1977. Educational and testing materials currently used by the B Reader program include a training syllabus, a certification examination and a re-certification examination. These are all based on older, film-based technology. The ILO system has recently been changed to allow modern digital chest images to be used for classification. NIOSH has recently completed rulemaking to allow digital chest images to be used for coal workers' surveillance. Thus, physician training and certification must also be updated to use digital chest imaging. This effort will include identifying key knowledge and competencies to be taught and tested, developing and validating new teaching and testing materials addressing the key knowledge and competencies, and establishing plans for ongoing quality assessment and improvement of the teaching and testing program.


Simone Tramma, MD, MS,
1600 Clifton Road NE MS E20,
Atlanta, GA 30329-4018,