Chest Radiography

The NIOSH B Reader Program

Special Notice

B Reader examinations will open at the NIOSH facility in Morgantown, WV on August 1, 2022. Call (888) 480-4042 or email to schedule your exam. Go to the 2022 B Reader Examination Schedule for dates.

Exams must be scheduled at least two weeks in advance of testing dates. Space is granted as available.

B Reader looking at an xray


In 1949, the International Labour Office (ILO) annouced standards for systematically describing and recording radiographic appearances of certain abnormalities caused by the inhalation of dusts. The intent of the standards was to achieve uniformity in assessing pneumoconiosis across readers. However, it was determined that readers, despite employing the classification scheme, still disagreed with each other and with themselves to an excessive degree (Felson 1973). As a consequence, NIOSH concluded that a proficiency program was needed to provide a pool of qualified readers. The NIOSH B Reader Program began in 1974, although it was not until 1978 that the B reader examination was given extensively (Attfield 1992).

The B Reader examination was initially developed to identify physicians qualified to serve in national pneumoconiosis programs directed at coal miners and others who suffer from dust-related illness. This included epidemiologic research on coal workers’ pneumoconiosis and the compensation of coal miners with pneumoconiosis under programs processed by government agencies (Morgan 1979). The original intent of the B Reader Program still exists, but B Readers are also now involved with epidemiologic evaluation, surveillance, and worker monitoring programs involving many types of pneumoconioses. 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 ability to provide accurate and precise ILO classifications.

Page last reviewed: February 19, 2020