Subpart Z
Yes. Chest X-rays must be classified in accordance with the ILO International Classification of Radiographs of Pneumoconioses (revised edition 2011), as required by 1915.1001 App E. The rule also requires recording the classification on a CDC/NIOSH (M) 2.8 form with at least the content in items 1 through 4.
Only a qualified reader may classify chest X-rays: a B-Reader, a board eligible/certified radiologist, or an experienced physician with known expertise in pneumoconioses, per 1915.1001 App E. Employers must ensure the person doing the classification meets one of those categories.
Classifications must be recorded on a CDC/NIOSH (M) 2.8 form, and at minimum the information within the bold lines (items 1 through 4) of that form must be included, as required by 1915.1001 App E. The regulation states this specific format but clarifies the form itself is not to be submitted to NIOSH.
No. Chest X-rays must be classified only by a B-Reader, a board eligible/certified radiologist, or an experienced physician with known expertise in pneumoconioses, so an untrained clinician cannot perform official classifications even under supervision, according to 1915.1001 App E. Employers must ensure the classifier meets one of the specified qualifications.
When classifying film chest X-rays, the physician must have immediately available a complete set of the ILO standard format radiographs provided for use with the ILO Guidelines (revised 2011), per 1915.1001 App E. This ensures consistent comparison to the ILO standards during classification.
For digitally-acquired chest X-rays, the physician must have immediately available a complete set of ILO standard digital chest radiographic images for reference, and the classification must be based on viewing electronic copies—not on printed transparencies—per 1915.1001 App E.
No. Classification of digitally-acquired chest X-rays must be based on viewing images displayed as electronic copies and shall not be based on viewing hard copy printed transparencies, according to 1915.1001 App E. This maintains fidelity to digital image characteristics.
No. The regulation requires using the CDC/NIOSH (M) 2.8 form format for recording classifications, but explicitly states that this form is not to be submitted to NIOSH, per 1915.1001 App E.
At minimum, the content within the bold lines of the CDC/NIOSH (M) 2.8 form (items 1 through 4) must be included when recording classification results, as required by 1915.1001 App E. Employers should ensure those fields are completed for each classified film.
No. Because the standard requires classification only by a B-Reader, a board eligible/certified radiologist, or an experienced physician with known expertise in pneumoconioses, the classifier listed on the CDC/NIOSH (M) 2.8 form must be one of those qualified individuals, per 1915.1001 App E.
Yes. The regulation allows classification by a board eligible/certified radiologist even if they are not a B-Reader, as long as they have recognized expertise in diagnosing pneumoconioses, per 1915.1001 App E. Employers should document the radiologist's qualifications.
Yes. The regulation specifies use of the Guidelines for the use of the ILO International Classification of Radiographs of Pneumoconioses (revised edition 2011), and the physician must have the ILO standard radiographs available for reference when classifying, as stated in 1915.1001 App E.
No. The physician must have immediately available a complete set of the ILO standard format radiographs (for film) or a complete set of ILO standard digital images (for digital), as required by 1915.1001 App E. Using incomplete or unofficial reference sets would not meet the rule's requirement.
The rule requires classification of digitally-acquired chest X-rays based on viewing images displayed as electronic copies and having ILO standard digital images immediately available for reference, but it does not prescribe specific hardware or software; employers must ensure the viewing system preserves diagnostic image quality and allows comparison to the ILO digital standards, per 1915.1001 App E.
Employers should document the classification on the CDC/NIOSH (M) 2.8 form including at least items 1–4 and identify that the ILO (2011 revised) classification system was used and who performed the reading (B-Reader, board eligible/certified radiologist, or experienced physician), as required by 1915.1001 App E. Keep completed forms in the employee medical record as appropriate.
No. The regulation explicitly states the CDC/NIOSH (M) 2.8 classification form is not to be submitted to NIOSH; it is to be used for recording classifications locally, per 1915.1001 App E.
If the physician has known expertise in pneumoconioses, that physician may classify chest X-rays even if not board-certified or a B-Reader, because 1915.1001 App E allows an 'experienced physician with known expertise in pneumoconioses' to perform classifications; employers should document the physician's relevant experience and credentials.
Yes. The ILO International Classification (revised 2011) must be used for classifying both film and digitally-acquired chest radiographs, with film readers using the ILO standard format radiographs and digital readers using the ILO standard digital chest radiographic images, as stated in 1915.1001 App E.