Radiology assessments for chest X-rays

Medical assessment by specialist radiologists

Examining medical officers or appointed medical advisers (AMAs) who order chest X-rays are required to provide sufficient information to the radiologist, outlining the worker's coal dust exposure and the need to assess the X-ray for pneumoconiosis to the International Labour Organization (ILO) International Classification of Radiographs of Pneumoconioses (ILO Classification).

Two-reader process for chest X-rays

Since July 2016, US-based B-readers accredited by the National Institute for Occupational Safety and Health (NIOSH) have provided a dual-reading service to Queensland's coal mine workers.

X-rays are read to the ILO Classification, which provides a rigorous screening process for reporting on the potential presence of disease.

Sending X-rays to US-based B-readers through the University of Illinois at Chicago (UIC) was an interim solution until an Australian-based dual-reading service was established.

On 1 March 2019, Lungscreen Australia replaced US-based B-reading for all Queensland coal mine worker chest X-rays. All chest X-rays must now be sent to Lungscreen Australia.

Amendments to the Coal Mining Safety and Health Regulation 2017 that commenced on 1 March 2019 made this a mandatory requirement of the Coal Mine Workers' Health Scheme.

Lungscreen will classify coal mine worker chest X-rays to the ILO Classification and will provide the final ILO report back to the referring doctor.

Other Australian B-readers registered with Resources Safety & Health Queensland (RSHQ) can undertake the first B-read and provide this to Lungscreen to complete the dual-reading process.

If AMAs or employers choose to use other Australian B-readers registered with RSHQ for the first read, please consult with your B-reader for referral instructions to the relevant X-ray imaging clinic/s registered with RSHQ.

If the chest X-ray examination identifies abnormalities, the AMA is required to follow the Mine dust lung disease clinical pathways guideline (PDF, 789KB) for follow-up investigations and referral to appropriate medical specialists.

The UIC will continue to audit a sample of chest X-rays submitted with health assessment records as part of the ongoing quality assurance program as recommended by the Monash University review.

Workers will be provided a consent form to allow RSHQ to provide their records for auditing.

To support this process:

  • From 1 March 2019, Lungscreen will conduct 2 reads (and conduct any adjudications) for any X-ray sent to it unless it receives the first ILO report by another Australian B-reader registered with RSHQ. In these cases, Lungscreen will conduct 1 read and any adjudications before issuing the final report.
  • Readers must complete an ILO Classification form.
  • All digital chest X-ray images and reports, including the final ILO classification form, are sent to the AMA.

For copies of the ILO classification form phone (07) 3818 5420 or email

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