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 Coal Mine Workers' Health Scheme (CMWHS) Clinical pathways guideline (PDF, 702KB) 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

Also consider...


Contact the Health Surveillance Unit