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 please call (07) 3818 5420 or email HSU@rshq.qld.gov.au.
- New process for reading chest X-rays – information for doctors (PDF, 465KB).
- New process for reading chest X-rays – information for imaging clinics (PDF, 474KB).
- B-reading process with Lungscreen Australia: Step by step guide and workflow – periodic health assessment from 1 March 2019 (PDF, 808KB).
- New process for reading chest X-rays - information for workers (PDF, 461KB).