Abstract
RATIONALE AND OBJECTIVES: Chest radiographs are recommended for prevention and detection of pneumoconiosis. In 2011, the International Labour Office (ILO) released a revision of the International Classification of Radiographs of Pneumoconioses that included a digitized standard images set. The present study compared results of classifications of digital chest images performed using the new ILO 2011 digitized standard images to classification approaches used in the past. MATERIALS AND METHODS: Underground coal miners (N = 172) were examined using both digital and film-screen radiography (FSR) on the same day. Seven National Institute for Occupational Safety and Health-certified B Readers independently classified all 172 digital radiographs, once using the ILO 2011 digitized standard images (DRILO2011-D) and once using digitized standard images used in the previous research (DRRES). The same seven B Readers classified all the miners' chest films using the ILO film-based standards. RESULTS: Agreement between classifications of FSR and digital radiography was identical, using a standard image set (either DRILO2011-D or DRRES). The overall weighted κ value was 0.58. Some specific differences in the results were seen and noted. However, intrareader variability in this study was similar to the published values and did not appear to be affected by the use of the new ILO 2011 digitized standard images. CONCLUSIONS: These findings validate the use of the ILO digitized standard images for classification of small pneumoconiotic opacities. When digital chest radiographs are obtained and displayed appropriately, results of pneumoconiosis classifications using the 2011 ILO digitized standards are comparable to film-based ILO classifications and to classifications using earlier research standards.