Institution Ass. Prof. Ivan Mikov, MD, PhD

Title
Author(s)
Institution
Address for
correspondence
MARK D
International Classification of Radiographs of
Pneumoconioses
Ass. Prof. Ivan Mikov, MD, PhD,
Specialist in Occupational Medicine
Department of Occupational Medicine,
Medical Faculty, University of Novi Sad, Yugoslavia
Department of Occupational Medicine,
Medical Faculty, University of Novi Sad
Futoska 121,
21000 Novi Sad, FR Yugoslavia
Tel. + 381 21 613 998, 614 277, Fax: + 381 21 624 128
e-mail: driva@eunet.yu
Keywords Pneumoconiosis, Chest radiograph, Classification, International
Labour Office, Occupational lung disease, Worker, Health
surveillance
Learning objectives
(expected outcome)
Synopsis (Abstract) Definition of pneumoconiosis
Definition and objective of the radiographic classification of
pneumoconioses
Features of the ILO classification system
I. Technical quality
II. Parenchymal opacities
III. Pleural abnormalities
IV. Symbols
Uses of the classification
1. Workers health surveillance
2. Epidemiological research
3. Compensation
4. Education and training
References
Teaching methods - Introductory lecture with transparencies
- Distribution of the ILO short scheme of the classification
during the lecture
- Presentation of 22 standard chest radiographs of
pneumoconioses on a view box
- Presentation of pneumoconiosis clinical case reports,
comparison of their chest radiographs with the standard
radiographs on a view box and interpretation
Specific recommendations .
for teacher
Assessment of
students
Recommendation for
module evaluation
Written exam: multiple-choice questions.

International Classification of Radiographs of Pneumoconioses
Ivan Mikov, MD, PhD, Department of Occupational Medicine,
Medical Faculty, University of Novi Sad, Novi Sad, FR Yugoslavia
Outlines of the lecture:
Definition of pneumoconiosis:
The term pneumoconiosis is used to cover group of lung diseases, which result from the
inhalation of dust and should be used for all dust damage to the alveolar part of the
lung, including the airways that have no mucociliary lining.
Definition and objective of the radiographic classification of pneumoconioses:
The International Labour Office (ILO) has issued an internationally accepted standard
method for the classification of the radiographic changes seen in pneumoconiosis. The
ILO has published the last revision in 1980.
The ILO classification, which is based on the posteroanterior chest radiograph, is a
descriptive system consisting of a glossary of terms and a set of 22 standard radiographs
illustrative of the parenchymal and pleural changes of the pneumoconioses.
The objective of the classification is to enable the radiographic changes seen in
pneumoconioses to be coded in a simple reproducible form.
The method of reading the radiographs is to compare each worker's radiograph with a
set of standard radiographs supplied by the ILO.
Features of the ILO classification system:
I. Technical quality:
The classification requires films of excellent quality. The accurate classification of poor
quality films remains a problem. The reader's opinion about the film quality is recorded
as 1,2,3 or 4 i.e. unreadable.
II. Parenchymal opacities:
The classification grades the parenchymal pattern of the pneumoconioses based on
shape, size extent and profusion.
a.) Small opacities:
- Profusion (numbers: 0, 1, 2 and 3 combined in binary fashion) e.g. 2/2 or 2/3
- Extent (lung fields - RU, RM, RL, LU, LM and LL)
- Shape and size (two-letter combinations: round shape - p, q, r and irregular shape - s, t,
u) e.g. q/q or q/t

.) Large opacities (capital letters: A, B and C)
III. Pleural abnormalities:
Pleural thickening and pleural calcification are also categorized and quantified.
IV. Symbols:
Recording of other abnormalities seen on the chest radiograph. e.g. em (emphysema), tb
(tuberculosis), ca (cancer) etc.
Uses of the classification:
1. Workers health surveillance
The ILO classification is useful for screening and surveillance programmes, which must
try to recognize early radiographic abnormalities, to identify sentinel health events and
to monitor trends over the time.
2. Epidemiological research
It has proved very useful as a method of classifying chest radiographs for
epidemiological research, identifying health hazards and establishing exposure-response
relationships.
3. Compensation
4. Education and training
References:
1. International Labour Office. Guidelines for the use of ILO international
classification of radiographs of pneumoconioses. Occupational safety and health
series No. 22 (Rev. 80). Geneva: International Labour Office, 1980.
2. Rossiter CE, Jones RN. Radiographic classifications. In: McDonald JC (ed.). Recent
advances in occupational health. Edinburgh: Churchill Livingstone, 1981: 129-40.
3. Mikov M, Mikov I. Occupational Medicine. Belgrade: Naucna knjiga, 1995: 124-
34. (In Serbian)
4. Wagner GR. Screening and surveillance of workers exposed to mineral dusts.
Geneva: World Health Organization, 1996: 52-7.