The NIOSH B Reader Program

	MEDICAL INFORMATION The NIOSH B Reader Program by Maureen Summers, RN, MBA, CHE

Sample of B Readers By State Background of the Program ALOSH Offers Certification Prepare for the Examination More Information Additional Resources Many occupational health programs provide comprehensive medical surveillance services including chest x-rays with B Readings. Access to these readings depends on the state in which the occupational health program is located and the number of certified readers in the state. Currently there are only 531 certified B Readers in the United States. There is a decided advantage to providing these readings within your program as it reduces the cost of shipping the x-rays and the delay of waiting for the results. Many occupational health programs believe that only radiologists can become certified as B Readers, but occupational health physicians can also become certified. The OSHA standard Interpretation of Chest Roentgenogram–Mandatory–1915.1001 App E requires that roentgenograms shall be interpreted and classified only by a B Reader—a board eligible/certified radiologist or an experienced physician with known expertise in pneumoconiosis. Additionally, all readers shall have immediately available for reference a complete set of the ILO-U/C International Classification of Radiographs for Pneumoconiosis, 1980. Sample of B Readers By State The list of certified B Readers by state is available on the National Institute for Occupational Safety and Health (NIOSH) web site: www.cdc.gov/niosh/readstat.html. The physician name, hospital, location, and telephone number are listed. Here’s a sample of the number of B Readers in a few selected states: Pennsylvania 71 Ohio 33 Georgia 10 Connecticut 4 Maine 4 South Carolina 3 Vermont 1 Montana 0 [top] Background of the Program B Reader certification was developed in response to the Federal Mine Safety and Health Act of 1977. The Act mandates the classification of chest x-rays for pneumoconiosis utilizing the ILO System and Standard Films for the Coal Workers’ X-ray Surveillance Program. The U.S. Department of Labor Regulations requires that chest x-rays of asbestos-exposed workers be classified utilizing the same system. NIOSH B Reader approval is granted to physicians who demonstrate proficiency in the classification of chest x-rays under this system. The standard films are necessary when participating in the B Reader examination. They are available at the American College of Radiology (ACR) Symposium on Radiology of the Pneumoconiosis. The ILO is expected to release a revised edition of the ILO Classification of Radiographs of Pneumoconiosis in the near future. ALOSH Offers Certification To obtain proficiency a physician must pass the NIOSH B Reader Certification Examination. These examinations are offered monthly at the Appalachian Laboratory for Occupational Safety and Health (ALOSH) located in Morgantown, West Virginia. B Readers are granted a certificate and must re-certify every four years. Slightly more than half of the NIOSH-certified B Readers renew their certification for an additional four-year period. Prepare for the Examination NIOSH strongly recommends that pre-test preparation be undertaken, as the examination is difficult. There is a 50/50 pass/fail rate, and if a physician fails the examination, there is a six-month waiting period before s/he can retake it. It is necessary to be familiar with the ILO Classification System and the Roentgenographic Interpretation Form (the form is available at www.cdc.gov/niosh/omb-0920.html. Applicants can pursue two methods in preparing for the examination: The NIOSH Self-Study Syllabus, which is available through ALOSH and was developed specifically for examination preparation. Attendance at an ACR Symposium on Radiology of the Pneumoconiosis, which is offered every two to three years. [top] Applicants in the United States may obtain the syllabus referenced above by mail on a first-come, first-served basis from ALOSH prior to the scheduled testing. Also, applicants can obtain the syllabus by visiting the Morgantown, West Virginia, site to study prior to the examination. In addition, there are nine other stationary locations across the country and eighteen international sites. More Information ALOSH/NIOSH Surveillance Branch Coal Workers’ Health Surveillance Activity P.O. Box 4258 Morgantown, WV 26504 888.480.4042 Additional Resources www.cdc.gov/niosh/pamphlet.html www.osha.gov Recent Question from a Reader about B Reader Exam Fees Question: "In this article the B Reader exam is discussed. Thus far, I’ve been unable to identify the actual cost of the exam. Is the test taker required to purchase the study materials and pay for the exam fee? Thank you in advance for your time and consideration." Mark L. Robinson, Senior Consultant MMI, an affiliate of CARCO Group, Inc. Answer: "I contacted [August, 2003] the ALOSH/NIOSH Surveillance Branch, which is listed in the article for further information. The fees are as follows: B Reader Examination – No fee NIOSH Self Study – $500 deposit, refunded on return of the Self Study ILO SYSTEM and Standard films must be available – Cost approximately $500 I hope this information is helpful." – Maureen Summers, Tracker Editor [top]

About the author: MAUREEN SUMMERS, RN, MBA, CHE is the editor of the Occupational Health Tracker. She is a certified healthcare executive with extensive clinical and management experience in occupational health and rehabilitation. Ms. Summers has an active occupational health consulting business based in Kennebunk, Maine. She welcomes communication from Tracker readers and/or potential authors. Ms. Summers may be reached at 207.985.4918 or via e-mail: editor@systoc.com.