{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T12:51:15Z","timestamp":1754398275458},"reference-count":9,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,7,10]]},"published-print":{"date-parts":[[2017,8]]},"abstract":"Objective<\/jats:title>The National Institute for Occupation Safety and Health-administered Coal Workers\u2019 Health Surveillance Program (CWHSP) provides radiographic pneumoconiosis screening for US coal miners. Radiographs are classified by readers according to International Labour Office criteria. In addition to pneumoconiotic parenchymal and pleural lung abnormalities, readers document radiographic features of importance (other symbols). Other symbols are not meant to imply a diagnosis or interpretation but are relevant as they provide information beyond a pneumoconiosis classification for features related to dust exposure and other aetiologies. Our objective was to summarise other symbol data from 48 years of CWHSP participants.<\/jats:p><\/jats:sec>Methods<\/jats:title>Chest radiograph classifications obtained from CWHSP participants between July 1968 and July 2016 were analysed. Any \u2018other symbol\u2019 indication from any of the readings were counted. Frequencies were tabulated by individual reader and those identified by any reader.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 469\u2009922 radiographs included in this study, nearly 15% had at least one reader identify a radiographic feature of importance. The most commonly identified other symbol was cancer (excluding mesothelioma) (6.83%), followed by emphysema (1.68%). Some features were rarely identified over the 48 years of data collection such as rheumatoid pneumoconiosis (n=46), pneumothorax (n=32), mesothelioma (n=12) and rounded atelectasis (n=4).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>This is the largest study to date describing radiographic features of importance as part of routine chest radiographic surveillance. While these symbols are not diagnostic they can be used to describe features associated with dust exposure. One of the most commonly identified radiographic features in our population is emphysema which is associated with respirable dust exposure. These results can be compared with other dust exposed populations.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2017-015876","type":"journal-article","created":{"date-parts":[[2017,8,12]],"date-time":"2017-08-12T00:25:24Z","timestamp":1502497524000},"page":"e015876","update-policy":"http:\/\/dx.doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Radiographic features of importance in the National Institute for Occupational Safety and Health-administered Coal Workers\u2019 Health Surveillance Program: characterising the use of the \u2018other symbols\u2019"],"prefix":"10.1136","volume":"7","author":[{"given":"Cara N","family":"Halldin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet M","family":"Hale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J","family":"Blackley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A Scott","family":"Laney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,8,11]]},"reference":[{"key":"2024051613202153000_7.8.e015876.1","unstructured":"International Labour Office. Guidelines for the use of the ILO international classification of radiographs of pneumoconioses. Geneva: International Labour Office, 2011."},{"key":"2024051613202153000_7.8.e015876.2","first-page":"647","article-title":"Evaluation of a system recording non-pneumoconiotic abnormalities as part of coal worker's x-ray surveillance programme","volume":"47","author":"Collet","year":"1990","journal-title":"Br J Ind Med"},{"key":"2024051613202153000_7.8.e015876.3","doi-asserted-by":"crossref","first-page":"375","DOI":"10.7205\/MILMED.170.5.375","article-title":"Trends in pleural radiographic findings in the Navy asbestos Medical Surveillance Program (1990-1999)","volume":"170","author":"Muller","year":"2005","journal-title":"Mil Med"},{"key":"2024051613202153000_7.8.e015876.4","first-page":"879","article-title":"The NIOSH B reader certification program. an update report","volume":"34","author":"Wagner","year":"1992","journal-title":"J Occup Med"},{"key":"2024051613202153000_7.8.e015876.5","first-page":"336","article-title":"Pneumoconiosis prevalence among working coal miners examined in federal chest radiograph surveillance programs--United States, 1996-2002","volume":"52","author":"Centers for Disease Control and Prevention (CDC)","year":"2003","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2024051613202153000_7.8.e015876.6","first-page":"875","article-title":"A report on a workshop on the National Institute for Occupational Safety and Health B reader certification program","volume":"34","author":"Attfield","year":"1992","journal-title":"J Occup Med"},{"key":"2024051613202153000_7.8.e015876.7","unstructured":"Specifications for Medical Examinations of Underground Coal Miners\". Title 42 Code of Federal Regulations, Pt. 37. 2014."},{"key":"2024051613202153000_7.8.e015876.8","unstructured":"National Institute for Occupational Safety and Health. Coal Workers' Health Surveillance Program (CWHSP) Data Query System. https:\/\/webappa.cdc.gov\/ords\/cwhsp-database.html (accessed 21 Nov 2016)."},{"key":"2024051613202153000_7.8.e015876.9","doi-asserted-by":"crossref","unstructured":"Halldin CN , Blackley DJ , Petsonk EL , et al . Pneumoconioses tadiographs in a large population of U.S. coal workers: variability in A Reader and B Reader classifications by using the International Labour Office classification. Radiology 2017:162437. 162437.doi:10.1148\/radiol.2017162437","DOI":"10.1148\/radiol.2017162437"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-015876","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T20:25:28Z","timestamp":1715891128000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-015876"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8]]},"references-count":9,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2017,8,11]]},"published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1136\/bmjopen-2017-015876"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-015876","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8]]}}}