Abstract
The ILO (1980) Classification has been revised during recent years.
The new version is now available as the International Classification
of Radiographs of Pneumoconioses (Revised edition 2000). The Guidelines
booklet is currently available only in English. Those involved felt
it was important to maintain continuity with the ILO (1980) edition,
in particular to retain the standard radiographs, despite their restricted
quality, so as to ensure comparability with earlier national and
international data sets. The standard films illustrating pleural
abnormalities, and 'u'-shadows, have been modified and reconstituted.
The most important changes relate to assessment of film quality,
pleural abnormalities, and additional symbols. In Germany, film quality
is characterised as "+", "+-", "+--" and ü" according to whether
the ability to assess pneumoconiosis is judged to be unimpeachable
("+") to unusable (ü"). If a film is not classified as "+", then
written comments regarding defects are required. For "diffuse" pleural
thickening, the ILO (2000) edition now requires the presence also
of obliteration of the costophrenic angle. This was not required
in the earlier (1980) edition and, as previously, is also not stipulated
in the German version. A minimum width of 3 mm (previously 0-5 mm),
coded ä", is required both for plaques as well as for the margin
to the lateral chest wall. Congruence is thus achieved for criteria,
which, in German practice, lead to an indication of suspect occupational
disease. Plaques on the diaphragm are not considered for measurement
of extent; they are only coded as present or absent. If calcification
is identified, then this must also be classified and measured as
a localised plaque. Extent of calcification on its own, previously
coded "0" to "3", is no longer specified. The following new symbols,
illustrated by new diagrams, have been introduced: aa = atherosclerotic
aorta; at = apical thickening; cg = calcified granuloma (or other
non-pneumocononiotic nodules); me = mesothelioma (already previously
differentiated from "ca" on the German record sheet); pa = plate
atelectasis; pb= parenchymal bands; ra = rounded atelectasis; od
= other disease. (Examples of the latter are illustrated diagrammatically
by lobar pneumonia, aspergilloma, goiter and hiatal hernia.) Earlier
national differences (ILO 1980/German Federal Republic) on particular
issues have also been agreed among German "double-readers" "Zweitbeurteiler".
However, conformity between the original (ILO 2000) text and the
national (German) modified text has been retained in large measure.
The detailed descriptions of the standard films differ in certain
respects from the German (1980) definitions. Some revision of individual
descriptions of the films are proposed. Except for a few differences,
agreement was reached here too. The definitive date for the change
in Germany is expected to be in early 2004. The standard films are
already available now through ILO offices in Geneva or Bonn (addresses
in appendix.)
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