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The ILO International Classification of Radiographs of Pneumoconioses is a system of Since , the ILO has periodically published guidelines on how to classify chest X-rays for pneumoconiosis. The purpose of the Classification was to. ILO Classification The International Labour Organization (ILO) is a specialized agency of the Radiograph showing Simple Coal Workers’ Pneumoconiosis. The object of the classification is to codify the radiographic . defect likely to impair classification of the radiograph of pneumoconiosis. 3, Poor.

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ILO Classification

Despite all the national and international energies devoted to their prevention, pneumoconioses are still very present both in industrialized and developing countries, and are responsible for the disability and impairment of many workers. This is why the International Labour Office ILOthe World Health Organization WHO and many national institutes for occupational health and safety continue their fight against these diseases and to propose sustainable programmes for preventing them.

Part of this programme is based on medical surveillance which includes the reading of thoracic raviographs to help diagnose this pneumoconiosis. This is one example which explains why the ILO, in cooperation with many experts, has developed and updated on a continuous basis a classification of radiographs of pneumoconioses that provides a means for recording systematically the radiographic abnormalities in the chest provoked by the inhalation of dust.

The scheme is designed for classifying the appearances of posterio-anterior chest radiographs. The object of the classification is to codify the radiographic abnormalities of pneumoconioses in a simple, reproducible manner. The classification does not define pathological entities, nor take into fo working capacity. The classification does not imply legal definitions of pneumoconioses for compensation purposes, nor imply a level at which compensation is payable.

Nevertheless, the classification has been found to have wider uses than anticipated. It is now extensively used internationally for epidemiological research, for the surveillance of those industry occupations and for clinical purposes. Use clxssification the scheme may lead to better international comparability of pneumoconioses statistics. It is also used for describing and recording, in a systematic way, part of the information needed for assessing compensation.

The most important condition for using this system of classification with full value from radiogdaphs scientific and ethical point of view is to read, at all times, films to be classified by systematically referring to the 22 standard films provided pnwumoconiosis the ILO International Classification set of standard films.

If the reader attempts to classify a film without referring to any of the standard films, then no mention of reading according to the Pneumoconiozis International Classification of Radiographs should be made. The possibility of deviating from the classification pneumpconiosis over or under reading is so risky that rxdiographs or her reading should not be used at least forr epidemiological research or international comparability of pneumoconioses statistics.

The first classification was proposed for silicosis at the Pnemoconiosis International Conference of Experts on Pneumoconioses, held in Johannesburg in It combined both radiographic appearances and impairment of lung functions. Ina new classification based purely on radiographic changes was established Geneva classification Since, it has been revised several times, the last time inalways with the objective of providing improved versions to be extensively used for clinical and epidemiological purposes.


Each new version of the classification promoted by the ILO has brought modifications and changes based on international experience gained in the use of earlier classifications.

The description of standard radiographs is given in table 1. The summary of the classification is given in vor 2. It retained the principle of former classifications and Summary of details of classification.

The Classification is based on a set of standard radiographs, a written text and a set of notes OHS No.

There are no features to be seen in a chest radiograph which are pathognomonic of dust exposure. The essential principle is that all appearances which are consistent with those defined and represented in the standard radiographs and the guideline for the use of the ILO International Classification, are to be classified. If the reader believes that any appearance is probably or definitively not dust related, the radiograph should not be classified but an appropriate comment must be added.

The 22 standard radiographs have been selected after international trials, in such a way as to illustrate the mid-categories standards of profusion of small opacities and to give examples of category A, B and C standards for large opacities.

Pleural abnormalities diffuse pleural thickening, plaques and obliteration of costophrenic angle are also illustrated on different radiographs. Discussion in particular at the Seventh International Pneumoconioses Conference, held in Pittsburgh inindicated the need for improvement of some parts of the classification, in particular those concerning pleural changes.


The experts made the suggestion that the short classification is of no advantage and can be deleted. As regards pleural abnormalities, the group agreed that this classification would classificatioon be divided into three parts: Diffuse pleural thickening might be divided into chest wall and diaphragm.

They were identified according to the six zones—upper, pneumooconiosis and lower, of both right and left lungs. If a pleural thickening is circumscribed, it could be identified as a plaque.

All plaques should be measured in centimetres.

ILO Classification – Wikipedia

The obliteration of the costophrenic angle should be systematically noted whether it exists or not. It is important to identify whether the costophrenic angle is visible or not. This is because of its special importance in relation to pleural diffuse thickening. Whether plaques are classified or not should be merely indicated by a symbol. The flattening of the diaphragm should be recorded by an additional symbol since it is a very important feature in asbestos exposure.

ILO International Classification of Radiographs of Pneumoconioses (digital format)

A full description of the classification, including its applications and limitation is found in the publication ILO The revision of the classification of radiographs is a continuous ILO process, and a revised guideline should be published in the near future taking into account the recommendations of these experts. Monday, 28 February Rate this item 1 2 3 4 5 0 votes. Rheumatoid pneumoconiosis in left lower zone.

The small opacities are difficult to classify because of the presence of the large opacities. Note the left costophrenic angle obliteration. Categories 1, 2 and 3—increasing profusion of small opacities as defined by the corresponding standard radiographs. The category of profusion is determined by considering the profusion as a whole over the affected zones of the lung and by comparing this with the standard radiographs.

Three sizes are defined by the appearances on standard radiographs: The presence of a significant number of another shape and size is recorded after the oblique stroke. Category B — one or more opacities larger or more numerous than those in category A whose combined area does not exceed the equivalent of the right upper zone.

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Category C — one or more opacities whose combined area exceeds the equivalent of the right upper zone.

The maximum width usually occurs at the inner margin of the rib shadow at its outermost point. If pleural thickening is seen face-on only, width cannot usually be measured. Read times Last modified on Tuesday, 11 October More in this category: The Body Part II. Tools and Approaches Part V. Vascular pattern is well illustrated.

Also shows vascular pattern, but not as clearly as example 1. Profusion of small opacities is more marked in right lung. The heart shadow is slightly displaced to the left. Kerley lines in lower right zone. Emphysema in upper zones.

Honeycomb lung appearance is not marked. This radiograph defines the lower limit for costophrenic angle obliteration. Note shrinkage in lower lung fields. Pleural thickening is present in the apices of the lung. Definition of pleura is slightly imperfect. The pleural thickening present face on, is of indeterminate width, and extent 2. The pleural thickening present in profile, is of width a, and extent 2. Not associated small calcifications.

Circumscribed, calcified pleural thickening of extent 2. Calcified and uncalcified pleural thickening present face on, is of indeterminate width, and extent 2. Acceptable, with no technical defect likely to impair classification of the radiograph of pneumoconiosis. Poor, with some technical defect but still acceptable for classification purposes. The category of profusion is based on assessment of the concentration of opacities by comparison with the standard radiographs.

Category O—small opacities absent or less profuse than the lower limit of category 1. The zones in which the opacities are seen are recorded.

The letters p, q and r denote the presence of small, rounded opacities. The letters s, t and u denote the presence of small, irregular opacities. For mixed shapes or sizes of small opacities, the predominant shape and size is recorded first.

The categories are defined in terms of the dimensions of the opacities. Two types of pleural thickening of the chest wall are recognized: Both types may occur together. Pleural thickening of the chest wall is recorded separately for the right R and left L thorax. For pleural thickening seen along the lateral chest wall the measurement of maximum width is made from the inner line of the chest wall to the inner margin of the shadow seen most sharply at the parenchymal-pleural boundary.

The presence of pleural thickening seen face-on is recorded even if it can be seen also in profile. Extent of pleural thickening is defined in terms of the maximum length of pleural involvement, or as the sum of maximum lengths, whether seen in profile or face-on. A plaque involving the diaphragmatic pleura is recorded as present Y or absent Nseparately for the right R and left L thorax.

The presence Y or absence N of costophrenic angle obliteration is recorded separately from thickening over other areas, for the right R and left L thorax. The lower limit for this obliteration is defined by a standard radiograph. If the thickening extends up the chest wall, then both costophrenic angle obliteration and pleural thickening should be recorded. The site and extent of pleural calcification are recorded separately for the two lungs, and the extent defined in terms of dimensions.

Coalescence of small pneumoconiotic opacities.