The ILO International Classification of Radiographs of Pneumoconioses Since 1980

Events preceding publication of the ILO's 1980 revision of the Pneumoconiosis Classification are summarized, and subsequent developments are reviewed. Four suggestions for modifications to the 1980 Classification are described: (a) a reduction in the number of standard films, from 22 to 14, by introducing more ‘quadrant’ standards; (b) changes in the description of how to classify pleural abnomalities, to enable separate recording of pleural plaques, diffuse pleural thickening, and costophrenic angle obliteration; (c) controlled trials to identify, and assess the utility of, ‘boundary standards’; and (d) a modification of the text to remove the requirement for an initial clinical judgement before using the Classification, regarding the presence of pneumoconiosis. All these ideas have been endorsed recently by a group of experts who have been consulting with the ILO about possible modifications to the Classification. The ILO is collaborating with those experts and the U.S. National Institute of Occupational Safety and Health in a trial of suggestion (a) for more quadrant standards.