The ILO 1980 classification has recently been revised. The new version is now available as the International Classification of Radiography of Pneumoconioses (revised edition 2000). The guidelines booklet is currently only available 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. The standard films for illustrating pleural abnormalities and “u“ shadows, have been modified. The most important changes relate to assessment of film quality, pleural abnormalities, and additional symbols. In Germany, film quality is characterised as “+, +/—, +/— —“ and “u“ according to whether it is judged to be irreproachable (“+“) or unusable (“u“) for the assessment of pneumoconiosis. 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 obliteration of the costophrenic angle. This was not required in the earlier edition and, as previously, is also not stipulated in the German version. A minimum width of 3 mm (previously 0—5 mm), coded “a“, is required both for plaques as well as for the margin to the lateral chest wall. Congruence with criteria which in German practice lead to the indication of a suspected occupational disease has thus been achieved. Plaques on the diaphragm are not considered in their 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. The 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-pneumoconiotic nodules); me = mesothelioma (already previously differentiated from “ca“ on the German record sheet); pa = plate atelectasis; pb = parenchymal bands; ra = rounded atelectasis; od = ther disease. (Examples of the latter are illustrated diagrammatically by lobar pneumonia, aspergilloma, goitre and hiatus hernia). Earlier national differences (ILO 1980/German Federal Republic) on particular issues have also been agreed among German “double readers“. However, conformity between the original (ILO 2000) text and the national (German) modified text has been retained to a large extent. 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. In most cases agreement has been reached here, too. The definitive date for the change in Germany is expected to be in early 2004. The standard films are already available through ILO offices in Geneva or Bonn (addresses in the Appendix).
