Evaluating lung X-rays and pulmonary function tests

February 4, 1985
Mr. Milan Racic
Health and Safety Director
Allied Industrial Workers of America
[Recipient address omitted]
Dear Mr. Racic:
Your letter to Assistant Secretary Rowland dated December 12, 1984, recommending a field Instruction addressing the evaluation of X-rays and pulmonary function tests and relaying information to employees was forwarded to the Directorate of Technical Support for response. We apologize for the delay in responding.
As you know, and as Dr. Selikoff states in his letter to you, B-readers are an asset because they have been trained to interpret X-rays but there are many proficient physicians in the field who are not certified B-readers and nevertheless well qualified to evaluate pneumoconiosis. It would be difficult to set guidelines which would allow employers and employees to select physicians with such expertise.
Furthermore, asking employees to live with a diagnosis of lung "change" on X-rays or an altered pulmonary function test which reflects a decrement due to aging or smoking, may be contrary to the interests of the employee who may be deprived of a full life and wholesome employment for the wrong reasons.
The questions you raise are complex but will be given our full attention and we will explore the possibility of meeting your concerns, namely, early diagnosis of lung disease directly attributable to an occupational hazard.
Thank you for your continuing interest in occupational safety and health.
Sincerely,
Edward J. Baier
Director
Directorate of Technical Support

[Requester letter reproduced on OSHA page; omitted here.]