Occupational Imaging
Broken Hill Radiology provides occupational imaging services to support the assessment and monitoring of workers who may be exposed to dust and other occupational respiratory hazards.
Our occupational imaging services include ILO Chest X-rays and High-Resolution CT (HRCT), with imaging performed to appropriate clinical and occupational health requirements.
ILO Chest X-rays
An ILO Chest X-ray is a specialised chest X-ray used to assess and monitor workers exposed to respirable dust in the workplace.
The International Labour Organization (ILO) has developed a standardised system for describing and classifying changes seen on chest X-rays where pneumoconiosis may be present. Pneumoconiosis is a group of occupational lung diseases caused by breathing in certain types of dust over time.
ILO Chest X-rays may form part of occupational health surveillance for workers with current or previous exposure to substances such as:
- Silica or silica-containing dust
- Coal dust
- Asbestos
- Mining and quarrying dust
- Construction dust
- Engineered stone dust
- Other potentially harmful airborne particulates
The standardised ILO classification allows appropriately trained medical practitioners to consistently identify and record radiographic changes that may be associated with occupational lung disease.
An ILO Chest X-ray does not, by itself, confirm a diagnosis of pneumoconiosis. The results are considered alongside factors such as the worker's occupational exposure history, symptoms, lung function tests, and, where appropriate, other imaging such as High-Resolution CT (HRCT).
Frequently Asked Questions About ILO Chest X-rays
What is the difference between an ILO Chest X-ray and a standard chest X-ray?
The X-ray is taken similarly to a conventional chest X-ray. The main difference is how the images are assessed and reported.
An ILO Chest X-ray is reviewed according to the International Labour Organization's standardised classification system for radiographic changes associated with pneumoconiosis. This provides a consistent way to record abnormalities that may be associated with occupational dust exposure.
Why might I need an ILO Chest X-ray?
You may be referred for an ILO Chest X-ray as part of workplace health surveillance if you currently work, or previously worked, in an occupation involving exposure to potentially harmful dust.
It may also be requested where there are concerns about occupational lung disease or as part of ongoing monitoring following previous workplace exposure.
Can an ILO Chest X-ray diagnose silicosis or other occupational lung diseases?
An ILO Chest X-ray can identify and classify changes that may be associated with silicosis and other forms of pneumoconiosis, but the X-ray alone does not necessarily establish a diagnosis.
Your doctor or occupational health practitioner will consider the imaging findings together with your exposure history, symptoms, clinical examination and other investigations.
Further testing, including lung function testing or an HRCT scan, may sometimes be recommended.
How do I prepare for an ILO Chest X-ray?
Usually, no special preparation is required.
You may be asked to remove jewellery, clothing or other objects containing metal from the chest area because they can interfere with the X-ray image. You may also be asked to change into a gown.
Tell the radiographer before your examination if you are pregnant or think you may be pregnant.
What happens during an ILO Chest X-ray?
You will usually stand upright with your chest positioned against the X-ray detector.
The radiographer will position you carefully and ask you to take a deep breath and hold your breath briefly while the image is taken.
Remaining still helps produce a clear image suitable for assessment.
The imaging itself generally takes only a few minutes.
What happens if my ILO Chest X-ray shows an abnormality?
An abnormal ILO Chest X-ray does not automatically mean that you have an occupational lung disease.
Your doctor or occupational health practitioner will review the results in the context of your occupational exposure and medical history. Depending on the findings, further assessment may include respiratory function testing, specialist medical review or HRCT imaging of the lungs.
High-Resolution CT (HRCT)
High-Resolution Computed Tomography, commonly called HRCT, is a specialised CT imaging technique that produces highly detailed cross-sectional images of the lungs.
HRCT provides much more detail of lung tissue than a standard chest X-ray and can show changes that may be difficult or impossible to identify on plain X-rays.
It can provide detailed images of the small airways, air sacs and supporting tissues of the lungs and may be particularly helpful when interstitial or occupational lung disease is suspected.
HRCT may be requested when:
- Occupational lung disease is suspected
- A chest X-ray shows an abnormality requiring further investigation
- Symptoms or lung function tests raise concerns despite a normal or inconclusive chest X-ray
- The extent or pattern of an established lung condition needs to be assessed
- Changes in known lung disease need to be monitored
HRCT may assist in assessing conditions associated with occupational exposure, including:
- Silicosis
- Asbestosis
- Coal workers' pneumoconiosis
- Other forms of pneumoconiosis
- Interstitial lung disease
- Pulmonary fibrosis
- Pleural thickening or other pleural abnormalities associated with asbestos exposure
- Some diseases affecting the small airways
The appearance and distribution of abnormalities on HRCT can provide valuable information to the doctor assessing possible occupational lung disease.
Frequently Asked Questions About HRCT
What is the difference between HRCT and a standard chest CT?
HRCT is a CT technique specifically designed to provide very detailed images of the lung tissue.
Thin-section images and specialised image reconstruction techniques allow the radiologist to examine the fine structure of the lungs in greater detail than is generally possible with a routine chest X-ray and may provide additional information compared with a standard CT protocol.
Depending on the reason for the examination, images may also be obtained while you are lying in different positions or while breathing in or out.
Why would I need an HRCT if I have already had a chest X-ray?
Chest X-rays provide an important overview of the lungs but cannot show the same level of detail as an HRCT.
Some early, subtle or complex lung abnormalities may not be clearly visible on a chest X-ray. If your symptoms, occupational exposure history, lung function results, or chest X-ray suggest further investigation is needed, your doctor may recommend HRCT.
Does an HRCT require an injection or contrast?
A dedicated HRCT examination of the lungs is usually performed without intravenous contrast.
However, CT protocols can vary depending on what your doctor is investigating. If additional conditions need to be assessed, a different CT examination or contrast may occasionally be required.
The imaging practice will provide specific instructions for your examination.
What happens during an HRCT?
You will lie on a table that moves through the CT scanner.
The scanner takes multiple X-ray images from different angles, which a computer processes to produce highly detailed images of your lungs.
You will need to remain still and will usually be asked to hold your breath for short periods while images are taken.
Depending on the clinical question, additional images may be taken while you lie on your back or stomach, or while you breathe in or out.
How long does an HRCT take?
The scanning component is generally quick and may take about 5 to 10 minutes.
Your overall appointment may be longer to allow for registration, preparation, positioning and checking the images before you leave.
Is HRCT safe?
HRCT uses X-rays and therefore involves exposure to ionising radiation. Your doctor will recommend the examination when the expected diagnostic benefit outweighs the potential radiation risk.
Modern CT equipment and imaging protocols are designed to obtain the required diagnostic information while keeping radiation exposure as low as reasonably achievable.
Tell your doctor and the imaging staff if you are pregnant or think you may be pregnant before having a CT examination.
Can HRCT diagnose silicosis or asbestosis?
HRCT can show patterns of lung and pleural abnormalities that may strongly suggest conditions such as silicosis or asbestosis and can help assess their extent.
However, imaging findings are not considered in isolation. A diagnosis is generally based on the combination of imaging, occupational exposure history, symptoms, clinical findings and investigations such as lung function testing.
What happens after my HRCT?
There are generally no special restrictions following an HRCT performed without contrast, and you can normally return to your usual activities immediately.
A radiologist will interpret the images and prepare a report for your referring doctor or occupational health practitioner. They will discuss the results with you and advise whether any further assessment, monitoring or treatment is required.
Who May Require Occupational Imaging?
Occupational imaging may be requested for people who currently work, or have previously worked, in industries where exposure to respirable dust is a recognised risk.
This can include workers in mining, quarrying, construction, demolition, tunnelling, manufacturing and other dust-generating industries.
Imaging may be undertaken as part of workplace health surveillance, investigation of respiratory symptoms or follow-up of previously identified abnormalities.
Referrals and Appointments
The type of imaging required will depend on the worker's occupational history, exposure and the requirements of the referring practitioner or occupational health program.
Please bring your imaging request and any relevant previous chest X-rays, CT scans or reports to your appointment if these are not already available to Broken Hill Radiology.
