NIOSH B Reader Training and Examination

Earn up to 20.5 AMA PRA Category 1 Credits

NIOSH B Reader Training and Examination

This three-day course is designed to provide practicing physicians with the skills needed to sit for the National Institute for Occupational Safety and Health (NIOSH) B Reader Certification Examination. During the program, participants will receive lectures on the imaging features of pneumoconiosis and the International Labor Organization (ILO) classification system for chest radiographs interspersed with hands-on classification of chest radiographs from an enriched set of cases. Faculty will provide direct supervision and assistance. On the third day of the course, attendees will have the opportunity to sit for the NIOSH B Reader Certification Examination.

Course Materials
Access Course Materials

If you have registered for an upcoming NIOSH B Reader Training and Examination course or completed a course, access the course materials. 

Target Audience

Physicians interested in becoming NIOSH certified B readers or current B readers interested in updating their practice. A valid U.S. medical license is required to sit for the examination.

View the B Reader Physician Application for Certification »

Project Background/Practice Gap


Pneumoconiosis is a progressive and irreversible interstitial lung disease caused by inhaling respirable mineral dusts, most typically in occupational settings. Pneumoconiosis can be identified by evaluating changes on chest radiographs. The National Institute for Occupational Safety and Health (NIOSH) is required by the Federal Mine Safety and Health Act of 1977 [Pub. L. 91–173; Approved Dec. 30, 1969; 83 Stat. 742] to carry out a national program of health surveillance for coal miners, including periodic chest radiography to identify pneumoconiosis (specifically coal workers’ pneumoconiosis, also known as Black Lung). As part of this surveillance, chest radiographs must be classified for the presence and severity of appearances of pneumoconiosis according to the Guidelines for the Use of the International Labour Office (ILO) International Classification of Radiographs of Pneumoconioses. The ability to use the ILO classification system is a highly specialized skill and most physicians are unfamiliar with the system. Thus, in order to carry out its surveillance responsibilities, NIOSH has developed regulations to maintain a pool of physicians “who have demonstrated ongoing proficiency . . . in classifying the pneumoconioses" using the ILO system (42 CFR 37).

To establish this pool and evaluate the proficiency of readers’ use of the ILO system in an ongoing manner, NIOSH developed the B Reader Program in 1974. The B Reader Program maintains a self-study syllabus which helps physicians learn about classification of radiographs of pneumoconiosis according to the ILO system. The B Reader program also administers a certification examination evaluating the ability to classify chest radiographs using the ILO classification system. In order to become a B Reader, a licensed physician must successfully pass the B Reader Certification Examination. In order to maintain certification, B Readers must be recertified by passing periodic re-examinations every 4 years. Physician test candidates can prepare for examinations by reviewing the self-study syllabus material or by attending a B Reader Course. In the past, there has been a history of NIOSH working with the American College of Radiology (ACR) to put on such courses. Also, NIOSH occasionally teaches a course at the NIOSH facility in Morgantown or at external sites at the request of stakeholders. However, due to personnel and resource constraints, NIOSH is very limited in its ability to provide such courses on its own.

Demand for B Readers has increased over the years. Since the B Reader Program was developed in the 1970s, several other federal and state medical monitoring and disability compensation programs have instituted the requirement for using physicians familiar with the ILO system or are certified B Readers to classify radiographs for the presence and severity of findings of pneumoconiosis (Standards for Determining Coal Miners’ Total Disability or Death Due To Pneumoconiosis [20 CFR 718]; Occupational Safety and Health Standards General Industry[Respirable Crystalline Silica] [29 CFR 1910.1053] and Construction [29 CFR 1926.1153]; Occupational Safety and Health Standards for Asbestos in General Industry [Subpart Z of 29 CFR 1910.1001], Shipyard Employment [Subpart Z of 29 CFR 1915.1001], and Construction [Subpart Z of 29 CFR 1926.1101]). B Readers may classify chest radiographs in other workplace settings where monitoring of workers for interstitial lung disease is needed, or in support of public health research studies. Additionally, the opinions of B Readers regarding the presence and severity of chest radiographic findings are often considered in compensation cases and other administrative and legal proceedings.

Over the past 10 years, NIOSH, with the help of partners, has worked to modernize B Reader training and testing material to include modern, digitally-acquired chest radiographs instead of older film-based chest radiographs. Additionally, implementation of the silica standard noted above has increased the demand for B Readers. Over the same time period, the population of B Readers has decreased from nearly 400 in the mid-2000s, to 165 today. Also, the average age of the remaining B Readers has progressively increased to an average of more than 60 years old. To address increased demand, remedy attrition, and bring on a new generation of B Readers, NIOSH requires the assistance of stakeholders to conduct outreach to the appropriate physician populations, make training more widely available, and offer increased accessibility to examination opportunities.

Program and Learning Objectives

At the conclusion of this course, participants will be able to:

  • Describe the radiographic findings of pneumoconiosis including small and large lung opacities and pleural disease
  • Use the ILO system to classify chest radiographs for pneumoconiosis
  • Recognize digital radiography artifacts and their impact on radiograph interpretation
  • State medicolegal and regulatory components of the B reading program
  • Possess knowledge to sit for the NIOSH B Reader Certification Examination

Accreditation Information

Accreditation Statement: The American College of Radiology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement: The American College of Radiology designates this live activity for a maximum of 20.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Accredited CME Activity that includes Evaluation of the Learner with Feedback: This activity includes evaluation of the learner with feedback for American Board of Radiology diplomates not completing their OLA annual progress requirement.

Maintenance of Certification Royal College of Physicians and Surgeons of Canada:  Through an agreement between the American College of Radiology and the Royal College of Physicians and Surgeons of Canada, MOC Program Participants may record self-assessment programs or simulation activities developed and accredited by the American College of Radiology in Section 3 of the Royal College's MOC Program.

For questions about the accreditation of this activity, please contact

 7 am  Workstation Introduction
 8 am  Introduction to the NIOSH B Reader Program
 8:30 am  Imaging of Coal Worker’s Pneumoconiosis and Silicosis
 9 am  Imaging of Asbestos-Related Lung and Pleural Disease
 9:30 am  ILO classification - Parenchymal Opacities
 10 am  Break
 10:15 am  ILO classification – Pleural Abnormalities
 10:45 am  ILO classification – Obligatory Symbols
 11:15 am  NIOSH B Reading Form
 11:30 am  Supervised Case Review
 12 noon  Lunch
 12:30 pm  Supervised Case Review
 2:45 pm  Break
 3 pm  Supervised Case Review
 5:30 pm  Break
 6 pm  Optional Time for Self-Review of Cases
 8 pm  ACR Education Center Closes
 7 am  Optional Time for Self-Review of Cases
 8 am  Quality and Digital Radiography Artifacts
 8:30 am  Supervised Case Review
 10 am  Break
 10:15 am  Supervised Case Review
 11:30 am  Medicolegal and Regulatory Considerations
 12 noon  Lunch
 12:30 pm  Incorporating B Reading into your Practice
 1 pm  Supervised Case Review
 3 pm  Break
 3:15 pm  Optional Time for Self-Review of Cases
 5 pm  ACR Education Center Closes
8 am

NIOSH B Reading Certification Examination

 2 pm Exam Concludes

Course Co-Directors

Jeffrey Kanne, MD, FACR, FCCP

University of Wisconsin-Madison

Cristopher Meyer, MD, FACR

University of Wisconsin-Madison


Americans with Disabilities Act

The ACR encourages the participation of all people. Individuals requiring auxiliary aids or services identified in the Americans with Disabilities Act should contact our Meeting Services team at


For each course, ACR works diligently to reserve the accommodations we need for our attendees. The hotel we choose is a safe, reputable, and centrally located property. The rates at the hotel are negotiated on behalf of attendees to be lower, more equitable, and more predictable over time than the regular rates offered to the public.


Westin Reston Heights
11750 Sunrise Valley Drive
Reston, VA 20191

Room Rate: $119 - $159/night for single/double + taxes and fees 

Reservation deadline: Fourteen (14) days prior to each course.

Deposit: First room night deposit or guarantee with a major credit card.

Cancellation: Please notify the hotel at least 24 hours before arrival.

Rooms are available at the rates listed on a first-come, first-served basis. Reservations made after the reservation deadline for each course will be accepted on a space-available basis.

If you have trouble receiving the ACR Education Center rate using the link, please contact ACR Meeting Services at



Reservation Link

 Mini Hotel Code

 Reston, VA  June 12 - 14, 2024 Book Hotel  NB6 

Air Transportation

The Westin Reston Heights is located just 10 minutes from Dulles International Airport (IAD) and Ronald Reagan National Airport (DCA) is approximately 40 minutes from the hotel.

If you need assistance booking your flight, please contact Corporate Travel Planners (CTP Travel) at 1.888.317.7814. A travel agency fee will apply to all reservations.

Ground Transportation

The new Silver Line Metro Station at Wiehle-Reston East is just a few minutes from the ACR Education Center and connects Reston to Tysons Corner, Washington, DC, and the greater DC metro area.

Complimentary daily shuttle bus service will be provided between the Westin Reston Heights and the ACR Education Center for all registrants.


Depart Westin

Arrive ACR Ed Center

Depart ACR Ed Center

Arrive Westin

Depart ACR Ed Center for IAD

Day 1 6:50am 7am
Day 1 7am 7:10am
Day 1 7:20am 7:30am
Day 1 7:40am 7:50am
Day 1 8am 8:10am
Day 1 8:20am 8:30am
Day 1 5:30pm 5:45pm
Day 1 6pm 6:15pm
Day 1 6:30pm 6:45pm
Day 1 7pm 7:15pm
Day 1 7:30pm 7:45pm
Day 1 8pm 8:15pm
Day 2 6:50am 7am
Day 2 7am 7:10am
Day 2 7:20am 7:30am
Day 2 7:40am 7:50am
Day 2 8am 8:10am
Day 2 8:20am 8:30am
Day 2 3pm 3:15pm
Day 2 3:30pm 3:45pm
Day 2 4pm 4:15pm
Day 2 4:30pm 4:45pm
Day 2 5pm 5:15pm
Day 3 7:20am 7:30am
Day 3 7:35am 7:45am
Day 3 7:50am 8am
Day 3 12:30pm
Day 3 1:15pm
Day 3 2pm