Explanation of Radiological Interpretations of Chest X-Rays in the USPHS Asbestos Studies (1966)

This document, labelled "Tentative 10/1/66", explained how readers would interpret chest X-ray films in U.S. Public Health Service (USPHS) asbestos chest studies. It was a set of reading instructions, not a study, and reported no subjects, results or conclusions. Films were to be classified using the USPHS modification of the ILO classification for small and large opacities. Changes that did not fit that scheme were to be called "alpha", a diffuse pattern of ill-defined shadows. Alpha was graded into categories 1 to 3 by the extent of chest involvement and the profusion of the lesions. "Y" was for films where an alpha pattern was suspected but not definite. "Z" covered several uncertain findings, such as nodulation too limited for category 1. Readers were also to note which part of the lung was mainly involved. They were to grade non-calcified pleural changes and pleural calcification as minimal, moderate or extensive. They were to mark an irregular ("shaggy") heart border when 25% or more of either heart border was irregular and poorly defined on the PA (posteroanterior) view. They were also to mark a honeycomb appearance.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

From J-M's medical library

This copy comes from the Johns-Manville medical library. It was among the papers J-M kept in its medical library without an index entry.

We publish this piece for research and commentary: it shows what the medical literature in a leading asbestos company's own library said on the subject, and when. Our summary above is our own reading of it. The copyright stays with the publisher.