Conversion to use of digital chest images for surveillance of coal workers' pneumoconiosis (black lung)

To protect the health of active U.S. underground coal miners, the National Institute for Occupational Safety and Health (NIOSH) has a mandate to carry out surveillance for coal workers' pneumoconiosis, commonly known as Black Lung (PHS 2001). This is accomplished by reviewing chest x-ray films obtained from miners at approximately 5-year intervals in approved x-ray acquisition facilities around the country. Currently, digital chest images are not accepted. Because most chest x-rays are now obtained in digital format, NIOSH is redesigning the surveillance program to accept and manage digital x-rays. This paper highlights the functional and security requirements for a digital image management system for a surveillance program. It also identifies the operational differences between a digital imaging surveillance network and a clinical Picture Archiving Communication Systems (PACS) or teleradiology system.