 Despite well-known risks and mitigation efforts, occupational lung diseases such as the pneumoconioses continue to arise for a variety of reasons [4-11]. Medical imaging continues to play a critical role in the diagnosis and management of occupational lung disease, with increasing use of chest CT, particularly at reduced dose [12-14]. Various biomarkers in conjunction with medical imaging are proving to further refine assessment [15-20]. As in other areas of diffuse lung disease, multidisciplinary assessment consistently demonstrates improved characterization of occupational lung disease [21-28]. Special Imaging Considerations Imaging of emerging occupational lung diseases deserves special consideration. Imaging and pathologic manifestations may not be known in the setting of a new and unique exposure, potentially requiring a broader diagnostic evaluation than the variants discussed below [6,29-38]. Discussion of Procedures by Variant Variant 1: Occupational exposure, screening, and surveillance of lung disease. Initial imaging. Radiography Chest Driven by the International Labor Organization classification scheme for screening and surveillance of pneumoconioses, chest radiography remains an important imaging modality in the arena of occupational lung disease. Epidemiologic studies using radiographs to screen United States coal miners continue to demonstrate developing coal workers pneumoconiosis [9,11,39,40]. Screening and surveillance of various occupations with chest radiographs reveal ongoing and new lung disease risks [7,8,41,42]. Additionally, chest radiographs have demonstrated correlation with physiologic testing [43]. In 2011, the International Labor Organization criteria for radiograph acquisition have expanded to include digital radiography with flat-panel detector viewing [44]. More recent studies continue to support the equivalence of analog radiography and digital radiography [40,45-47].
Occupational Lung Diseases PCAs.  Despite well-known risks and mitigation efforts, occupational lung diseases such as the pneumoconioses continue to arise for a variety of reasons [4-11]. Medical imaging continues to play a critical role in the diagnosis and management of occupational lung disease, with increasing use of chest CT, particularly at reduced dose [12-14]. Various biomarkers in conjunction with medical imaging are proving to further refine assessment [15-20]. As in other areas of diffuse lung disease, multidisciplinary assessment consistently demonstrates improved characterization of occupational lung disease [21-28]. Special Imaging Considerations Imaging of emerging occupational lung diseases deserves special consideration. Imaging and pathologic manifestations may not be known in the setting of a new and unique exposure, potentially requiring a broader diagnostic evaluation than the variants discussed below [6,29-38]. Discussion of Procedures by Variant Variant 1: Occupational exposure, screening, and surveillance of lung disease. Initial imaging. Radiography Chest Driven by the International Labor Organization classification scheme for screening and surveillance of pneumoconioses, chest radiography remains an important imaging modality in the arena of occupational lung disease. Epidemiologic studies using radiographs to screen United States coal miners continue to demonstrate developing coal workers pneumoconiosis [9,11,39,40]. Screening and surveillance of various occupations with chest radiographs reveal ongoing and new lung disease risks [7,8,41,42]. Additionally, chest radiographs have demonstrated correlation with physiologic testing [43]. In 2011, the International Labor Organization criteria for radiograph acquisition have expanded to include digital radiography with flat-panel detector viewing [44]. More recent studies continue to support the equivalence of analog radiography and digital radiography [40,45-47].