Sample Letter to the radiographic facility

Robert F Kennedy

ABC HOSPITAL

1808 SHERMAN DR

PRINCETON, IN 47670

Dear Robert F Kennedy

Congratulations! Your application to be an approved facility for the National Institute for Occupational Safety and Health (NIOSH), Coal Workers' Health Surveillance Program (CWHSP), under the Federal Mine Safety and Health Act of 1977, has been approved.

The CWHSP operates under the regulations set forth in 42 CFR Part 37. Those regulations contain the requirements, responsibilities, and procedures for approved NIOSH facilities and were effective on October 15, 2012. They can be found at: https://www.ecfr.gov/cgi-bin/text-idx?node=pt42.1.37. As a NIOSH approved facility, we ask that you pay particular attention to Section 37.40, “Specifications for Performing Chest Radiographic Examinations.” Under that Section, 37.41 deals with film radiographs and 37.42 deals with digital radiographs.

The consultant panel, who reviewed and evaluated the chest and step wedge radiographs for the unit(s) listed below, indicated that they were of satisfactory quality. Comments from the consultants are also enclosed.

^{Facility Number: 12004}

Unit #	Certified	Manufacturer	Model	Type	Room
001	11/08/2012	GE HEALTHCARE	PROTEUS XR/A SYSTEM	D	1
002	06/05/2024	Shimadzu	UD150B-40-UL	D	2

As a reminder, a completed radiograph examination for the CWHSP consists of the following items being sent to the CWHSP at the address shown above:

• Completed, signed Miner Identification Document (CDC/NIOSH 2.9)

• Single posteroanterior (PA) projection radiograph (see Section 37.42 in the Regs for specifications) *

Note:

* Digital radiographs must be sent using SAMS/PICOM Cloud. The digital radiograph should be identified with the name, birthdate, and patient identification number in the DICOM header.

** For each chest radiograph obtained at an approved facility using a digital radiography system, a qualified and licensed physician who reads chest radiographs in the normal course of practice must provide an initial clinical interpretation and notification of any significant abnormal findings other than pneumoconiosis. An A or B Reader is no longer required for the first interpretation of a digital radiograph at the facility site. This first interpretation will be considered a clinical reading only. Please pay particular attention to the Chest Radiograph Classification Form (CDC/NIOSH 2.8) section 4E, as providing the date the worker or the worker’s physician was notified of any significant abnormalities will satisfy Section 37.54 of the Regs - “A notice of the communication must be submitted to NIOSH.”

All forms can be downloaded from the CWHSP web site http://www.cdc.gov/niosh/topics/cwhsp/

Just a few reminders:

Miners must be completely disrobed from the waist up at the time the radiograph is taken. Please make sure all necklaces are removed, as well as any nipple rings. If the miner refuses to remove nipple rings, please make a note on the radiograph that nipple rings were present. Also, if the miner has long hair pulled back into a pony tail, please clip the pony tail to the top of their head, as additional bands along the pony tail can sometimes show up on the radiograph as an abnormal artifact.

Before the miner is advised that the examination is concluded and is allowed to leave, the radiograph must be processed and inspected and accepted for quality by the physician, or if the physician is not available, acceptance may be made by the radiologic technologist. In the case of a substandard radiograph, another must be immediately made. Substandard digital radiographs made of miners should be deleted and substandard film (analog) radiographs should be clearly marked and sent to us for destruction. You are also prohibited from creating copies of the radiographs.

There is a time limit of 14 days (Section 37.60) from the date of the radiograph to the time when the radiograph must be submitted to us. This time limit may be extended for radiographs made for a pre-employment physical examination. However, we are not permitted to accept any radiograph that is more than six months old. Pre-employment radiographs should not be submitted until the coal mine operator advises you that the miner has been hired. For these radiographs, please write "pre-employment" on the Miner Identification Document. Aside from pre-employment radiographs, please do not submit radiographs to the CWHSP for anyone who was not employed at an underground coal mine at the time of the examination.

Please note that under the regulations, contractors working at a coal mine site are included in the definition of a coal mine operator. When employees of an on-site contractor at a mine are examined, the name and identification number of the contractor must be included on the Miner Identification Document. Reimbursement for radiographs of contract employees is the responsibility of the contractor, not the mine operator.

In acquisition and submitting chest radiographs and the related information for miners, you must comply fully with 42 CFR Part 37, and all other applicable regulations. Confidentiality is of major importance. Please assure that miner examinations and reports are entirely confidential. Invoices for examinations, but no reports of the findings, should be sent to the operator or contractor. Our quality control procedures will include a verification of compliance with all regulations.

Our website (https://wwwn.cdc.gov/niosh-rhd/cwhsp/mineplans.asp) provides a listing of coal operators nationwide that have been notified by NIOSH of the requirement to provide chest radiographs to their employees. The listing includes the Mine Name, Mine Identification Code, Company Address, Mine Operator, Company Contact Person for the Plan, the Company Telephone Number, and the Date on which a new plan is required. You may wish to contact the coal companies listed in your area, advise them of the resources and availability of your approved facility, and encourage them to use your facility as the radiograph provider for their employees. We also have a website that provides a listing of all NIOSH-approved facilities (https://wwwn.cdc.gov/niosh-rhd/cwhsp/FacilityMap.aspx).

Thank you for your willingness to participate as a NIOSH approved facility in the CWHSP. Please contact us if we can be of further assistance or if you have any questions or comments.

Sincerely,

Tia McClelland

Program Manager

Coal Workers' Health Surveillance Activity

Respiratory Health Division

Enclosures