title: Changes in B-readings over time in the United States Navy Asbestos Medical Surveillance Program.
abstract: OBJECTIVE
  To study the impact of variability among B-readers on clinical occupational medicine.
  
  
  METHODS
  A total of 419,770 B-reading reports from February 1980 to May 2004 in the US Navy Asbestos Medical Surveillance Program were analyzed for changes in category from the previous B-reading on each individual worker.
  
  
  RESULTS
  Over 7% of films were categorized as worse (ie, read as going from negative to positive), and over 6% were categorized as better. When profusion categories were reported as different from the previous reading (over 6% of the time), they were more frequently read as 2 or more minor categories worse or better.
  
  
  CONCLUSIONS
  Changes from previous B-readings are common, and may have clinical and other implications, which are discussed. B-readings should not be used as the sole basis for determining the presence or absence of pneumoconiosis.
authors.affiliation: Navy Environmental Health Center, Military Sealift Fleet Support Command, Norfolk, VA 23708-2103, USA. mullerj@nehc.med.navy.mil
authors.forename: John G
authors.initials: JG
authors.lastname: Muller
authors.forename: W Garry
authors.initials: WG
authors.lastname: Rudolph
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Lieske
authors.forename: Jose E
authors.initials: JE
authors.lastname: Hernandez
authors.forename: Moore H
authors.initials: MH
authors.lastname: Jan
authors.forename: Gosia
authors.initials: G
authors.lastname: Kubiak
mesh_terms: D001194:Asbestos / Q000009:adverse effects / Q000592:standards; D001195:Asbestosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008400:Mass Chest X-Ray / Q000592:standards*; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data; D008886:Military Hygiene / Q000592:standards; D009326:Naval Medicine; D015588:Observer Variation; D016272:Occupational Health; D009786:Occupational Health Services; D011159:Population Surveillance / Q000379:methods*; D015203:Reproducibility of Results; D014481:United States
chemical_list: D001194:Asbestos