Nogami et al investigated the diagnostic performance of digital radiography evaluated by Asian Intensive Reader of Pneumoconioses (AIR Pneumo) readers using thin-section computed tomography (CT) as the gold standard, which showed considerably good specificity for detecting both parenchymal and pleural abnormalities of occupational lung disease.1 Pneumoconiosis, occupational exposure of mineral dust induced irreversible lung disorder, is representative occupational diseases, and the number of pneumoconiosis cases increased by a measure of 66.0% from 36 186 in 1990 to 60 055 in 2017 globally.2 Among them, more than half of pneumoconiosis cases were observed in East Asia. Furthermore, lots of countries in Asia do not have sufficient surveillance and screening system of occupational respiratory diseases, and there are some enterprises which did not strictly follow regulation, standards, and technical guidelines on occupational health management.3 Therefore, many cases with occupational respiratory disease may be potential present. The movement to eliminate pneumoconiosis is in progress worldwide, and International Labour Organization (ILO) and World Health Organization (WHO) jointly promote pneumoconiosis screening and surveillance system using ILO Classification of Radiograph of Pneumoconioses (ILO/ ICRP).4,5 In Japan, Occupational Lung Disease Study Group in Japan Society for Occupational Health has established the AIR Pneumo to educate physicians in the world to improve proficiency in reading radiographs of pneumoconiosis with collaboration with ILO and the United States National Institute of Occupational Safety and Health (NIOSH).6 This education program system was originally started at 2006 as an international medical collaboration with the Government of Thailand in order to find and raise up experts for the diagnosis of pneumoconiosis in the country. The AIR Pneumo is superior educational curriculum for pneumoconiosis by certifying physicians with acceptable proficiency after assessing their detecting ability for abnormal opacities on the chest radiographs (CXR), such as small opacities (rounded and irregular), large opacities, and pleural abnormalities based on diagnosis of pneumoconiosis. The AIR Pneumo certification examination is comparable to NIOSH B reader certification.7 The AIR Pneumo provides the 3 days’ training course composed of view box seminar for two day on CXR reading and following half-day examination using 60 radiographs. The main content in seminar is short lectures of pneumoconiotic opacities and, hands-on observation of CXR on the view box, which allows participants to see the same image as in the clinical practice.8) The AIR Pneumo has been expanding its role as certification curriculum for a single country to one for ASEAN nations. This paper also scientifically proves that this educational activity of Air Pneumo could promote a physician's proficiency in classifying CXR of pneumoconiosis. The objective of this paper was whether or not the prevalence of occupational environmental pulmonary disease findings on low-dose thin-slice chest CT is evaluated, and to compare the diagnostic performance with CXR evaluated by AIR Pneumo-trained physicians. The abnormalities in low-dose thin-slice CT images of 97 male construction workers as reference were assessed by Japan Society for Occupational Health board-certified occupational health physician with expert of interpretation of image, NIOSH B reader certification and a Japan Radiological Society board-certified radiologist, and the consistency of the image findings was analyzed. The rates of parenchymal abnormal findings in CT in construction workers are 9.3% of irregular opacities, 1.0% of ground glass opacities, 18.6% of emphysema, 1.0% of honeycombing, 1.0% of lung cancer, and of them pleura are 45.4% of pleural plaque, and 6.2% of pleural calcification. Regarding that irregular opacities and pleural abnormalities, which is observed on CT image, are compatible with asbestos-related diseases, it is considered that the CXR taken at same day is suitable picture for the diagnosis of asbestosis. The abnormalities in CXR of male construction workers were assessed by four physicians composed to AIR Pneumo-trained physicians

中文翻译：

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日本职业性呼吸系统疾病诊断教育计划的进展-亚洲尘肺强化读物（AIR Pneumo）活动-

Nogami 等人使用薄层计算机断层扫描 (CT) 作为金标准，研究了由亚洲尘肺强化阅读器 (AIR Pneumo) 阅读器评估的数字 X 光片的诊断性能，该检查对检测职业性肺实质和胸膜异常表现出相当好的特异性。肺病。1 尘肺病是职业接触矿物粉尘引起的不可逆转的肺部疾病，是具有代表性的职业病，全球尘肺病例数从 1990 年的 36 186 例增加到 2017 年的 60 055 例，增幅为 66.0%。2 其中，超过一半的尘肺病例发生在东亚。此外，亚洲许多国家没有足够的职业性呼吸系统疾病监测和筛查系统，还有一些企业没有严格遵守职业健康管理的法规、标准和技术指南。3因此，可能存在许多职业性呼吸系统疾病病例。消除尘肺病的运动正在世界范围内进行，国际劳工组织 (ILO) 和世界卫生组织 (WHO) 联合推广使用 ILO 尘肺放射照相分类 (ILO/ICRP) 的尘肺病筛查和监测系统。4,5 在日本，日本职业健康学会职业性肺病研究小组与国际劳工组织和美国国家职业安全与健康研究所 (NIOSH) 合作，成立了 AIR Pneumo，旨在教育世界各地的医生提高阅读尘肺病 X 光片的能力。6 该教育计划系统最初于 2006 年启动，作为与泰国政府的国际医疗合作，旨在寻找和培养该国尘肺病诊断专家。AIR Pneumo 是尘肺病的高级教育课程，在评估医生对胸片 (CXR) 上异常混浊的检测能力，例如小混浊（圆形和不规则）、大混浊和基于诊断的胸膜异常后，对医生的熟练程度进行认证尘肺病。AIR Pneumo 认证考试可与 NIOSH B 阅读器认证相媲美。7 AIR Pneumo 提供为期 3 天的培训课程，包括为期两天的 CXR 阅读视窗研讨会和使用 60 张 X 光片的半天考试。研讨会的主要内容是尘肺混浊的简短讲座，以及在观察盒上动手观察 CXR，使参与者看到与临床实践中相同的图像。8) AIR Pneumo 一直在扩大其作为认证的作用单一国家的课程到东盟国家的课程。本文还科学地证明了Air Pneumo的本次教育活动可以提高医师对尘肺CXR分类的熟练程度。本文的目的是是否评估低剂量薄层胸部 CT 上职业环境肺病发现的患病率，并将诊断性能与受过 AIR Pneumo 培训的医生评估的 CXR 进行比较。97 名男性建筑工人的低剂量薄层 CT 图像异常作为参考，由日本职业健康委员会认证的具有图像解释专家、NIOSH B 读卡器认证和日本放射学会委员会认证的职业健康医师评估 -经认证的放射科医生，并对图像结果的一致性进行了分析。建筑工人CT的实质异常率为9.3%不规则混浊、磨玻璃混浊1.0%、肺气肿18.6%、蜂窝状1.0%、肺癌1.0%，其中胸膜占胸膜45.4%斑块和 6.2% 的胸膜钙化。关于CT图像上观察到的不规则混浊和胸膜异常与石棉相关疾病相容，认为当天的CXR适合诊断石棉沉着病。由 AIR Pneumo 训练有素的医生组成的四名医生评估男性建筑工人的 CXR 异常