Workplace Chest X-Ray (PA Radiography)
What Is a Chest X-Ray and Why Is It Performed
PA chest radiography is the standard chest X-ray in which the beam enters through the patient’s back and exits through the front surface of the chest (in the posteroanterior direction). It is listed among the medical examinations performed as part of respiratory system screening within the health surveillance of workers (Art.5/4-a). The aim is to monitor respiratory system findings that may develop due to agents present in the working environment.
Technical Standards and DICOM Format
The regulation stipulates specific technical requirements for the device used in taking chest radiographs and for the output format (Art.9/2). It is essential that the X-ray device be integrated into the Ministry of Health information systems, that the image be obtained using digital techniques, and that it be delivered in a digital medium.
| Criterion | Requirement in the Legislation |
|---|---|
| Device integration | The X-ray device is integrated into the Ministry of Health information systems |
| Imaging technique | Computed radiography (CR) or digital radiography (DR) |
| Delivery format | DICOM format in a digital medium |
| Quality standard | International Labour Organization (ILO) quality and standards (Art.9/3) |
These requirements cover the taking of all PA chest radiographs in compliance with ILO quality and standards (Art.9/3).
Pneumoconiosis Evaluation and the ILO Classification
An additional evaluation method is defined for the chest radiographs of workers exposed to dusts that cause pneumoconiosis. These radiographs are read according to the current guideline of the ILO International Classification of Radiographs of Pneumoconioses, and the evaluation is performed by readers authorized by the Ministry of Labour and Social Security. This provision aims to monitor dust-related occupational diseases using an internationally recognized classification criterion.
Examination Location: Fixed Facility and Mobile Vehicle
Chest radiography may be taken in a fixed facility as well as in a mobile occupational health vehicle (Art.7). For X-ray imaging to be performed inside a mobile vehicle, a license from the Nuclear Regulatory Authority (NDK) is required. In this way, the authorization requirement regarding radiation safety applies to both fixed and mobile services.