transferring from his position to any position in any area of the mine where the concentration of respirable dust in the mine atmosphere is not more than 2.0 mg/m3 of air.

(b) Effective December 31, 1972, the option of transferring shall be to any area in the mine where the concentration of respirable dust in the mine atmosphere is not more than 1.0 mg/m3 of air, or, if such level is not attainable in such mine, to a position in the mine where the concentration is the lowest attainable below 2.0 mg/m3 of air.

(c) Any transfer under this section shall be for such period or periods as may be necessary to prevent further development of pneumoconiosis, and during such period or periods, the miner shall receive compensation for his work at not less than the regular rate of pay received by him immediately prior to his transfer.

SPECIFICATIONS FOR GIVING CHEST
ROENTGENOGRAMS

§ 37.20 General provisions.

(a) The chest roentgenographic examination shall be given in the locality in which the miner resides or in a location that is equivalent with respect to convenience of time and place. Examinations at the mine during, immediately preceding, or immediately following work and a "no-appointment" examination at a medical facility in a town easily accessible to a mining community or mining communities shall be considered of equivalent convenience for purposes of this section.

(b) The initial chest roentgenographic examination shall be supplemented by a completed miner's identification document (Form ECA-108) furnished by the U.S. Public Health Service.

(c) A roentgenographic examination shall be given by or under the supervision of a physician who regularly takes chest roentgenograms and who has demonstrated his ability to take high quality chest roentgenograms in accordance with section 37.21.

(d) Every chest roentgenogram shall (1) Be a posteroanterior view on a 14" x 17" or 14" x 14" film;

(2) Be taken with a diagnostic X-ray machine having a rotating anode tube;

(3) Have a broad range of contrast such as that which is produced by using 70-78 kV without grid or 110-145 kV with grid;

(4) Permit the study of pulmonary detail as well as an adequate viewing of the mediastinum; and

(5) Show the (i) date of exposure; (ii) hospital, clinic, or other facility where the roentgenogram was taken; and (iii) social security number of the miner. No other identifying information such as the miner's name or clinic number shall be recorded on the film.

(e) To ensure high quality chest roentgenograms: (1) the maximum exposure time shall not exceed 1/20 of a second; (2) minimum source to film distance shall not be less than 5 feet; and (3) medium speed film and medium speed intensifying screens shall be used.

(f) Upon notification by the Secretary that a film or group of films is not adequate for the purpose for which they were intended, the mine operator shall make provision for additional films or supplemental examinations as may be deemed necessary by the Secretary.

(g) No payment may be required of any miner in connection with any examination or test given to him under the Act. [35 F.R. 13206, Aug. 19, 1970, as amended at 36 F.R. 17577, Sept. 2, 1971]

§ 37.21

Ability to take high quality chest roentgenograms.

Ability to take high quality chest roentgenograms shall be demonstrated by submitting from the physician's files to the panel of radiologists, six sample chest roentgenograms which are of acceptable quality to the Panel. These shall have been taken within the last 12 months and shall identify the hospital, clinic, or other facility where each film was taken. These may be the same roentgenograms submitted pursuant to § 37.31(a) and will be returned to the physician.

§ 37.22 Protection against radiation emitted by roentgenographic equip

ment.

Fixed roentgenographic equipment, its use and the facilities in which such equipment is used, shall conform to the recommendations of the National Council on Radiation Protection and Measurements in NCRP Report No. 33 "Medical X-ray and Gamma-Ray Protection for Energies up to 10 MeV-Equipment Design and Use" (issued Feb. 1, 1968) which document is hereby incorporated by reference and made a part hereof. This document is available for examination at the Bureau, ALFORD, the Bureau of Occupational Safety and Health, 5600 Fish

ers Lane, Rockville, Md., and at the Public Health Service Information Center or Regional Office Information Centers as listed in 45 CFR 5.31. Copies of the document may be purchased for $1 each from NCRP Publications, Post Office Box 4867, Washington, D.C. 20008. An official historic file of NCRP Report No. 33 will be maintained at the Bureau of Occupational Safety and Health, 5600 Fishers Lane, Rockville, Md.

SPECIFICATIONS FOR READING, CLASSIFYING, AND SUBMITTING FILMS

§ 37.30 Reading and classifying chest roentgenograms.

(a) The interpretation of chest roentgenograms shall be classified in accordance with the ILO or UICC/Cincinnati Classification System and recorded on Form ECA-116.

(b) Reading and classification shall be performed only by a physician who regularly reads chest roentgenograms and who has demonstrated proficiency in the use of the ILO or UICC/Cincinnati Classification Systems in accordance with § 37.31.

§ 37.31

Proficiency in the use of the ILO or UICC/Cincinnati Classifications.

Proficiency in the use of the ILO or UICC/Cincinnati Classification Systems shall be demonstrated by either:

(a) Submitting from the physician's files six recent sample chest roentgenograms taken within the last 12 months to the panel of radiologists which are considered properly classified by the panel. The submission shall consist of two without pneumoconiosis, two with simple pneumoconiosis, and two with complicated pneumoconiosis and will be returned to the physician. (These may be the same roentgenograms submitted pursuant to § 37.21) or;

(b) Successful completion of a course approved by the Bureau in the ILO or UICC/Cincinnati Classification Systems. § 37.32 Submitting required chest roent

genograms.

All chest roentgenograms required to be taken under this part, together with their interpretations and the miner identification documents shall be submitted immediately after classification to ALFORD and become the property of the U.S. Public Health Service.

§ 37.33 Notification to miners of abnormal findings.

Findings or suspected findings of enlarged heart, tuberculosis, lung cancer, or any other significant abnormal findings other than pneumoconiosis shall be communicated by the physician reading and classifying the roentgenogram to the miner or new miner or to his designated physician, as indicated on the miner's identification document, and a copy of the communication shall be submitted to ALFORD.

NOTE: Guidelines for the selection of equipment and recommendations for the technique for obtaining high quality roentgenograms are available to any interested person. Requests should be directed to the Bureau of Occupational Safety and Health, 1014 Broadway, Cincinnati, Ohio 45202.

Subpart-Autopsies

AUTHORITY: The provisions of this Subpart issued under the authority of sec. 508, 83 Stat. 803; 30 U.S.C. 957.

SOURCE: The provisions of this Subpart appear at 36 F.R. 8870, May 14, 1971, unless otherwise noted.

The provisions of this subpart set forth the conditions under which the Secretary will pay pathologists to obtain results of autopsies performed by them on miners. § 37.201 Definitions.

As used in this subpart:

(a) "Secretary" means the Secretary of Health, Education, and Welfare.

(b) "Miner" means any individual who during his life was employed in any underground coal mine.

(c) "Pathologist" means (1) a physician certified in anatomic pathology or pathology by the American Board of Pathology or the American Osteopathic Board of Pathology, (2) a physician who possesses qualifications which are considered. "Board eligible" by the American Board of Pathology or American Osteopathic Board of Pathology, or (3) an intern, resident, or other physician in a training program in pathology who performs the autopsy under the supervision of a pathologist as defined in subparagraph (1) or (2) of this paragraph.

(d) "ALFORD" means the Appalachian Laboratory for Occupational Respiratory Diseases, Public Health Service, Department of Health, Education, and Welfare, Post Office Box 4257, Morgantown, WV 26505.

§ 37.202 Payment for autopsy.

(a) The Secretary will pay up to $200 to any pathologist who, after the effective date of the regulations in this part and with legal consent.

(1) Performs an autopsy on a miner and submits the findings and other materials to ALFORD in accordance with this subpart; and

(2) Receives no other specific payment, fee, or reimbursement in connection with the autopsy from the miner's widow, his family, his estate, or any other Federal agency.

(b) The Secretary will pay to any pathologist entitled to payment under paragraph (a) of this section and additional $10 if the pathologist can obtain and submits a good quality copy or original of a chest roentgenogram (posteroanterior view) made of the subject of the autopsy within 5 years prior to his death together with a copy of any interpretation made.

§ 37.203 Autopsy specifications.

(a) Every autopsy for which a claim for payment is submitted pursuant to this part:

(1) Shall be performed consistent with standard autopsy procedures such as those, for example, set forth in the "Autopsy Manual" prepared by the Armed Forces Institute of Pathology, July 1, 1960. (Technical Manual No. 8-300. NAVMED P-5065, Air Force Manual No. 160-19.) Copies of this document may be borrowed from ALFORD. (2) Shall include:

(i) Gross and microscopic examination of the lungs, pulmonary pleura, and tracheobronchial lymph nodes;

(ii) Weights of the heart and each lung (these and all other measurements required under sec. 37.203 (a) (2) shall be in the metric system);

(iii) Circumference of each cardiac valve when opened;

(iv) Thickness of right and left ventricles; these measurements shall be made perpendicular to the ventricular surface and shall not include trabeculations or pericardial fat. The rigrt ventricle shall be measured at a point midway between the tricuspid valve and the apex, and the left ventricle shall be measured directly above the insertion of the anterior papillary muscle;

(v) Size, number, consistency, location, description and other relevant details of all lesions of the lungs; (vi) Level of the diaphragm;

(vii) From each type of suspected pneumoconiotic lesion, representative microscopic slides stained with hematoxylin eosin or other appropriate stain, and one formalin fixed, paraffin-impregnated block of tissue; a minimum of three stained slides and three blocks of tissue shall be submitted. When no such lesion is recognized, similar material shall be submitted from three separate areas of the lungs selected at random; a minimum of three stained slides and three formalin fixed, paraffin-impregnated blocks of tissue shall be submitted. (b) Needle biopsy techniques shall not be used.

Every claim for payment under this subpart shall be submitted to ALFORD and shall include:

(a) An invoice (in duplicate) on the pathologist's letterhead or billhead indicating the date of autopsy, the amount of the claim and a signed statement that the pathologist is not receiving any other specific compensation for the autopsy from the miner's widow, his surviving next-of-kin, the estate of the miner, or any other source.

(b) Completed PHS Consent, Release and History Form (See Fig. 1). This form may be completed with the assistance of the pathologist, attending physician, family physician, or any other responsible person who can provide reliable information.

(c) Report of autopsy:

(1) The information, slides, and blocks of tissue required by this subpart.

(2) Clinical abstract of terminal illness and other data that the pathologist determines is relevant.

(3) Final summary, including final anatomical diagnoses, indicating presence or absence of simple and complicated pneumoconiosis, and correlation with clinical history if indicated.

thorize the performance of an autopsy (--------) on said de(Limitation, if any, on autopsy) ceased. I understand that the report and certain tissues as necessary will be released to the United States Public Health Service and to

(Name of Physician securing autopsy) I understand that any claims in regard to the deceased for which I may sign a general release of medical information will result in the release of the information from the Public Health Service. I further understand that I shall not make any payment for the autopsy.

Occupational and Medical History

1. Date of Birth of Deceased

(Month, Day, Year) 2. Social Security Number of Deceased

(City, County, State)

(Years)

4. Place of Last Mining Employment:

Name of Mine

Name of Mining Company

Mine Address

5. Last Job Title at Mine of Last Employment

(e.g., Continuous Miner Operator,
motorman, foreman, etc.)

(State)

Interviewer:

PART 51-GRANTS TO STATES FOR COMPREHENSIVE HEALTH PLANNING AND PUBLIC HEALTH SERVICES

Subpart A-Grants to States for Comprehensive

Sec.

51.1

51.2

51.3

Health Planning

Applicability.

Definitions.

Submission of State programs.

51.4 State program requirements.

51.109 Nondiscrimination

(Signature)

(Address)

(Date)

on account of race, color, or national origin. AUTHORITY: The provisions of this Part 51 issued under secs. 215, 314, 58 Stat. 690, as amended 80 Stat. 1181; 42 U.S.C. 216, 246. Subpart A-Grants to States for Comprehensive Health Planning

The regulations of this subpart apply to grants to assist the States, including the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Trust Territory of the Pacific Islands, in comprehensive and continuing planning for their current and future health needs in terms of health services, health manpower and health facilities, as authorized pursuant to section 314(a) of the Public Health Service Act, as amended, hereinafter referred to as the "Act."

[33 F.R. 13026, Sept. 14, 1968]

State agency pursuant to section 314(a) of the Act and the regulations of this subpart.

(b) "State agency" means the single State agency (which may be an interdepartmental agency) designated in the State program for administering or supervising the administration of the State's health planning functions under the State program.

(c) "Secretary" means the Secretary of Health, Education, and Welfare and any other officer or employee of the Department of Health, Education, and Welfare to whom the authority involved may be delegated.

[32 F.R. 10792, July 22, 1967, as amended at 33 F.R. 13026, Sept. 14, 1968]

§ 51.3 Submission of State programs.

In order to receive funds from an allotment under this subpart, a State must submit to and have approved by the Secretary, a State program which contains the information and meets the requirements specified in the Act and in the regulations of this subpart. Such program shall be submitted by the State agency officially designated and authorized to administer it and carry out the functions prescribed hereunder. The effective date for Federal financial participation in the costs of carrying out such a program from any State shall be that date, after the enactment of the first Federal appropriation act containing grant funds for the purposes authorized hereunder, on which the first State program submitted by the State is approved by the Secretary.

[32 F.R. 10792, July 22, 1967, as amended at 33 F.R. 13026, Sept. 14, 1968]

§ 51.4

State program requirements.

(a) Responsibility of State agency. The State program must provide that the State agency will either administer or supervise the administration of the activities to be carried out under it. In order to assure adequate supervision by the State agency of the administration of activities under the State program carried out by other agencies, institutions, organizations, or individuals, the State program must show with respect to any such activity that the State agency (1) is able to obtain from such other agency, institution, organization. or individual the data needed for formulation and evaluation of, and accountability for, planning activities; (2) has established methods for performing con

tinuing professional and administrative evaluations of such activities; and (3) is in a position to take such steps as may be necessary to assure that such activities meet Federal and State requirements.

(b) State health planning council. The State program must provide for the establishment of a State health planning council to advise the State agency in carrying out its functions under the approved State program. Council membership shall include representatives of State agencies (other than the designated State agency) and local agencies and of nongovernmental groups concerned with health services in the State. A majority of the council members must be consumer representatives whose major occupation is neither the administration of health activities nor the performance of health services. The council shall meet as often as necessary and at a minimum twice a year for the purposes of consulting with and advising the State agency with respect to:

(1) Scope of planning activities to be undertaken by the State agency;

(2) The recommendations to be made by the State agency as a result of such activities; and

(3) Necessary review and modifications of the State program.

(c) Expenditure of grant funds. The State program must set forth policies and procedures for the expenditure of funds under the program, which shall provide that:

(1) The scope of comprehensive planning will encompass the health services, facilities, and manpower to meet the physical, mental, and environmental health needs of the people of the State, and the financial and organizational resources through which these needs may be met;

(2) Such planning will be concerned with both publicly and privately supported health services and activities;

(3) A method for determining priorities of planning activity will be established to ensure that the most critical planning problems are scheduled for early attention;

(4) Methods will be established for obtaining and utilizing, in the formulation of planning priorities and recommendations, effective and appropriate informational support, including statistical data and, where feasible, social, economic, demographic, and similar base data consistent with those to be utilized for other