within which the operator may provide examinations to its miners employed at its coal mine. The period shall begin no sooner than 32 years and end no later than 41⁄2 years subsequent to the ending date of the previous 6-month period specified for a coal mine either by the operator on an approved plan or by ALOSH if the operator did not submit an approved plan. Within the period specified by ALOSH for each mine, the operator may select a 6-month period within which to provide examinations in accordance with a plan approved under § 37.5.

EXAMPLE: ALOSH finds that examinations were previously provided to miners employed at mine Y in a 6-month period from July 1, 1979, to December 31, 1979. ALOSH notifies the operator at least 3 months before July 1, 1983 (31⁄2 years after December 31, 1979) that the operator may select and designate on its plan the next 6-month period within which to offer examinations to its miners employed at mine Y. The 6-month period shall be scheduled between July 1, 1983, and July 1, 1984 (between 31⁄2 and 41⁄2 years after December 31, 1979).

(3) Within either the next or future period(s) specified by ALOSH to the operator for each of its coal mines, the operator of the coal mine may select a different 6-month period for each of its mines within which to offer examinations. In the event the operator does not submit an approved plan, ALOSH will specify a 6-month period to the operator within which miners shall have the opportunity for examinations.

(b) Mandatory examinations. Every operator shall provide to each miner who begins working in or at a coal mine for the first time after December 30, 1969:

(1) An initial chest roentgenogram as soon as possible, but in no event later than 6 months after commencement of employment. A preemployment physical examination which was made within the 6 months prior to the date on which the miner started to work will be considered as fulfilling this requirement. An initial chest roentgenogram given to a miner according to former regulations for this subpart prior to August 1, 1978 will also be considered as fulfilling this requirement.

(2) A second chest roentgenogram, in accordance with this subpart, 3 years following the initial examination if the miner is still engaged in underground

coal mining. A second roentgenogram given to a miner according to former regulations under this subpart prior t August 1, 1978 will be considered as für filling this requirement.

(3) A third chest roentgenogram ! years following the second chest roentgenogram if the miner is still ergaged in underground coal mining and if the second roentgenogram shows evidence of category 1, category 2, caregory 3 simple pneumoconioses, or complicated pneumoconioses (ILO Classification).

(c) ALOSH will notify the miner when he or she is due to receive the second or third mandatory examina tion under (b) of this section. Similarly, ALOSH will notify the coal mine operator when the miner is to be given a second examination. The operator will be notified concerning a miner's third examination only with the miner's written consent, and the notice to the operator shall not state the medical reason for the examination nor that it is the third examination in the series. If the miner is notified by ALOSH that the third mandatory examination is due and the operator is not so notified, availability of the roentgenographic examination under the operator's plan shall constitute the operator's compliance with the requirement to provide a third mandatory examination even if the miner refuses to take the examination.

(d) The opportunity for chest roentgenograms to be available by an operator for purposes of this subpart shall be provided in accordance with a plan which has been submitted and approved in accordance with this subpart.

(e) Any examinations conducted by the Secretary in the National Study of Coal Workers' Pneumoconiosis after | January 1, 1977, but before August 1, ¦ 1978 shall satisfy the requirements of this section with respect to the specific examination given (see §37.6(d)).

[43 FR 33715, Aug. 1, 1978; 43 FR 38830, Aug. 31, 1978, as amended at 49 FR 7563, Mar. 1, 1984]

thin 120 calendar days after August 1978. In the case of a person who after igust 1, 1978, becomes an operator of mine for which no plan has been apoved, that person shall submit a plan thin 60 days after such event occurs. separate plan shall be submitted by e operator and by each construction ntractor for each underground coal ine which has a MSHA identification imber. The plan shall include:

(1) The name, address, and telephone imber of the operator(s) submitting Fe plan;

(2) The name, MSHA identification imber for respirable dust measureents, and address of the mine inuded in the plan;

(3) The proposed beginning and endng date of the 6-month period for volntary examinations (see §37.3(a)) and he estimated number of miners to be iven or offered examinations during ne 6-month period under the plan;

(4) The name and location of the aproved X-ray facility or facilities, and he approximate date(s) and time(s) of ay during which the roentgenograms will be given to miners to enable a deermination of whether the examinaions will be conducted at a convenient ime and place;

(5) If a mobile facility is proposed, She plan shall provide that each miner be given adequate notice of the opporSunity to have the examination and that no miner shall have to wait for an examination more than 1 hour before or after his or her work shift. In addition, the plan shall include:

(i) The number of change houses at the mine.

(ii) One or more alternate nonmobile approved facilities for the reexamination of miners and for the mandatory examination of miners when necessary (see §37.3(b)), or an assurance that the mobile facility will return to the location(s) specified in the plan as frequently as necessary to provide for examinations in accordance with these regulations.

(iii) The name and location of each change house at which examinations will be given. For mines with more than one change house, the examinations shall be given at each change house or at a change house located at a convenient place for each miner.

(6) The name and address of the "A" or "B" reader who will interpret and classify the chest roentgenograms.

(7) Assurances that: (i) The operator will not solicit a physician's roentgenographic or other findings

concerning any miner employed by the operator,

(ii) Instructions have been given to the person(s) giving the examinations that duplicate roentgenograms or copies of roentgenograms will not be made and that (except as may be necessary for the purpose of this subpart) the physician's roentgenographic and other findings, as well as the occupational history information obtained from a miner unless obtained prior to employment in a preemployment examination, and disclosed prior to employment, will not be disclosed in a manner which will permit identification of the employee with the information about him, and

(iii) The roentgenographic examinations will be made at no charge to the miner.

(b) Operators may provide for alternate facilities and "A" or "B" readers in plans submitted for approval.

(c) The change of operators of any mine operating under a plan approved pursuant to §37.5 shall not affect the plan of the operator which has transferred responsibility for the mine. Every plan shall be subject to revision in accordance with paragraph (d) of this section.

(d) The operator shall advise ALOSH of any change in its plan. Each change in an approved plan is subject to the same review and approval as the originally approved plan.

(e) The operator shall promptly display in a visible location on the bulletin board at the mine its proposed plan or proposed change in plan when it is submitted to ALOSH. The proposed plan or change in plan shall remain posted in a visible location on the bulletin board until ALOSH either grants or denies approval of it at which time the approved plan or denial of approval shall be permanently posted. In the case of an operator who is a construction contractor and who does not have a bulletin board, the construction contractor must otherwise notify its employees of the examination arrange

ments. Upon request, the contractor must show ALOSH written evidence that its employees have been notified.

(f) Upon notification from ALOSH that sufficient time has elapsed since the previous period of examinations, the operator will resubmit its plan for each of its coal mines to ALOSH for approval for the next period of examinations (see §37.3(a)(2)). The plan shall include the proposed beginning and ending dates of the next period of examinations and all information required by paragraph (a) of this section.

[43 FR 33715, Aug. 1, 1978; 43 FR 38830, Aug. 31, 1978]

§ 37.5 Approval of plans.

(a) Approval of plans granted prior to August 1, 1978 is no longer effective.

(b) If, after review of any plan submitted pursuant to this subpart, the Secretary determines that the action to be taken under the plan by the operator meets the specifications of this subpart and will effectively achieve its purpose, the Secretary will approve the plan and notify the operator(s) submitting the plan of the approval. Approval may be conditioned upon such terms as the Secretary deems necessary to carry out the purpose of section 203 of the act.

(c) Where the Secretary has reason to believe that he will deny approval of a plan he will, prior to the denial, give reasonable notice in writing to the operator(s) of an opportunity to amend the plan. The notice shall specify the ground upon which approval is proposed to be denied.

(d) If a plan is denied approval, the Secretary shall advise the operator(s) in writing of the reasons for the denial.

§37.6 Chest roentgenographic exami

nations conducted by the Secretary. (a) The Secretary will give chest roentgenograms or make arrangements with an appropriate person, agency, or institution to give the chest roentgenograms and with "A" or "B" readers to interpret the roentgenograms required under this subpart in the locality where the miner resides, at the mine, or at a medical facility easily accessible to a mining community or mining communities, under the following circumstances:

(1) Where, in the judgment d Secretary, due to the lack of absc medical or other necessary facita personnel at the mine or in the where the miner resides, the r roentgenographic examination be given.

(2) Where the operator has n mitted an approvable plan.

(3) Where, after commencement: operator's program pursuant të proved plan and after notice to erator of his failure to follow proved plan and, after allowing B endar days to bring the progran compliance, the Secretary deter and notifies the operator in that the operator's program stil to comply with the approved plaz

(b) The operator of the mine sha imburse the Secretary or other pers agency, or institution as the Secr may direct, for the cost of conduct each examination made in accorda with this section.

(c) All examinations given or ranged by the Secretary will con with the time requirements of 15 Whenever the Secretary gives of ranges for the examinations of mine at a time, a written notice of the rangements will be sent to the operat who shall post the notice on the bulletin board.

(d) Operators of mines selected * ALOSH to participate in the Natic Study of Coal Worker Pneumoconiosis (an epidemiologis study of respiratory diseases in miners) and who agree to cooper will have all their miners afforded th opportunity to have a roentgenogram required hereunder & no cost to the operator. For future aminations and for mandatory exam nations each participating operat shall submit an approvable plan.

§ 37.7 Transfer of affected miner less dusty area.

(a) Any miner who, in the judgmen of the Secretary based upon the inter pretation of one or more of the miners chest roentgenograms, shows category 1 (1/0, 1/1, 1/2), category 2 (2/1, 2/2, 2/3), ( category 3 (3/2, 3/3, 3/4) simple pneumoconioses, or complicated

pneumoconioses (ILO Classification shall be afforded the option of transfer

>m his or her position to another n in an area of the mine where cacentration of respirable dust in -ne atmosphere is not more than /m3 of air, or in such level is not able in the mine, to a position in ine where the concentration of able dust is the lowest attainable 2.0 mg/m3 of air.

Any transfer under this section be in accordance with the procespecified in part 90 of title 30, of Federal Regulations.

33715, Aug. 1, 1978; 43 FR 38830, Aug. 31, s amended at 44 FR 23085, Apr. 18, 1979; 7563, Mar. 1, 1984]

Roentgenographic examination t miner's expense.

y miner who wishes to obtain an ination at his or her own expense n approved facility and to have itted to NIOSH for him or her a plete examination may do so, prod that the examination is made no er than 6 months after the most Int examination of the miner subted to ALOSH. ALOSH will provide nterpretation and report of the exnations made at the miner's exse in the same manner as if it were mitted under an operator's plan.

change in the miner's transfer ats under the act which may result m this examination will be subject the terms of § 37.7.

7.20 Miner identification document. As part of the roentgenographic exination, a miner identification dochent which includes an occupational story questionnaire shall be cometed for each miner at the facility here the roentgenogram is made at time the chest entgenogram required by this subLrt is given.

.e

same

PECIFICATIONS FOR PERFORMING CHEST ROENTGENOGRAPHIC EXAMINATIONS

37.40 General provisions.

(a) The chest roentgenographic examnation shall be given at a convenient ime and place.

(b) The chest roentgenographic examnation consists of the chest oentgenogram, and a complete toentgenographic Interpretation Form

(Form CDC/NIOSH (M) 2.8), and miner identification document.

(c) A roentgenographic examination shall be made in a facility approved in accordance with §37.42 by or under the supervision of a physician who regularly makes chest roentgenograms and who has demonstrated ability to make chest roentgenograms of a quality to best ascertain the presence of pneumoconiosis.

§37.41 Chest roentgenogram specifications.

(a) Every chest roentgenogram shall be a single posteroanterior projection at full inspiration on a film being no less than 14 by 17 inches and no greater than 16 by 17 inches. The film and cassette shall be capable of being positioned both vertically and horizontally so that the chest roentgenogram will include both apices and costophrenic angles. If a miner is too large to permit the above requirements, then the projection shall include both apices with minimum loss of the costophrenic angle.

(b) Miners shall be disrobed from the waist up at the time the roentgenogram is given. The facility shall provide a dressing area and for those miners who wish to use one, the facility shall provide a clean gown. Facilities shall be heated to a comfortable temperature.

(c) Roentgenograms shall be made only with a diagnostic X-ray machine having a rotating anode tube with a maximum of a 2 mm. source (focal spot).

(d) Except as provided in paragraph (e) of this section, roentgenograms shall be made with units having generators which comply with the following: (1) The generators of existing roentgenographic units acquired by the examining facility prior to July 27, 1973, shall have a minimum rating of 200 mA at 100 kVp.; (2) generators of units acquired subsequent to that date shall have a minimum rating of 300 mA at 125 kVp.

NOTE: A generator with a rating of 150 kVp. is recommended.

(e) Roentgenograms made with battery-powered mobile or portable equipment shall be made with units having a

minimum rating of 100 mA at 110 kVp. at 500 Hz, or of 200 mA at 110 kVp. at 60 Hz.

(f) Capacitor discharge and field emission units may be used if the model of such units is approved by ALOSH for quality, performance, and safety. ALOSH will consider such units for approval when listed by a facility seeking approval under $37.42 of this subpart.

(g) Roentgenograms shall be given only with equipment having a beamlimiting device which does not cause large unexposed boundaries. The beam limiting device shall provide rectangular collimation and shall be of the type described in part F of the suggested State regulations for the control of radiation or (for beam limiting devices manufactured after August 1, 1974) of the type specified in 21 CFR 1020.31. The use of such a device shall be discernible from an examination of the

roentgenogram.

(h) to insure high quality chest roentgenograms:

(1) The maximum exposure time shall not exceed 20 of a second except that with single phase units with a rating less than 300 mA at 125 kVp. and subjects with chests over 28 cm. posteroanterior, the exposure may be increased to not more than 10 of a second;

(2) The source or focal spot to film distance shall be at least 6 feet;

(3) Medium speed film and medium speed intensifying screens are recommended. However, any film-screen combination, the rated "speed" of which is at least 100 and does not exceed 300, which produces roentgenograms with spatial resolution, contrast, latitude and quantum mottle similar to those of systems designated as "medium speed" may be employed;

(4) Film-screen contact shall be maintained and verified at 6 month or shorter intervals;

(5) Intensifying screens shall be inspected at least once a month and cleaned when necessary by the method recommended by the manufacturer;

(6) All intensifying screens in a cassette shall be of the same type and made by the same manufacturer;

(7) When using over 90 kV., a suitable grid or other means of reducing scattered radiation shall be used;

(8) The geometry of the radiographic system shall insure that the central axis (ray) of the primary beam is perpendicular to the plane of the film surface and impinges on the center of the film;

(9) A formal quality assurance program shall be established at each facility.

(1) Radiographic processing:

(1) Either automatic or manual film processing is acceptable. A constant time-temperature technique shall be meticulously employed for manual processing.

(2) If mineral or other impurities in the processing water introduce difficulty in obtaining a high-quality roentgenogram, a suitable filter or pu- | rification system shall be used.

(j) Before the miner is advised that the examination is concluded, the roentgenogram shall 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 a case of a substandard roentgenogram, another shall be immediately made. All substandard roentgenograms shall be clearly marked as rejected and promptly sent to ALOSH for disposal.

(k) An electric power supply shall be used which complies with the voltage, current, and regulation specified by the manufacturer of the machine.

(1) A densitometric test object may be required on each roentgenogram for an objective evaluation of film quality at the discretion of ALOSH.

(m) Each roentgenogram made hereunder shall be permanently and legibly marked with the name and address or ALOSH approval number of the facility at which it is made, the social security number of the miner, and the date of the roentgenogram. No other identifying markings shall be recorded on the roentgenogram.

[43 FR 33715, Aug. 1, 1978, as amended at 52 FR 7866, Mar. 13, 1987]

$37.42 Approval of roentgenographic facilities.