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[Federal Register Volume 89, Number 242 (Tuesday, December 17, 2024)]
[Notices]
[Page 102147]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-29622]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Docket No. CDC-2024-0103; NIOSH 355]

Expansion of NIOSH B Reader Certification Eligibility; Request 
for Information

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Request for information.

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SUMMARY: The B Reader Program, administered by CDC's National Institute 
for Occupational Safety and Health (NIOSH), is seeking information from 
experts in occupational respiratory health surveillance and radiology, 
nurse practitioners, physician assistants, workers exposed to mineral 
dust and unions representing such workers, industry and other parties 
interested in allowing nurse practitioners and physician assistants to 
be eligible to take the NIOSH B Reader examination and become certified 
B Readers if they successfully pass the examination.

DATES: Comments must be received by March 17, 2025.

ADDRESSES: Submit comments by either of the following methods:
     Federal eRulemaking Portal: https://www.regulations.gov. 
Follow the instructions for submitting comments.
     Mail: NIOSH Docket Office, Robert A. Taft Laboratories, MS 
C-34, 1090 Tusculum Avenue, Cincinnati, Ohio 45226-1998.
    Instructions: All written submissions received in response to this 
document must include the agency name and docket number (CDC-2024-0103; 
NIOSH-355) for this activity. All relevant comments, including any 
personal information provided, will be posted without change to https://www.regulations.gov. Do not submit comments by email.

FOR FURTHER INFORMATION CONTACT: Laura E. Reynolds, NIOSH B Reader 
Program, Respiratory Health Division, 1095 Willowdale Road, MS HG900.2, 
Morgantown, WV 26505-2888; (304) 285-5853 (this is not a toll-free 
number); [email protected].

SUPPLEMENTARY INFORMATION: The NIOSH B Reader program, established in 
42 CFR 37.52, certifies physicians as being able to apply the 
International Labour Organization (ILO) International Classification of 
Radiographs of Pneumoconioses in classifying posteroanterior chest 
radiographic images for the presence and severity of appearances of 
pneumoconiosis (a type of dust-induced lung disease). In the United 
States, B Readers classify chest radiographic images of workers 
participating in health surveillance programs.\1\ These workers have 
jobs involving exposure to mineral dusts that can cause pneumoconiosis 
such as coal mine dust, crystalline silica, and asbestos.
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    \1\ See https://www.cdc.gov/niosh/chestradiography/php/breader/.
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    B Readers participate in several types of activities involving 
classification of chest radiographs. Physicians who classify chest 
radiographs for certain Federal surveillance programs such as the NIOSH 
Coal Workers' Health Surveillance Program must be B Readers. 
Additionally, B Readers provide classifications for research purposes 
and for certain legal and administrative activities such as 
compensation programs.
    Currently, only physicians licensed to practice medicine in the 
United States can serve as certified B Readers in the United States, 
and only after successfully completing the B Reader examination. The 
examination, developed by NIOSH in partnership with the American 
College of Radiology, is rigorous and tests physicians' ability to 
apply the ILO classification system. International physicians may also 
take the B Reader examination to document their ability to apply the 
ILO classification system, but those who pass the examination do not 
serve as certified B Readers in the United States.
    As of October 2024, 184 U.S. physicians based in 35 States and 2 
Territories are NIOSH-certified B Readers. NIOSH is interested in 
ensuring that B Readers are available to classify chest radiographs 
obtained in all states and territories. To meet this goal, NIOSH is 
requesting information from parties interested in allowing nurse 
practitioners and physician assistants to be eligible to take the NIOSH 
B Reader examination and become certified B Readers if they 
successfully pass the examination. NIOSH is particularly interested in 
receiving information about the following questions:
    1. What is the current demand for B Readers, and would expanding 
the program to include nurse practitioners and physician assistants 
help meet this demand?
    2. Are there specific geographic areas or populations that might 
benefit from having nurse practitioners and physician assistants 
certified as B Readers?
    3. Are there any potential risks associated with expanding the B 
Reader certification to nurse practitioners and physician assistants 
and, if so, how can those risks be mitigated?
    4. ILO classification of chest radiographs is not the same as 
clinical interpretation. Are there states where scope of practice and 
standards of care allow nurse practitioners and physician assistants to 
perform clinical interpretation of chest radiographs without physician 
oversight? In states where physician oversight is required for clinical 
interpretation, is it also required for ILO classification? What would 
be the best approach to ensuring that appropriate clinical 
interpretations are obtained for all contemporary chest radiographs 
undergoing ILO classification by nurse practitioners and physician 
assistants?
    5. How do you anticipate different interested parties (e.g., 
physicians, nurse practitioners and physician assistants, industry 
representatives, workers, health profession boards) would view the 
potential expansion of the B Reader program to include non-physicians?
    6. What challenges might arise during the implementation of this 
expansion, and how could they be effectively managed?
    7. Do you have any other information or comments relevant to 
whether nurse practitioners and physician assistants should be able to 
become B Readers and, if so, the best way to implement that expansion?

John J. Howard,
Director, National Institute for Occupational Safety and Health, 
Centers for Disease Control and Prevention, Department of Health and 
Human Services.
[FR Doc. 2024-29622 Filed 12-16-24; 8:45 am]
BILLING CODE 4163-18-P
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