According to Quebec's guidelines, chest X-ray is the only tool recommended to screen for silicosis. Pulmonary lesions can be found on chest X-rays before the presence of symptoms. Naturally films must be read by a B-reader. Pulmonary function testing is useless when workers do not experience pulmonary symptoms.
Physical examination is also useless at the screening level.
The use of a standardized pulmonary questionnaire may be useful only to screen for chronic bronchitis, mainly related to tobacco smoking. These high-risk levels should not be tolerated for being very hazardous. When adequate protective gears are supplied, chest X-ray could be done less frequently for obvious reasons, one good exemple would be every 3 years. They must have a pulmonary examination every 3 years including a physical examination and a chest X-ray. The first examination for employees who have never been exposed to silica or asbestos should take place within the first 6 years after being hired.