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Q&As on Business and Occupational Safety and Health


Company level OSH management system

Question: We are currently developing an OSH management system for our company. What are the elements and processes we need to bear in mind?

Answer: Safety and health in the workplace is a shared responsibility. Employers should provide workers with safety-related information and training in order to make sure that they have understood the risks involved and the relevance of the safety measures taken, including the use of personal protective equipment (PPE). Workers in turn should apply the safety measures, including the use of PPE. Both managers and workers should accord highest priority to the principle of prevention.

The ILO advocates the following elements of an effective OSH management system[1]:

1. The employer, in consultation with workers and their representatives, should set out in writing an OSH policy, which should be:

  • specific to the organization and appropriate to its size and the nature of its activities;
  • concise, clearly written, dated and made effective by the signature or endorsement of the employer or the most senior accountable person in the organization;
  • communicated and readily accessible to all persons at their place of work;
  • reviewed for continuing suitability; and
  • made available to relevant external interested parties, as appropriate.

2. The OSH policy should include, as a minimum, the following key principles and objectives to which the organization is committed:

  • protecting the safety and health of all members of the organization by preventing work-related injuries, ill health, diseases and incidents;
  • complying with relevant OSH national laws and regulations, voluntary programmes, collective agreements on OSH and other requirements to which the organization subscribes;
  • ensuring that workers and their representatives are consulted and encouraged to participate actively in all elements of the OSH management system; and
  • continually improving the performance of the OSH management system.

3. Worker participation is an essential element of an effective OSH management system. The employer should ensure that workers and their safety and health representatives are consulted, informed and trained on all aspects of OSH, including emergency arrangements, associated with their work.

The employer should make arrangements for workers and their safety and health representatives to have the time and resources to participate actively in the processes of organizing, planning and implementation, evaluation and action for improvement of the OSH management system. The employer should ensure, as appropriate, the establishment and efficient functioning of a safety and health committee and the recognition of workers' safety and health representatives, in accordance with national laws and practice.

A health and safety policy implemented at the enterprise level should be applied consistently in order to be effective.

[1]See, Guidelines on occupational safety and health management systems ILO-OSH, section 3.1-3.2


Personal protective equipment (PPE)

Question: Must a company accommodate religious beliefs which hinder wearing of personal protective equipment (beards which interfere with safety masks, head coverings which prevent wearing of safety helmets, etc.)?

Answer: Religious discrimination includes distinctions made on the basis of expression of religious beliefs or membership in a religious group. Although discrimination on the basis of religious beliefs should not be permitted, there may be legitimate bases for imposing requirements in the workplace which restrict the worker’s freedom to practice a particular religion.

A religion may require a special type of clothing which may not be compatible with personal protective equipment (PPE). In such cases the worker's right to practice fully his or her faith or belief at the workplace needs to be weighed against the need to meet genuine safety requirements.

Enterprises are encouraged to make reasonable efforts to accommodate particular religious customs. Workers, in particular through their representatives, should be consulted on possible steps which could be taken to accommodate religious practices.

National employers' and workers' organizations may have further suggestions and guidance on PPE and accommodation of local religious customs.

Question: Is it acceptable practice for a company to fire a worker on the spot without a second warning for failure to wear PPE?

Answer: A worker should not be fired for misconduct that under national law or practice would justify termination only if repeated on one or more occasions, unless the employer has given the worker appropriate written warning[1]. While an employee may be validly dismissed for his/her misconduct, such as the violation of work rules related to safety and health, steps should be taken to ensure that employees are aware of their obligations and the consequences of violating the work rules.

The immediate firing of workers for not wearing his or her PPE indicates that the company does not have a clear understanding of how OSH should be managed effectively within an enterprise. A positive commitment to OSH brings great benefits to the workers and the well-being of them and their families; and to the enterprise in terms of productivity and sustainability. Good safety and health is good business and must be a concern for all parties involved.

Safety and health in the workplace is a shared responsibility. Employers should provide workers with safety-related information and training in order to make sure that they have understood the risks involved and the relevance of the safety measures taken, including the use of personal protective equipment (PPE). Workers in turn should apply the safety measures, including the use of PPE. Both managers and workers should accord highest priority to the principle of prevention.[2]

Worker participation is also an essential element of the OSH management system. The employer should ensure that workers and their safety and health representatives are consulted, informed and trained on all aspects of OSH, including emergency arrangements, associated with their work. The employer should make arrangements for workers and their safety and health representatives to have the time and resources to participate actively in the processes of organizing, planning and implementation, evaluation and action for improvement of the OSH management system. The employer should ensure, as appropriate, the establishment and efficient functioning of a safety and health committee and the recognition of workers' safety and health representatives, in accordance with national laws and practice.

National employers' and workers' organizations may have further suggestions and guidance to support the company in developing an effective and appropriate OSH management system.

[1]Termination of Employment Recommendation, 1982 (No. 166), paragraph 7
[2]During the discussions concerning adoption of the Promotional Framework for Occupational Safety and Health Convention, (No. 187) and Recommendation (No. 197), 2006 it was emphasized that “Employers and workers should all actively participate in securing a safe and healthy working environment through a system of defined rights, responsibilities and duties, and the principle of prevention should be accorded the highest priority.”

Question: Is it acceptable that the workers must pay themselves for their personal safety equipment?

Answer: Companies are urged to maintain the highest standards of safety and health, in conformity with national requirements.[1]

A key first step is promoting within the enterprise a culture of prevention where the right to a safe and healthy working environment is respected and where employers and workers actively participate in securing a safe and healthy working environment.[2] Policies should seek foremost to prevent accidents and injury to health by minimising, to the extent reasonably practicable, the causes of hazards inherent in the working environment.[3]

Adequate protective clothing and protective equipment are also important for prevention. They should be provided wherever necessary[4] free of charge to the workers.[5]

Workers and their representatives should be provided adequate information on safety measures to be taken and given appropriate training.[6]

[1]ILO Tripartite Declaration of Principles Concerning Multinational Enterprises and Social Policy, (MNE Declaration) para. 38.
[2]Promotional Framework for Occupational Safety and Health Convention, 2006 (No. 187), Art. 1(d).
[3]Occupational Safety and Health Convention, 1981 (No. 155), Art. 4(2).
[4]C. 155, Art. 16(3).
[5]C. 155, Art. 21.
[6]C. 155, Art. 19 (c) and (d), C170, Art. 15


Locking in workers

Question: Is it OK to lock workers inside for the night in order to make sure that the workers are not stealing?

Answer: Workers should not be locked in enterprises. The ILO advocates taking a "zero tolerance" approach to confinement at the workplace.[1]

Furthermore, locking workers in a factory is clearly contrary to occupational health and safety principles. If there is an accident it may result in civil liability for personal injury. Locking workers in a factory may also constitute under national law a criminal offence or civil tort of false imprisonment.

While it is legitimate for a company to take steps to secure its property, alternative means should be explored.

The national employers’ and workers’ organizations may have useful suggestions about effective alternative approaches.

[1]Combating forced labour: A handbook for employers and business, p. 8


OSH culture of prevention

Question: What does ILO consider to be the key elements of an OSH system?

Answer: Companies are urged to maintain the highest standards of safety and health, in conformity with national requirements.[1]

A key element is promoting a culture of prevention within the enterprise where the right to a safe and healthy working environment is respected and where employers and workers actively participate in securing a safe and healthy working environment.[2] Policies should seek foremost to prevent accidents and injury to health by minimizing, to the extent reasonably practicable, the causes of hazards inherent in the working environment.[3]

Chemical, physical and biological substances and agents under the control of the company should not pose a risk to the health of workers when the appropriate measures of protection are taken. Machinery, equipment and processes should be safe and without risk to health[4].

Adequate protective clothing and protective equipment are also important for prevention. They should be provided wherever necessary[5] free of charge to the workers[6].

Efforts should be made to adapt machinery, equipment, working time, and organisation of work and work processes to the physical and mental capacities of the workers[7]. Adaptations should take into account gender differences. Pregnant or breastfeeding women should not be required to perform work that might be prejudicial to the health of either the mother or child[8].

Measures should be put in place to deal with emergencies and accidents, including adequate first-aid arrangements[9].

Companies should establish and apply procedures for the recording and notification of dangerous occurrences and occupational accidents and diseases. Companies should play a leading role in examination of the causes of industrial safety and health hazards and in the application of resulting improvements within the enterprise.[10]

Workers, including through their representatives, have an important role to play in preventing hazards[11] and cooperation between management and workers is essential[12]. Companies should make available to the representatives of workers in the enterprise information on the safety and health standards relevant to their local operations. They should make known any special hazards and related protective measures associated with new products and processes[13]. Workers and their representatives should be provided adequate information on safety measures to be taken and given appropriate training[14].

Workers or their representatives should be allowed to consult workers’ organizations about such information provided they do not disclose commercial secrets. They also should be allowed to bring in outside technical advisors, provided management agrees[15].

A worker should report to the immediate supervisor any situation which he or she has reasonable justification to believe presents an imminent and serious danger. The worker has the right to refuse to resume work until the employer has taken any remedial action required to remove the imminent and serious danger to life or health.[16]

Where appropriate, companies are encouraged to incorporate matters relating to safety and health in agreements with workers’ representatives[17].

Whenever two or more undertakings engage in activities simultaneously at one workplace, they should collaborate in ensuring hazards are minimized[18].

At the national level, companies should cooperate fully with the competent safety and health authorities, representatives of the workers’ and employers’ organizations and established safety and health organizations.[19]

At the international level, companies should cooperate in preparation and adoption of international safety and health standards.[20]

[1]ILO Tripartite Declaration of Principles Concerning Multinational Enterprises and Social Policy, (MNE Declaration) para. 38
[2]Promotional Framework for Occupational Safety and Health Convention, 2006 (No. 187), Art. 1(d).
[3]Occupational Safety and Health Convention, 1981 (No. 155), Art. 4(2)
[4]C. 155, Art. 16(1)
[5]C. 155, Art. 16(3).
[6]C. 155, Art. 21
[7]C.155, Art. 5 b
[8]Maternity Protection Convention, 2000 (No.183), Art. 3
[9]C. 155, Art. 18
[10]MNE Declaration, para. 38
[11]C. 155, Art. 19(a) and (b)
[12]C. 155, Art. 20; C170, Art 16
[13]ILO MNE Declaration, para. 38
[14]C. 155, Art. 19 (c) and (d), C170, Art. 15
[15]C. 155, Art. 19(c) and (e).
[16]C. 155, Art. 19(f).
[17]ILO MNE Declaration, para. 40
[18]C. 155, Art. 17
[19]ILO MNE Declaration, para. 40
[20]ILO MNE Declaration, para. 39


Exposure to hazardous substances

Question: Are there ILO instruments to guide companies on preventing the exposure of its workers to carcinogens?

Answer: Special measures regarding chemicals include the labeling or marking of all chemicals used at work so as to indicate their identity[1]. Hazardous chemicals should be labeled so that the workers can easily understand their classification, the hazards they present and the safety precautions to be observed[2]. Chemical data sheets should be made available to workers and their representatives[3].

Management should ensure that workers are not exposed to chemicals to an extent which exceeds exposure limits or other exposure criteria for the evaluation and control of the working environment established by the competent authority, or by a body approved or recognized by the competent authority, in accordance with national or international standards.

They should also assess the exposure of workers to hazardous chemicals and monitor and record the exposure of workers. These records should be made accessible to the workers and their representatives[4]. Companies should establish an appropriate system for keeping and maintaining records for an appropriate period of time[5].

Companies should take special measures concerning carcinogenic substances or agents and make every effort to replace carcinogenic substances or agents with those which are non-carcinogenic or less harmful[6]. Specific measures should be taken for the prevention and control of asbestos[7].

The number of workers exposed and the duration and degree of such exposure should be reduced to the minimum compatible with safety[8]. Workers who have been exposed or are likely to be exposed to carcinogenic substances or agents should be provided with all relevant information on the dangers involved and measures to be taken[9].

Workers should be provided with medical examinations or biological or other tests or investigations during the period of employment and thereafter as needed to evaluate their exposure and supervise their state of health in relation to the occupational hazards[10]. If qualified medical advice recommends, the worker or workers in question should be removed from exposure[11], and provided alternative employment or other means to maintain their income[12].

The minimum age for hazardous work involving exposure to substances, agents or processes which could damage health should be 18 years[13].

[1]C170, Art. 7(1)
[2]C170. Art. 7(2)
[3]C170. Art. 10(1)
[4]C170, Art. 12
[5]C. 139, Art. 3
[6]Occupational Cancer Convention, 1974 (No. 139), Art. 2(1)
[7]C. 162, Art. 3
[8]Ibid, Art. 2(2
[9]Ibid, Art. 4.
[10]Ibid, Art. 5
[11]Radiation Protection Convention, 1960 (No. 115), Article 14
[12]C. 115, Footnote 20; General Observation 1992, para 32; C. 162, Para 21(3)
[13]Worst Forms of Child Labour Recommendation, 1999 (No. 190), Part II, para. 3(d)


Uranium radiation protection

Question: Which international labour standards can be referenced when setting requirements for international nuclear fuel suppliers regarding uranium mining?

Answer: For detailed guidance on good practices you may wish to consult the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources (BSS). The BSS were published in 1996 and jointly sponsored by ILO, FAO, IAEA, OECD/NEA, PAHO and WHO. Specific requirements regarding uranium mining and nuclear fuel suppliers are included in the BSS.

The BSS provide a worldwide basis for harmonized radiation protection standards that complement and are promoted on the basis of the ILO Radiation Protection Convention (No. 115) and Recommendation (No. 114). The BSS are also part of the IAEA safety standards and the IAEA has been promoting these standards through its technical cooperation Model Project on Upgrading Radiation Protection Infrastructure in more than 100 countries.

 

To help member States to apply the requirements in the BSS, the IAEA and ILO have prepared the following safety guides and other guidance documents which are applicable to uranium mining which can provide you with more detailed safety specifications:


Safety supervisors at construction sites

Question: How many safety supervisors are required at a high rise building construction site?

Answer: Employers are encouraged to “provide such supervision as will ensure that workers perform their work with due regard to their safety and health.”[1] There is no prescribed number of safety supervisors, as this is not the only element that counts. The competencies of those supervisors and assigning clear responsibilities and authority play an equally important role.

Every construction company of any size should appoint a safety officer or officers—a properly qualified person (or persons) whose special and main responsibility is the promotion of safety and health[2].

In addition, first level supervisors (also referred to as “foreman”, “chargehand”, or “ganger”) with clear responsibilities are fundamental to safety in construction. They also have a role in safety over their particular group of workers, and, as a minimum, each company represented on site should have such supervisors. Supervisors are responsible for ensuring that[3]:

  • working conditions and equipment are safe;
  • workplace safety is regularly inspected;
  • workers have been adequately trained for the job they are expected to do;
  • workplace safety measures are implemented;
  • the best solutions are adopted using available resources and skills; and
  • necessary personal protective equipment is available and used.

Each supervisor requires the direct support of site management[4]. Supervisors should possess adequate qualifications, such as suitable training and sufficient knowledge, experience and skill for the safe performance of the specific work[5].

When two or more employers undertake activities simultaneously at one construction site the principal contractor, who has actual control over or primary responsibility for the overall construction site activities, should be responsible for coordinating and ensuring compliance with the prescribed safety and health measures. If the principle contractor is not present at the site, he or she should nominate a competent person or body to ensure coordination and compliance (an overall safety supervisor or safety coordinator). However, each employer remains responsible for the application of the prescribed safety measures in respect of the workers under his or her authority. All employers or self-employed persons operating simultaneously at the site have a duty to cooperate.[6]

Another group of people which can also be thought of as "supervisors" in a looser sense are the OSH representatives appointed by workers and trade unions to represent them. It has been shown over and over again that where there are worker safety representatives work is safer. Their role cannot be over-emphasized.[7] A safe construction site requires regular inspection and remedial measures. The training of workers enables them to recognize the risks involved and how they can overcome them. Workers should be shown the safe way of getting a job done[8]. Employers should establish committees with representatives of workers and management or make other suitable arrangements consistent with national laws and regulations for the participation of workers in ensuring safe working conditions[9].

In summary, on any site where there are two or more contractors at any one time, as is the case in any high rise building site, there has to be an overall safety coordinator/supervisor. Individual contractors would be responsible, under the supervision of the coordinator, for ensuring the safety and health of their workers and any sub-contracted firms for which they are responsible. Their responsibilities include provision of information, training, site induction (if this has not been carried out by the principal contractor), etc. There has to be two-way coordination between the overall coordinator, the principal contractor and other contractors on site. Whether other safety supervisors are needed on-site depends on many considerations:

  • the size and complexity of the worksite;
  • the number of other companies working on site, all or some of which may have safety supervisors of their own (present either all of the time or part of the time if also responsible for other sites);
  • what has been required by the risk assessment (assuming one has been done), e.g., the
  • assessment might call for the presence of safety supervisors at certain areas and times;
  • the presence and competence of individual company supervisors (foremen);
  • the presence and level of development of a safety culture; and
  • the level of engagement of trade union safety representatives.

National employers and workers organizations are also a very important source of information on national law, regulation and collective bargaining agreements pertaining to safety requirements at construction sites.

[1]ILO Code of Practice on Safety and Health in Construction, 1992, Section 2.2.7.
[2]ILO Safety, health and welfare on construction sites: A training manual, 1995, Section 2.2.1
[3]Training manual, Section 2.2.1
[4]Training manual, Section 2.2.2
[5]Safety and Health in Construction Convention, 1988 (No. 167), Art. 2(f)
[6]C. 167, Art. 8
[7]See, "The role of worker representation and consultation in managing health and safety in the construction industry," pp. 19-23 for a discussion of the empirical evidence
[8]Training manual, Section 2.2.2
[9]Code of Practice, Section 2.2.3

Question: I would like to know if there are standards for personal protective equipment against accidents with snakes for workers of fruit plantations.

Answer: The ILO Code of practice on Safety and Health in Agriculture includes guidance on personal protective equipment for agricultural workers. Although not specifically addressing snake bite prevention, the Code does recommend high boots or safety footwear which is slip-resistance with shin-guards (espinilleras) and knee protection when work. Medical services in the plantation should have antidotes for those snakes, serpents or spiders that are poisonous and endemic in the area.

More general guidance can be found in the Safety and Health in Agriculture Convention, 2001 (No. 184) and Recommendation, 2001 (No. 192) which provide a comprehensive approach to preventive measures in agriculture, including preventive measures against contact with wild or poisonous animals.

Question: What are the requirements for providing chairs to cashiers/tellers?

Answer: The Hygiene (Commerce and Offices) Convention, 1964 (No. 120) provides that sufficient and suitable seats should be supplied for workers and workers should be given reasonable opportunities of using them.

Question: I would like to request information about ILO norms and regulations that apply to people working for airlines (flight attendants or air steward, and pilots). I am interested in knowing if there is a norm concerning the type of tasks they perform due to the high altitude, the radiation and pressurization, and whether there exist applicable norms over the time they can and should work in this activity.

Answer: The Radiation Protection Convention of 1960 (No. 115), and the Radiation Protection Recommendation of 1960 (No. 114), establish the appropriate measures to achieve an effective protection of all workers from ionising radiations, from the point of view of their health and safety.

The Employment Injury Benefits Convention of 1964 [Schedule I amended in 1980] (No. 121), and the ILO List of Occupational Diseases (revised 2010), are also applicable to the protection of flight attendants or air steward, and pilots.

The “Radiation protection of workers (ionising radiations)” publication of 1987 provides guidance to all activities that involve workers being exposed to ionising radiations in the work place, including flight attendants or air steward, and pilots.

More detailed information can be found in “Radiation protection and safety of radiation sources: International basic safety standards – Interim edition”, jointly sponsored by the Food and Agriculture Organization of the United Nations (FAO), the International Atomic Energy Agency (IAEA), the ILO, the Organisation for Economic Co-operation and Development/Nuclear Energy Agency (OECD/NEA), the Pan American Health Organization (PAHO) and the World Health Organization (WHO).

Question: I wanted to ask you what is according to the norms, the minimum space that an office worker must have in a corporate building. Where can I find that norm to print it?

Answer: The Hygiene (Commerce and Offices) Recommendation of 1964 (No. 120) specifies in its section VII, Working Space the following:

26. (1) All workplaces should be so laid out and work-stations so arranged that there is no harmful effect on the health of the worker.

(2) Each worker should have sufficient unobstructed working space to perform his work without risk to his health.

27. The competent authority should specify-- (a) the floor area to be provided in enclosed premises for each worker regularly working there;

(b) the minimum unobstructed volume of space to be provided in enclosed premises for each worker regularly working there;

(c) the minimum height of new enclosed premises in which work is to be regularly performed.

Question: Is it still safe for a 70 year old man to work offshore, in the Persian Gulf, humidity sometimes 100%, temperature from 30 to 40 degrees Celsius.

Answer: Two general principles of the safety and health provisions of international labour standards are: 1) hazards inherent in the working environment should be minimized, so far as reasonably practicable; and 2) the work should be adapted to the physical and mental capabilities of the workers. If older workers need special accommodations it should be provided.

Question: I would like to know how to make a plan for labour risks prevention and for protection and health promotion measures for workers in agriculture.

Answer: The main international labour norms about health and safety in agriculture are the Safety and Health in Agriculture Convention of 2001 (No. 184), and Recommendation of 2001 (No. 192). There is also a new Code of Practice on Safety and Health in Agriculture.

Question: Our workers work in teams of four to lift 90 kg bags and place it vertically on the shoulder of a worker who carries it to the vehicle to be loaded. We would like to know the maximum allowable weight to be handled safely by a worker as per ILO standards or what are the ILO guidelines to determine the maximum?”

Answer: A worker should not be required or permitted to engage in the manual transport of a load likely to jeopardise his or her health or safety. The maximum permissible weight is 55 kg for an adult male, and substantially less for young worker and women. (See Maximum Weight Convention (No. 127) and Maximum Weight Recommendation (No. 128), paragraph 14). Companies are encouraged to use suitable technical devices as much as possible (Article 7(2) of the Convention).

The Code of practice on safety and health in agriculture provides further guidance. Workers who handle (lift, carry, and position) heavy objects (weighing in excess of 23 kg) at rates exceeding three times per minute for more than two hours are at risk of experiencing lower back injury, generalized fatigue, and possibly heat stress due to the combination of the weight of the object, the manner, frequency and duration of the task, and other environmental influences such as working in direct sunlight, near heat sources such as electric generators, air compressors, internal combustion engines, etc. The assessment of the health impact of the transportation of loads by an individual worker concerns not only the weight, but other factors, including the initial and sustained forces, the distance from body to object being lifted (sagittal plane), the different lift positions (floor to knuckle height, knuckle to shoulder height, etc.), the task frequency and worker’s gender (see paragraphs 9.2.1.5 and 9.2.2.1).

The International Ergonomics Association and the ILO published the Ergonomic checkpoints in agriculture which provides guidance on carrying heavy weights (see checkpoint 7). See also Maximum weights in load lifting and carrying (ILO OSH Series No 59).

Question: According to your standards, would you please be able to tell me if a firm based of 8-12 people needs a Health and Safety officer, or if a fire warden and a first aider is enough?

Answer: The principles of the international labour standards concerning safety and health do not directly address your question; but they do provide some general guidelines which may be of use.

The principles encourage “at the level of the workplace, the establishment of safety and health policies and joint safety and health committees and the designation of workers' occupational safety and health representatives, in accordance with national law and practice.” See, Promotional Framework for Occupational Safety and Health Recommendation, 2006 (No. 197), paragraph 5(f).

In practice, a specific threshold number of employed workers is generally used in most countries to trigger the requirement for the establishment of a safety and health committee (typically 20 employees). For smaller workplaces (5-19 workers), some countries require the appointment of a safety representative who will have basic knowledge on OSH focusing on prevention.

The important point is to have someone who is adequately trained to ensure an effective system for hazard identification, risk assessment, preparation and implementation of safety programs. In particular, the person should be adequately trained in all relevant aspects of OSH risk prevention. The principles also stress the importance of dialogue and cooperation at the level of the enterprise, regardless of the number of employees. See, Guidelines on occupational safety and health management systems ILO-OSH (2001).

Question: Is portable x-ray equipment technically appropriate for an occupational medical examination, or should I keep on using a fixed x-ray?

Answer: The competent authorities in each country determine the type of x-ray equipment that can be used for chest x-ray examinations as well as for medical care. In several countries, both Digital Radiography (DR) and Computed Radiography (CR) are utilized for these types of examinations. If the portable ones have DR equipment that has been certified by the competent national authorities as appropriate for chest x-ray examinations, such units can be used in addition to the chest x-ray examinations (CR or DR) with fixed x-ray equipment in medical institutions.

The reference to the definitions of technical terms, as well as information relevant to digital radiography can be found in Chapter 6 of the “Guidelines for the use of the ILO International Classification of Radiographs of Pneumoconioses, Revised edition 2011”.