To compare of quality control for chest radiography between special examination (SEP) and medical institution for pneumoconiosis (MIP). For the first time, we had visited at 33 institutions (SEP; 17 institutions, MIP; 16 institutions) to evaluate the quality control of chest radiography which is used in diagnosis of patients with pneumoconiotic complications. Image quality was rated by two experienced chest radiologists, and evaluated for radiological technique (RT), reading environment (RE) and image quality (IQ) between SEP and MIP according to the guideline published by OSHRI. Generator capacity, used duration and modality of chest radiography equipment were not signigicant difference between SEP and MIP, but there were signigicant difference in tube voltage and grid ratio used for chest radiography except to tube current and exposure time. SEP was statistically significant higher in RT (71.2 vs. 54.5, p=0.015), RE (78.8 vs. 51.5, p=0.007) to MIP, but not significant difference in IQ (64.8 vs. 59.3, p=0.180). For reliable and precisional diagnosis of patients with pneumoconiotic complications, the MIP requires the evaluation and education of quality control for improving chest radiography.