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December 2017 – Strengthening the NSW coal industry health surveillance scheme to better protect workers

The re-identification of coal workers pneumoconiosis (CWP) in the coal mining industry prompted CS Health to undertake a review of the NSW health surveillance scheme for coal workers (Order 41) to ensure that it had none of the systemic issues identified in the Queensland system that led to a failure to identify cases of CWP in workers.

The reviews compared the content of the Order 41 medicals against what would be considered best practice in the health surveillance setting to manage issues such as dust-related disease and other occupational health risks.

A number of recommendations were made and have been, or are currently being, implemented. This follows industry consultation regarding changes to the medical content of Order 41 that was completed earlier this year.

The proposed changes were based on advice from a range of professional bodies and included:

  • Increasing the frequency of chest x-rays to three years for underground coal miners and at risk surface coal miners, with a maximum period of six years for all other coal miners.
  • Including Respiratory fit testing as a proactive step in protecting workers’ health and providing ongoing education in the use of personal protection.
  • Implementing improved clinical standards and training for doctors and other health professionals who conduct health assessments for coal workers.

The following changes have been, or are currently being, implemented:

  • ILO Standard reading and reporting for all chest x-rays commenced in January 2017
  • Consolidation of chest x-ray providers to ensure reliability and only utilise Radiologists on the approved RANZCR list.
  • Introduction of quarterly audits to check accuracy of x-rays and reporting.
  • Improved testing and training standards for spirometry and installation of new equipment across all CS Health offices and mobile health units.
  • A protocol to follow-up any workers identified with possible dust disease was developed and implemented in 2016 in conjunction with Professor Deborah Yates and Dr Susan Miles as our preferred Respiratory Physicians.

Coal Services and the Queensland Department meet on a regular basis in regard to CWP and any developments that may impact on the NSW health surveillance program.  Dr David Meredith (Senior Medical Officer, CS Health) is also a member of the Dust Collaborative Working Group advising the Queensland Department of health matters.