Taking steps to combat black lung

From January 2017, the Queensland Government made certain measures to protect coal mine workers against coal worker’s pneumoconiosis (CWP), or black lung, into laws as part of its efforts to reduce the instances of the disease.

These stipulate that all new coal mine workers are to have respiratory function and chest x-rays once they enter the industry; above-ground coal workers must have respiratory function and chest x-rays at least once every 10 years – underground workers once at least every five years; and mining companies must provide dust monitoring data to the Mines Inspectorate every three years.

It also enables retired coal mine workers to ask their employer for a retirement examination which includes chest x-rays and respiratory function tests.

Black lung, which is caused by constant exposure to breathable coal dust, was thought to have been eradicated 30 years ago, however there are currently 20 confirmed cases in Australia. Of these, 19 are from Queensland, with one case affecting a worker from New South Wales.

Following these measures, the Queensland Government made reforms to the Mine Workers Health Scheme in March, as an added preventative step against black lung.

At the time, Queensland’s natural resources and mines minister Anthony Lynham highlighted that around 5000 International Labour Organisation (ILO) standard x-rays had been conducted by Queensland radiologists since July last year and reassessed by a United States B-reader – a physician that can detect instances of pneumoconiosis.

However, the state will begin implementing a Queensland based system from July this year that will assess the x-rays twice. There will also be stricter guidelines for those conducting spirometry (lung capacity) tests by July this year as well.

The reforms also include the development of a process for clinically diagnosing CWP, designed in collaboration with medical experts, as well as a health assessment form to gather health information of coal mine workers.

The Queensland Department of Natural Resources and Mines (DNRM) will also implement an electronic health record system by the end of this year, allowing current and former coal mine workers to access their own health records regardless of where they work or live.

“It also means that doctors will have better information and contractors, working for multiple employers, no longer require multiple medicals or x-rays,” Lynham said.

The Queensland Government has also taken additional measures in terms of compensation. Black-lung affected workers are already able to receive compensation through WorkCover and common law damages regardless of their age or employment status.

Under these measures, all medical examination examination costs for former coal mine workers concerned that they have black lung will be paid by WorkCover; workers with simple CWP, whose disease progresses, will be allowed to reopen their claim in order to access more benefits of the worker’s compensation scheme; additional rehabilitation support will be provided to assist workers back into alternative employment; and worker’s compensation arrangements will be streamlined to align them with the Coal Mine Workers’ Health Scheme.

Prior to these addition measures, the Coal Workers’ Pneumoconiosis Select Committee launched an Inquiry into CWP, with public hearings held throughout Queensland since October last year to further understand how the disease resurfaced.

The Inquiry enabled victims, members of the community and experts to give evidence to highlight the impacts of black lung on workers and the community. It also featured input from US black lung expert Dr Robert Cohen, who traveled to Queensland for the hearing. Cohen was also instrumental in identifying a number of black lung cases in Australia.

The Inquiry follows on from previous research on black lung such as the Monash University study and the findings of the Senate Select Committee on Health.

Initially, the Inquiry’s findings were to be presented to the Legislative Assembly in April this year, however, this has been extended to September.

The Construction, Forestry, Mining and Energy Union (CFMEU), have so far supported the interim findings of the Inquiry and are awaiting its recommendation.

“The CFMEU has supported all black lung victims and led the fight for justice and a safer workplace,” CFMEU mining and energy division president Stephen Smyth said.

“We look forward to being closely consulted on the recommendations and development of the policy response.”

Smyth also highlighted the importance of enforcing reduced legal dust limits before the next state election as well as a monitoring and compliance regime that operates independent of employers.

The current coal dust limit in Queensland is 3mg/m3 of air, which is higher than the level in NSW and the US at 2.5mg/m3 of air. The Select Committee on Health called for the Queensland to reduce its limits to that level, which is the lowest Australian standard.

With the extended due date of the Inquiry’s findings, the Queensland Resources Council raised concerns about the broadening of the scope of the committee even before the Inquiry was complete, with CEO Ian Macfarlane saying it created uncertainty and delayed the outcomes for black lung sufferers.

“Industry is already taking pro-active steps to address dust levels on mine sites and we are working with unions and governments to ensure levels are kept below the regulated limits,” Macfarlane said.

Another issue the QRC stressed on was the need for better medical assessments of coal mine workers to ensure any case of black lung is caught early.

“There must be a significant improvement in the standard of medical assessments that our coal workers are required to undergo,” Macfarlane said.

“We want nothing less than the world’s best practice when it comes to the industry. It is vital the radiologists are highly skilled and using the best equipment that is available to make sure that we are getting every case at its earliest stages.”

Ensuring the right fit

Terry Gorman, senior occupational hygienist at 3M, highlighted that the concept of a black lung resurgence is debatable, suggesting that it has always been here.

“It has just been unreported or undiagnosed rather than not being there,” he told Australian Mining.

3M, which develops a range of safety products and technologies, also designs a range of respirators to protect workers against respirable contaminants.

Gorman emphasised the importance of strict monitoring on site to prevent dust exposure and said more can be done by mine operators in this respect.

“There are always improvements that can happen with the controls that are put in place, whether they be ventilation, other work practices or personal protective equipment improvements,” he said.

Gorman also said more can be done by state governments, particularly in Queensland and New South Wales where the majority of Australia’s coal mines reside.

“Their performance could be better,” he said. “They have certainly taken off focus on the disease in years past and have not been keeping up with their required oversight of the exposures and worker health.

“There has been, as we know now, a number of cases of black lung being diagnosed with the potential for many more to be diagnosed.”

One of the ways to minimise the risks of inhaling coal dust is through respirators, however, Gorman said these are mostly effective when used appropriately.

“In the past [dust exposure] has occurred because not enough attention has been paid to the use of equipment with the training of workers and fit testing for products to make sure they suit the individual,” he said.

Gorman further emphasised the importance of properly fitted masks.

“Tight fitting masks need to conform to the face of the wearer,” he said. “Not all masks fit every face.”

Gorman added the importance of using fit testing to determine if a particular mask appropriately fits the individual worker. He said fit testing should be done when an individual starts their employment and conducted regularly to ensure they still fit.

He further indicated that one of the biggest resistance to fit testing is the clean shaven requirement, whereby any significant facial hair, even stubble, can affect the effectiveness of respirators.

“The [hairs] act like steeples, literally holding it [the respirator] off the face,” he said,

Gorman also emphasised steps mine operators can take to ensure they keep their workers protected against dust inhalation.

“Operators should be undertaking regular workplace monitoring to determine the levels encountered by the workforce,” he said. “They should also ensure workers are being provided with equipment suitable for those exposures and that they receive the training required to use the equipment correctly.”

This article also appears in the May edition of Australian Mining.