Detection of coal mine dust lung diseases

Coal mine dust lung diseases (CMDLD) like CWP can take up to 10 years or more to develop, and even longer to produce noticeable symptoms.

While prevention is the best defence, identifying the disease in its early stages can prevent it from progressing to a point where it has an impact on your quality of life.

Coal Mine Workers’ Health Scheme

The Coal Mine Workers’ Health Scheme protects the long-term health of Queensland coal miners. It requires that every coal mine worker completes a health assessment at least once every 5 years.

Formerly known as the Coal Board Medical, it provides early diagnosis and intervention for diseases like CWP and silicosis. It is also used to determine your fitness for work.

Your employer must arrange and pay for your health assessments, including any additional tests or follow-up investigations of abnormal screening results.

From 1 January 2017, all Queensland coal mine workers employed for a task other than a ‘low risk’ task will receive a health assessment:

  • on entry to the industry or change in employer
  • at least every 5 years while employed in the industry
  • at retirement (on a voluntary basis).

From 1 March 2019, eligible former coal mine workers are able to obtain a respiratory health assessment through DNRME.

You might also be required to have a health assessment if your employer’s appointed medical adviser (previously called nominated medical adviser (NMA)) decides it is necessary (e.g. if on-site monitoring indicates high respirable dust levels).

Who is my appointed medical adviser (AMA)?

The AMA is a doctor appointed by your employer to undertake, manage and supervise Coal Mine Workers’ Health Scheme health assessments. These doctors must be appointed by employers from the list of doctors approved by DNRME. They are the only person authorised to complete Section 4 of your health assessment form and are responsible for ensuring that the results are reported.

Two workers talking onsite

People are definitely more aware of CWP now. Miner

Your health assessment

nurse walking towards seated worker in waiting room

When talking to your GP, it's important to tell them that you are, or have been, a coal mine worker.

Your health assessment will be conducted by your employer’s AMA, or another qualified doctor under the supervision of the AMA.

Your health assessment form comes in 4 sections, each completed by a different person.

Completed byIncludes
SECTION 1 Employer
  • AMA and employer details
  • your position
  • similar exposure groups
  • health risks associated with your employment
SECTION 2 You
  • your personal details
  • work and medical history
  • a copy of photo ID
SECTION 3AMA or examining doctor
  • clinical findings
  • chest X-ray results
  • spirometry test results
SECTION 4
Your health assessment report
AMA
  • review of clinical findings
  • fitness for duty
  • work restrictions
  • follow-up requirements

Respiratory component of the health assessment

The respiratory component of your health assessment includes:

  • spirometry (lung function) test, which must be compared to your previous spirometry results
  • chest X-ray.

Underground and above-ground workers need to undergo both of these at least once every 5 years.

Screening improvements

In response to new cases of CWP, the Coal Mine Workers’ Health Scheme has been strengthened to make sure no case goes undiagnosed, including:

  • improvements to chest X-rays - higher quality standards in line with international best practice, with X-rays dual-read to the ILO International Classification of Radiographs of Pneumoconioses
  • better training for health care professionals - new register with minimum requirements for doctors and medical providers approved to perform coal workers’ health assessments
  • new standards for spirometry (lung function) testing and training for spirometry personnel
  • optional respiratory assessments for retiring and former coal mine workers
  • improved filing of health records to allow comparisons of results over time.

Lung function test (spirometry)

Spirometry is a standard test used to diagnose conditions that affect your lung function, like chronic obstructive pulmonary disease (COPD) and asthma. To take a spirometry test, you breathe forcefully into a small machine called a spirometer.

Chest X-ray

As most early cases of simple CWP show no symptoms, regular chest X-rays are absolutely crucial to identifying the disease before it progresses.

If you require a chest X-ray, your NMA will refer you to a radiologist that has been approved to perform specialist CWP chest X-rays.

Since 27 July 2016, every coal mine worker’s chest X-ray is being examined against ILO standards by:

  1. an Australian radiologist listed on the Royal Australian and New Zealand College of Radiologists Register for CWP Screening
  2. US-based National Institute for Occupational Safety and Health (NIOSH) approved readers (called B-readers).

The Queensland Government is working to build Australian B-reader capacity to allow your X-rays to be dual-read in Australia.

ILO standards  

The International Labor Organization (ILO) has set an international standard to describe and code features in chest X-rays that could indicate pneumoconiosis.

The radiologist will compare your X-ray with standard images which show different levels of abnormalities in patients with possible pneumoconiosis. It helps your radiologist determine if the disease is present and how advanced it is.

Completing the assessment

Once all the required test results are compiled, the AMA reviews them and further investigations may be required if the screening tests show any abnormalities. Once finalised, the AMA completes Section 4 of your health assessment form and is responsible for forwarding information from your health assessment to:

  1. The Health Surveillance Unit of the Mines Inspectorate
    • the completed health assessment form
    • all medical reports (including both chest X-ray reports, spirometry report, CT scan report if required) for filing in your permanent record
  2. To you and your employer
    • a copy of Section 4 of your health assessment report

Your AMA is also required to keep a full copy of each health assessment they complete.

You can request copies of your past health assessments from either the AMA or the Department of Natural Resources, Mines and Energy.

For assistance, contact us on (07) 3818 5424 or HSU@dnrme.qld.gov.au.

Exit assessment  

As part of the improvements to the Coal Mine Workers’ Health Scheme, your employer needs to offer you the opportunity to have a health assessment when you retire, if:

  • you have worked in the industry for at least 3 years
    and
  • it has been 3 years since your last routine health check.

The exit assessment must be completed within a 6-month period starting 3 months before and extending to 3 months after your retirement date.

The exit assessment consists of a respiratory function test and chest X-ray.

Your employer must organise and pay for this assessment.

Clinical pathways guideline

To screen for abnormalities, doctors use a combination of chest X-ray and lung function test results. Because CWP often looks similar to other respiratory diseases in X-rays, CT scans are sometimes required to confirm diagnosis.

A standardised clinical pathways guideline (PDF, 702KB) has been developed for doctors to ensure a consistent approach to follow up and referral for screening tests with abnormal results.

If all tests are normal, no further action is required.

If your spirometry result is lower but not significantly so, you may need to have another assessment in a year’s time or sooner, depending on the cause.

You will be referred to a specialist for further assessment if you have any of the following:

  • spirometry results with more substantial decline in lung function
  • abnormal chest X-ray
  • unexplained, significant respiratory symptoms.

Worker undergoing lung function test

Visit your doctor or employer’s AMA immediately if you have concerns about your health.

Further assessment

The AMA will refer you to a specialist respiratory physician for further testing if your screening results are abnormal. If these indicate CWP or silicosis, a fitness for work assessment will be conducted.

A diagnosis of CWP or silicosis does mean the types of roles you can perform may change. A wide range of support has been made available to affected miners.

Taking charge of your health

Whether working or retired, you should visit your doctor or employer’s AMA immediately if you have concerns about your respiratory health.

When talking to your GP, it is important to tell them that you are, or have previously been, a coal mine worker.

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