What is it?

Coal workers’ pneumoconiosis or CWP, also known as ‘black lung’, is part of a group of diseases known as ‘coal mine dust lung diseases’ or CMDLD caused by long-term occupational exposure to high concentrations of respirable dust produced when coal mining. Other diseases within this group include Silicosis, Mixed Dust Pneumoconiosis (MDP) and Chronic Obstructive Pulmonary Disease (COPD). Typically it can take more than 10 years of prolonged elevated dust exposure to develop, but disease can develop sooner, particularly in circumstances a high exposure. The severity of the disease is linked to the length of exposure and composition of the respirable dust; the longer the exposure and higher the concentration the more serious the disease.

What are the health effects?

The coal dust collects in the alveoli (air sacs) of the lungs causing an inflammatory reaction which ultimately leads to scarring. The scarring reduces the elasticity of the lung ultimately reducing the capacity of the lungs over time.

What are the symptoms to look out for?

In the early stages there may be no visible symptoms apart from a shortness of breath or chronic cough. In the early stages, it may only be detected on x-ray, or by a reduction in your measured lung function. Over time, these symptoms may gradually become worse, with increasing shortness of breath, and later pulmonary hypertension and heart problems.

What are the recent changes to the QLD Coal Mine Workers Health Scheme?

As a consequence of the detection of “black lung” in some Queensland Miners in 2016 a review of the medical assessments process was completed. Legislation changes came into effect in 2018, with further changes in 2019. All changes are aimed to ensure coal employees are adequately screened for Coal Miners pneumoconiosis or “black lung”. Sonic HealthPlus’ Chief Medical Officer Dr Keith Adam, has been working closely with the Queensland Department of Natural Resources and Mines to ensure changes are implemented through the Sonic HealthPlus business.As of March 1 2019 further legislative changes come into effect including:

• Lungscreen Australia will now complete the B-read.       The cost of this service is no longer paid for by DNRME, and must be borne by the employer. Lungscreen will classify coal mine worker chest X-rays to the ILO Classification and will provide the final ILO report back to the referring doctor. There will no longer be an Interim Report available. The Section 4 can only be released AFTER the final B-read by Lungscreen. These changes will affect the cost of providing the Coal Mine Workers Health Scheme Medical to companies.

• It is mandatory for the Worker to register with Lungscreen to obtain an ID, before having an x-ray

• Approved provider network – including EMOs, NMAs, spirometry clinics and radiology providers

• Employers are required to appoint one or more medical practitioners as their Nominated Medical Adviser (NMA). The NMA's role is to carry out, supervise and report on health assessments and retirement examinations for the employer's coal mine workers.

How can exposure be managed in the workplace?

Assessing and managing the risk of exposure in a workplace can be challenging. Mine operators should be implementing measures to reduce the creation of dust during mining operations. Respiratory protection should be used when working in an environment susceptible to airborne dust and other contaminants, for example at the long wall. Complementary regulations require the regular monitoring of dust levels and assessment of the working environment. Regular reviews of work practices and and equipment should also be undertaken to minimise worker exposure to unhealthy dust levels.   Every effort should be made to reduce exposure and protective equipment must be correctly fitted and worn at all times. Health surveillance of workers is also one of the most effective ways to manage exposure.

Can it be treated?

There is no treatment for coal worker’s pneumoconiosis apart from managing the symptoms. The scarring of lungs is irreversible. Any workers diagnosed with the disease should avoid further exposure.

How can Sonic HealthPlus assist?

Sonic HealthPlus employs a number of occupational physicians who are experts in diagnosing coal worker’s pneumoconiosis and recommending measures to reduce exposure in the workplace. We have worked with the Department of Natural Resources, Mines and Energy in Queensland for many years to develop best practice health surveillance for the disease.We provide the following services to assist workplaces in managing the health surveillance for coal mine workers including:

• Specialist workplace assessment by occupational physicians who may assist in identifying high risk occupations and tasks.

• Our occupational physicians are available to explain the risk and health effects to your workers in your workplace.

• Providing health surveillance for exposed workers including:

  • Detailed work history.

  • General health questionnaire.

  • Specific respiratory symptom questionnaire.

  • Spirometry, performed in accordance with TSANZ guidelines.

  • Referral for a chest x-ray, reviewed by an accredited ILO reader.

  • High-resolution CT scanning may also be recommended.

  • Appointing a Nominated Medical Advisor (NMA).

For further information, don’t hesitate to contact our Specialist Services Unit for assistance on 1300 588 440.