Dean Barr A/Director, Coal Mine Workers’ Health Scheme Kerri Melkersson Director, Health Surveillance Unit, Department of Natural Resources, Mines and Energy Since the re-identification of coal workers’ pneumoconiosis in Queensland in 2015, and reforms resultant from the Monash and UIC independent expert review of 2016, the department has implemented improved screening methods for the detection of respiratory disease in coal mine workers. As at March 2019, more than 30,000 chest x-rays have been dual read to International Labour Organisation (ILO) standards, resulting in 99% returning a negative result for disease. Of the 1.0% which screened positive, 15 have resulted in a diagnosis of disease.</p . The department receives reports of cases of mine dust lung disease (MDLD) through a number of pathways; doctors, mine operators and the workers’ compensation scheme all provide confirmation of diagnoses within the mining and quarrying sectors. As at March 2019, 99 cases of MDLD have been reported across all sectors since 1984 (89 since 2015). Separate to the reforms implemented in the mining regulatory framework, the Queensland Parliament is considering a Bill to establish a Notifiable Dust Lung Diseases Register to be administered by Queensland Health. This will provide a further mechanism to ensure the incidence of disease is understood. This paper provides an overview of the current screening pathways to detect MDLD in Queensland mine workers.

Dr Rhiannon McBean, Research Coordinator, The Wesley Dust Disease Research Centre Coal Mine Dust Lung Disease (CMDLD) is a term for of all lung diseases caused by inhalation of coal mine dust. CMDLD includes pneumoconiosis; coal workers’ and mixed dust pneumoconiosis (CWP; MDP) and silicosis, as well as inflammatory-type diseases such as chronic obstructive pulmonary disease (COPD). CMDLD was undetected in the Queensland coal industry from 1984 to 2015. We aimed to understand the spectrum and severity of disease in recently diagnosed CMDLD cases (n= 79) by reviewing medical imaging, charts, lung function and occupational history. CMDLD pneumoconioses were diagnosed in 71% of cases; CWP was most common (34%). Advanced disease was observed on medical imaging for 24% of subjects. Lung function results were equally split, 47.2% normal and 52.7% abnormal. On average, the tenure in coal mining was 26 years (range 6-45). The majority of subjects (44%) had only worked in underground coal mines. Surprisingly, 27% of subjects reported to have never worked in an underground coal mine. We observed a diverse spectrum of diagnoses and severity ranged from mild to severe. Occupational history in terms of tenure and mine type varied across the subject group. It is hoped these findings will boost awareness of CMDLD

Assoc. Prof. John Schneider Occupational Physician, James Cook University, Mackay Clinical Campus Increasing awareness of workplace dust exposure due to media reporting of pneumoconioses such as “black lung” and silicosis, has resulted in increased health surveillance, radiological investigation and notification of possible work related lung disorders. The most common chronic lung condition associated with significant occupational dust exposure however, are not the pneumoconiosis. Subsequent decisions associated with the workers continuing employment can pose problems in both human resource and occupational health supervision and management. The reporting of changes in pulmonary imaging do not necessarily need to result in departure from the industry. With comprehensive medical management including Pulmonary Rehabilitation if necessary, and coordinated Pulmonary Protection programs involving both the workplace and treating medical practitioner many workers can continue to work productively within the industry until retirement.</p . The presentation will consider managing the health and workplace risks associated with continued employment of workers reported with positive health surveillance findings, including:-

• Work Related Lung Disorders
• Current dilemmas in employment management
• Interpretation and significance of medical reports
• Assessment and importance of lung function
• Pulmonary Rehabilitation
• Fitness for Work
• Occupational Rehabilitation
• Pulmonary Protection Programs
  • Risk management
  • Control of hazardous work exposures
  • Medical involvement in health management