Feedback
Mine dust lung disease reforms
A range of mine dust lung diseases (MDLD) – including coal workers' pneumoconiosis (CWP) – are caused by long-term exposure to mine dust. This guide explains how we are addressing MDLD in Queensland.
Resources Safety & Health Queensland (RSHQ) reports on the number of confirmed cases of MDLD, including CWP.
The Queensland Government has implemented all recommendations made by the review undertaken by Monash University in collaboration with the University of Illinois at Chicago. Reforms we have implemented include:
- the provision of worker information to miners, mining companies and other key stakeholders
- health surveillance and mandatory reporting of diseases
- new standards for the provision of spirometry and chest X-ray imaging
- new training courses for doctors undertaking health assessments and radiologists to achieve 'B-reader' qualification
- the development of clinical pathway guidelines, a requirement of doctor registration for undertaking coal mine worker health assessments
- a register of approved doctors, imaging and spirometry providers who meet required standards, training, qualifications and experience
- dual-reading of chest X-rays by 'B-reader' qualified specialists
- the transition to an electronic record management system to allow for the upload and retrieval of health assessments
- free health checks for retiring and former workers
- a database of dust monitoring results, published quarterly.
Significant work is also underway to deliver:
- funding for the development of real-time dust monitoring technologies that are safe for use in underground coal mines
- a research project to improve respirable dust monitoring and control in Australian coal mines.
Find out more about the CWP review and inquiries and access their reports.
Visit Miners' Health Matters to find out more about coal mine dust lung diseases and support for affected workers. You can also order copies of our free pocket guides for coal mine workers.
Queensland Government's response
Major reforms have been made to protect the occupational lung health of Queensland's coal mine workers.
Review and inquiry recommendations
Work to date has been guided by the recommendations in the independent review of the respiratory component of the Coal Mine Workers' Health Scheme (PDF, 2MB), undertaken by Monash University in collaboration with the University of Illinois at Chicago.
The CWP Select Committee released its final report (PDF, 8.7MB) in 2017, with a further 68 recommendations.
The government accepted all recommendations in principle and is on track to deliver on the actions and time frames committed to in the government's response (PDF, 3.1MB), tabled in parliament in September last year.
An independent Project Management Office has been formed to consult on some of the recommendations.
Reforms to date
Reforms that have been delivered to date are focused on 3 key areas:
- prevention
- early detection
- provision of a safety net for affected workers.
Government, industry, unions and the medical profession are working together to deliver on these areas.
Prevention
To prevent the occurrence of coal workers' pneumoconiosis (CWP), new dust control and monitoring standards have been developed, and coal mines are now required to report all dust monitoring results quarterly to the Mines Inspectorate. Additionally, the Safety in Mines Testing and Research Station (Simtars) is now delivering training to industry on monitoring respirable dust in coal mines.
Early detection
To ensure early detection of CWP, all coal mine workers' chest X-rays must now be examined against the International Labour Organization (ILO) International Classification of Radiographs of Pneumoconioses. Chest X-rays are examined by at least 2 medical experts. These experts have achieved B-reader accreditation from the US National Institute for Occupational Safety and Health (NIOSH).
Since the program was implemented in July 2016, more than 42,000 X-rays have been sent to the US for dual-reading. Sending X-rays to US-based accredited readers was an interim solution until an Australian-based dual-reading service was established.
On 1 March 2019, Lungscreen Australia replaced US-based B-reading for all Queensland coal mine worker chest X-rays. All chest X-rays must be sent to Lungscreen Australia from this date.
Amendments to the Coal Mining Safety and Health Regulation 2017 that commenced on 1 March 2019 make this a mandatory requirement of the Coal Mine Workers' Health Scheme.
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.
Other Australian B-readers registered with Resources Safety and Health (RSHQ) can undertake the first B-read and provide this to Lungscreen from 1 March 2019 to complete the dual-reading process.
- Read about the Two-reader process for chest X-rays (PDF, 843KB).
Regulatory changes on 1 January 2017 ensure all Queensland coal mine workers will receive a health assessment:
- upon entry to the industry
- at least every 5 years while employed in the industry
- at retirement (on a voluntary basis).
Regulatory changes on 20 July 2018 ensure all Queensland coal mine workers (above-ground and underground) undergo a chest X-ray and lung function test through spirometry at least every 5 years.
Electronic health records management
Coal mine worker health assessments must now be completed in ResHealth. This electronic records management system enables employers, workers and doctors to complete the health assessment form online and enhances RSHQs health surveillance capabilities.
Consistent diagnostic journey
The Mine dust lung disease clinical pathways guideline (PDF, 789KB) documents the recommended process for follow-up investigation of mine and quarry workers with abnormal screening results on respiratory examinations.
The Guideline was first published in 2017 in response to the re-identification of MDLD and was recommended following an independent review of the CMWHS by Monash University in collaboration with the University of Illinois at Chicago. The Guideline has been reviewed and updated to incorporate legislative amendments, audit learnings, and feedback from stakeholders.
The Resources Medical Advisory Committee, appointed by the Minister for Resources and Critical Minerals in 2021, has endorsed the revised Guideline.
The Guideline is applied by appointed medical advisers and other medical practitioners providing health services to coal mine workers.
Register of doctors and medical providers
In response to the Monash review recommendations, RSHQ introduced a register of doctors, X-ray imaging practices and spirometry practices that offer health services to Queensland's coal mine workers.
From 1 March 2019 the use of registered medical providers is a mandatory requirement of the Coal Mine Workers' Health Scheme.
Doctor training
A new training program has been developed for doctors providing health assessments for Queensland coal mine workers.
The training program includes medical surveillance, diagnosis, treatment and rehabilitation of individuals with coal mine dust lung disease.
Lung function testing
Spirometry is a lung function test that measures airflow from the lungs and is used, along with chest X-rays and other techniques, to identify possible indicators of coal mine dust lung disease (CMDLD).
In partnership with RSHQ, The Thoracic Society of Australia & New Zealand has developed new standards for conducting spirometry tests and spirometry training courses:
- Standards for the delivery of spirometry for resource sector workers (PDF, 1.0MB)
- Standards for spirometry training courses (PDF, 368KB)
The Spirometry Logbook (XLSX, 217KB) referenced in the standards for delivery is available at the TSANZ website.
X-ray standards
In response to the Monash review recommendations, new X-ray imaging standards were published in 2017 and subsequently updated in 2023:
These standards have been developed in consultation with Australian and international experts. They detail what is required when providing X-ray imaging services to Queensland coal mine workers, including requirements for qualifications, imaging equipment and software, image acquisition and quality control systems.
Safety net for affected workers
To provide a safety net for workers with the disease, WorkCover Queensland has established a dedicated team to assess and manage claims. This specialised team assists workers during the claims process and ensures all claims are processed in a timely manner.
Read about how WorkCover processes your CWP claim (PDF, 119KB).
On 23 August 2017, the Queensland Parliament passed the Workers' Compensation and Rehabilitation (Coal Workers' Pneumoconiosis) and Other Legislation Amendment Act 2017. This provides stronger workers compensation protections for current, retired and former coal mine workers.
- Find out more about changes to workers compensation protections.
- Contact WorkCover Queensland.
Resources safety and health regulator options
The Coal Workers' Pneumoconiosis Select Committee tabled a number of reports in Queensland Parliament relating to the re-emergence of coal workers' pneumoconiosis (CWP) in Queensland and other occupational respirable dust issues.
In its second report (PDF, 8.7MB), the committee made 68 recommendations.
An independently-led Project Management Office (PMO) was set up to investigate the recommendations relating to structural changes and funding of the regulator.
The PMO has now released its final report - Queensland resources safety and health - regulator and funding models (PDF, 794KB). Its recommendations include the establishment of a standalone independent regulator.
Response to the report
In response to the report, the Queensland Government intends to bring forward legislation to establish an independent statutory entity with responsibility for the regulation of safety and health in the resources sector in Queensland.
A draft of the proposed Bill making changes to the regulatory environment will be made available to stakeholders for consultation and comment .
Background to the report
Between March and May 2018, the PMO held 3 information forums and released a number of discussion papers and focus papers for public consultation.
To obtain a copy of the presentations, or the video of the first forum, email RSHQ.Corro@rshq.qld.gov.au. You can download the discussion and focus papers below.
- Discussion paper 1 - Options for resources safety and health regulator models in Queensland (PDF, 1.8MB)
- Resources safety and health regulator models - Cost Modelling (PDF, 1.0MB)
- Focus paper 1 - Overview of governance arrangement for public authorities (PDF, 1.4MB)
- Focus paper 2 - Proposed location of the regulator in Mackay (PDF, 1.6MB)
- Focus paper 3 - Simtars fee for service review (PDF, 1.3MB)
- Discussion paper 2 - Funding the resources safety and health regulator in Queensland (PDF, 898KB)
- Mine safety and health fee funding model options (PDF, 673KB)
- Focus paper 4 - An examination of the proposal to fund the regulator from mining royalties (PDF, 985KB)
- Focus paper 5 - Mobile health units (PDF, 1.0MB)
Review and parliamentary inquiries
Regulatory changes
Note: From 1 July 2020 the functions and powers performed or exercised by the Department of Natural Resources and Mines referenced below are now performed or exercised by Resources Safety and Health Queensland.
Senate Select Committee on Health
Queensland Health partnered with the Department of Natural Resources and Mines (DNRM)—now the Department of Natural Resources, Mines and Energy—to make a submission to the Parliament of Australia's Senate Select Committee on Health inquiry into coal workers' pneumoconiosis.
On 28 April 2016, the Senate Select Committee on Health released its report with 20 recommendations. A number of these recommendations, particularly those relating to nominated medical advisers, are being addressed through implementation of the Monash review recommendations. Other recommendations are addressed by the government's action on dust management.
- Joint Queensland Health and DNRM submission (PDF, 1.6MB)
- Fifth interim report of the Select Committee (Black Lung)
Monash review
An independent review of the Coal Mine Workers' Health Scheme was undertaken by the Centre of Occupational and Environmental Health at Monash University, in collaboration with the University of Illinois at Chicago. The review focused on the respiratory component of the health scheme. The outcomes of the Monash review were published on 13 July 2016.
Coal Workers' Pneumoconiosis Select Committee
On 15 September 2016, the Queensland Parliament appointed a 6-person select committee to inquire into CWP.
- Interim report - Report no. 1, 55th Parliament Coal Workers' Pneumoconiosis Select Committee, March 2017 (PDF, 832KB)
- Final report - Report no. 2, 55th Parliament Coal Workers’ Pneumoconiosis Select Committee, May 2017 (PDF, 8.7MB)
- DNRM submission to the committee (PDF, 3.1MB)
- Queensland Government response to the final report, September 2017 (PDF, 1.2MB).
Regulatory changes
Note: From 1 July 2020 the functions and powers performed or exercised by the Department of Natural Resources and Mines referenced below are now performed or exercised by Resources Safety and Health Queensland.
Coal workers
To address coal workers' pneumoconiosis, the government reviewed and amended the Coal Mining Safety and Health Regulation 2017 in 2017. Further changes to the regulation were made in 2018. The changes are detailed in:
- Mining Safety and Health Legislation (Coal Workers' Pneumoconiosis and Other Matters) Amendment Regulation 2016 (the Amendment Regulation 2016) and explanatory notes
- Coal Mining Safety and Health (Coal Workers' Pneumoconiosis) Amendment Regulation 2018 (the Amendment Regulation 2018) and explanatory notes.
Mineral mines and quarry workers
To enhance respiratory health surveillance for mineral mine and quarry workers, the government reviewed and amended the Mining and Quarrying Safety and Health Regulation 2017 in 2020. The changes are detailed in:
- Mining Safety and Health Legislation (Health Surveillance) Amendment Regulation 2020 (the Amendment Regulation 2020) and explanatory note.
2017
Commencing 1 January 2017, the changes included:
- strengthened respirable dust monitoring requirements
- coal worker's pneumoconiosis and certain other occupational diseases now listed as 'notifiable'
- broadened coal mine worker health assessment requirements
- the introduction of retirement examinations for coal mine workers leaving the industry
- the specified frequency of respiratory health screening for above-ground coal mine workers.
Regulatory requirements for the management of respirable dust are being strengthened for all Queensland coal mine operators. These changes require regular reporting of personal respirable dust monitoring records and specific actions by mines each time respirable dust concentrations exceed prescribed levels (including notification, investigation, system improvements and resampling).
In addition, the task of carrying out respirable dust sampling at a coal mine in accordance with AS 2985 will be listed as a prescribed task for section 76(3)(a) of the Coal Mining Safety and Health Act 1999. This means any person carrying out respirable dust sampling at a coal mine in accordance with AS 2985 must have the recognised competencies as determined by the Coal Mining Safety and Health Advisory Committee.
Recognised standards are a method used to achieve an acceptable standard of risk for people working in coal mines.
Two new recognised standards will drive best practice monitoring and control of respirable dust in coal mines:
- The recognised standard for monitoring respirable dust in coal mines provides the minimum requirements for monitoring and reporting respirable dust levels to be included in a coal mine's safety and health management system.
- The recognised standard for underground respirable dust control will provide a comprehensive approach for managing respirable dust using known risk management concepts and best practice dust management controls.
The Amendment Regulation 2016 also adds a number of occupational diseases that must be reported when the senior executive in charge of a mine site (the site senior executive) becomes aware of an occurrence. These notifiable diseases are chronic obstructive pulmonary disease, coal workers' pneumoconiosis, legionellosis and silicosis.
Find out more about reporting prescribed diseases.
To broaden health assessment requirements, the following changes apply:
- All new coal mine workers (to be employed for a task other than a low-risk task) undergo a health assessment inclusive of respiratory function and chest X-ray examinations on entry into the coal mining industry.
- Respiratory function and chest X-ray examinations for above-ground coal mine workers occur at least once every 10 years. (This has now been changed to at least once every 5 years for consistency with the requirements for underground coal mine workers.)
- Respiratory function and chest X-ray examinations for underground coal mine workers (and former underground workers working above-ground) occur at least once every 5 years.
- Respiratory function examinations undertaken as part of periodic health assessments include a comparative assessment with previous respiratory function results when available.
- All medical examinations are performed by a person qualified and competent to conduct the examination.
- X-ray examinations are performed in accordance with the International Labour Organization (ILO) Guidelines for the Use of the ILO International Classification of Radiographs of Pneumoconioses.
New employer obligations that commenced on 1 January 2017 provide retiring coal mine workers with the opportunity to voluntarily undergo an exit assessment (consisting of respiratory function and chest X-ray examinations). Employers are required to organise and pay for a retirement examination for any eligible retiring coal mine worker who requests one. The obligation applies to all retiring coal mine workers who have worked in the coal mining industry for at least 3 years and who have not already undergone such examinations as part of a routine health assessment during the past 3 years.
2018-19
The government has made further amendments to the Coal Mining Safety and Health Regulation 2017. These changes were required to sustain and enhance the improvements made in implementing the Monash review recommendations. They build on the regulation changes which commenced on 1 January 2017.
The amendments were rolled out in 2 phases.
From 20 July 2018, the changes:
- introduced health surveillance as a purpose of the scheme
- enabled health surveillance
- increased the minimum frequency of chest X-ray and spirometry examinations to 5 years for above-ground workers.
From 1 March 2019, the changes:
- established a mandatory 'approved provider' framework
- incorporated a right to a respiratory health assessment for retired and former workers
- included consequential amendments, including the replacement of the term 'nominated medical adviser' with 'appointed medical adviser'.
The changes introduced health surveillance as a purpose of the scheme, including respiratory health screening, referral for diagnosis and management and the monitoring of trends in coal mine dust lung disease.
The Amendment Regulation 2018 also includes changes to:
- allow the Department of Natural Resources, Mines and Energy (DNRME) to release identified data for the purposes of research if the research is approved by an ethics committee
- enable all workers to receive a comparative assessment by allowing the relevant doctor to access the worker’s previous assessments from DNRME without the worker's consent.
The frequency for respiratory screening for above-ground coal mine workers has been increased from at least once every 10 years to at least once every 5 years, aligning with what is required for underground workers.
The government introduced a voluntary register of doctors and medical providers in July 2017. Major coal companies agreed, where possible, to use registered medical providers to undertake health assessments. The amendments introduced an approved provider framework and made the use of these providers mandatory from 1 March 2019. From this date, only the providers approved by DNRME can carry out the following scheme functions:
- doctors carrying out assessments as examining medical officers
- doctors carrying out, supervising and reporting on assessments as appointed medical advisers (formerly known as nominated medical advisers)
- practices providing spirometry for an assessment
- practices taking chest X-rays for an assessment
- persons carrying out a chest X-ray examination for an assessment
- persons providing spirometry training to qualify an individual to perform spirometry for an assessment.
Under this framework, approved providers must be appropriately qualified and fit and proper, abide by prescribed guidelines, and be subject to audit.
On commencement of the approved provider framework, providers already registered with DNRME were taken to be approved providers; however, they must formally apply and be approved within the following 2-year transition period.
In addition, from 1 March 2019, employers must appoint a doctor (appointed medical adviser), who must be a supervising doctor approved by DNRME, to undertake the role of supervising and reporting on health assessments. Nominated medical advisers (NMA) who had been appointed by 1 March 2019 will be taken to be an appointed medical adviser under the amended regulation for a period of 12 months.
The Amendment Regulation 2018 provided a right to a voluntary respiratory health assessment for former coal mine workers through an assessment process administered by DNRME. Retiring coal mine workers are still entitled to ask their employer for an exit assessment (formerly known as a retirement examination) 3 months before or after their date of retirement.
The regulation also made amendments to define how doctors send health assessments to DNRME to support the transition to an electronic system of data entry and storage.
2020
Changes to the Mining and Quarrying Safety and Health Regulation 2017 commenced 1 September 2020.
These changes included:
- mandatory respiratory health surveillance for mineral mine and quarry workers unless risk is very low
- defined content of respiratory health medical examinations
- exit respiratory health medicals for workers leaving the industry
- right to free respiratory health medicals for retired and former workers.
The site senior executive (SSE) is required to arrange respiratory health surveillance to be undertaken prior to a person commencing work in the industry and then at least once every 5 years.
New medicals are not necessarily required when changing sites or employers, unless the risk has changed.
Medicals and any associated travel expenses must be paid by the employer.
As part of the transitional arrangements, SSEs had until 1 September 2022 to ensure all workers have had required medicals.
The SSE may, through a risk assessment that considers current and previous exposure, determine that respiratory health surveillance is not required if the worker’s exposure to respiratory hazards is so minimal that it can be effectively managed without respiratory health surveillance. This same mechanism applies under the Coal Mine Workers’ Health Scheme.
Medical examinations for respiratory health surveillance must include:
- a chest examination
- a chest X-ray, dual-read to the International Labour Organization (ILO) International Classification of Radiographs of Pneumoconioses
- a spirometry test and comparison with previous spirometry results if available.
Any abnormal results must be investigated (e.g. high resolution computed tomography scan).
In exceptional circumstances, the doctor may delay an examination for up to 12 months. The doctor will consider the risks associated with the examination against the risks of not doing this examination.
This provision addresses potential situations where there is a health risk to the worker associated with the examination that outweighs the risk to the worker of delaying the examination.
For example, where a worker is pregnant, the chest x-ray examination could be performed up to 12 months after the due date for the respiratory health surveillance, to minimise any risk to an unborn child.
Retiring mineral mine and quarry workers can request respiratory health surveillance from their employer.
The entitlement applies to all retiring workers who have worked in the mineral mine or quarry industry for at least 3 years and who have not already undergone such examinations during the past 3 years.
A person who has permanently stopped being a worker, worked for at least 3 years in the mineral mining and quarrying industry, and has not had respiratory health surveillance in the last 5 years, can obtain a free medical from the government.
Contact the Mine Dust Health Support Service on 1300 445 715 to apply.
Related information
- Read about the Coal Mine Workers' Health Scheme and the different roles and responsibilities under the scheme.
- Read about respiratory health surveillance for mineral mine and quarry workers.
- Find out about dust hazard management in mines.
- Learn about safety and health reporting requirements for mines.
- Access the register of doctors and medical providers.
- View the recognised competencies for coal mining positions.
© The State of Queensland 1995–2024
- Last reviewed: 08 Sep 2021
- Last updated: 08 Sep 2021