Australian coal dust exposure limits are not meeting international standards and should be more stringent to eradicate coal workers' pneumoconiosis (CWP), according to a Clinical Focus published in Medical Journal of Australia.
CWP, also known as "black lung" is an untreatable but preventable lung disease arising from chronic inhalation of coal dust. Recent reports suggest a resurgence of the disease which experts believe could point to a potential decline in exposure control.
According to Associate Professor Graeme Zosky, Associate Professor Deborah Yates and colleagues, current coal dust exposure limits vary between states and show considerable variations of monitoring protocols between sites.
"We strongly urge that the Australian guidelines be reviewed on the basis of current knowledge of CWP, in line with international standards, and that exposure limits and monitoring protocols are nationally standardised according to best practice guidelines," the authors wrote.
They also recommended a comprehensive screening program for workers at risk, which would include a questionnaire, medical imaging and detailed lung function testing. This should be performed every 3 years and "should be funded by the employer but preferably evaluated by physicians and radiologists not employed by the coal companies".
Workers who show a decline in lung function should be referred early to specialist respiratory physicians with an interest in occupational lung disease.
"Where pneumoconiosis is diagnosed, we recommend a system of mandatory reporting to a centralised occupational lung disease register," the authors advised, suggesting that such a register be established in order to detect potential difficulties in surveillance and prevention processes.
The researchers wrote that there needs to be additional training for general practitioners to help them identify current or retired workers at risk of pneumoconiosis.
"It is unacceptable that any new cases of CWP should be occurring in Australia in 2016, and our aim should be to eliminate CWP in Australia altogether," the authors concluded.
Article: Coal workers' pneumoconiosis: an Australian perspective, Graeme R Zosky, Ryan F Hoy, Elizabeth J Silverstone, Fraser J Brims, Susan Miles, Anthony R Johnson, Peter G Gibson and Deborah H Yates, Medical Journal of Australia, doi: 10.5694/mja16.00357, published 20 June 2016.