Abstract
ABSTRACTCoal mine lung dust disease (CMDLD) and artificial stone (AS) silicosis are preventable diseases which have occurred in serious outbreaks in Australia recently. This has prompted a TSANZ review of Australia's approach to respiratory periodic health surveillance. While regulating respirable dust exposure remains the foundation of primary and secondary prevention, identification of workers with early disease assists with control of further exposure, and with the aims of preserving lung function and decreasing respiratory morbidity in those affected. Prompt detection of an abnormality also allows for ongoing respiratory specialist clinical management. This review outlines a medical framework for improvements in respiratory surveillance to detect CMDLD and AS silicosis in Australia. This includes appropriate referral, improved data collection and interpretation, enhanced surveillance, the establishment of a nationwide Occupational Lung Disease Registry and an independent advisory group. These measures are designed to improve health outcomes for workers in the coal mining, AS and other dust‐exposed and mining industries.
Highlights
The recent reappearance of coal workers’ pneumoconiosis (CWP)[1,2] and emergence of artificial stone (AS)associated silicosis[3,4,5] has represented a failure of preventive systems to protect the respiratory health of workers in Australia
This paper provides a framework for an optimal surveillance system of these workers in Australia and New Zealand and for improvements in the existing respiratory surveillance programme (Box 1)
For AS workers previously exposed to high respirable crystalline silica (RCS) levels, active case-finding using conventional high-resolution CT (HRCT)/ spirometry/DLCO performed at accredited respiratory laboratories and radiological facilities using recommended protocols; follow-up by expert treating specialists/teams, preferably at occupational respiratory multidisciplinary team (MDT)
Summary
Respiratory surveillance for coal mine dust and artificial stone exposed workers in Australia and New Zealand: A position statement from the Thoracic Society of Australia and New Zealand*. PERRET,[1] SUSAN MILES,[2,3] FRASER BRIMS,[4,5] KATRINA NEWBIGIN,[6] MAGGIE DAVIDSON,[7] HUBERTUS JERSMANN,[8] ADRIENNE EDWARDS,[9] GRAEME ZOSKY,[10,11] ANTHONY FRANKEL,[12,13]. JOHNSON,[14] RYAN HOY,[15] DAVID W. WILLIAM MUSK,[5,17] MICHAEL J. ABRAMSON,[15] BOB EDWARDS,[6] ROBERT COHEN18 AND DEBORAH H.
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