WorkSafe Victoria has announced an update to the Occupational Health and Safety Regulations, requiring health assessments for those who work with crystalline silica.
The call for assessments comes after a rise in the number of silicosis cases in other states, linked to those who work with concrete, bricks, tiles, mortar and in artificial stone benchtop fabrication and installation. Working with artificial stone may be particularly hazardous.
According to WorkSafe, “Early and accurate identification of respiratory disease, including silicosis, allows for early intervention which can improve the health outcomes for workers. An assessment can also provide a baseline for future assessments when conducted before a person starts work in a crystalline silica process, or before a new process is implemented.”
Safe Work Australia’s publication Hazardous Chemicals Requiring Health Monitoring includes guidance on respiratory health assessments for workers exposed to crystalline silica. It sets out a process for baseline respiratory health assessments:
- Collection of demographic data (details like age and gender)
- Work history
- Medical history
- Physical examination with emphasis on the respiratory system
- Investigations (tests): standardised lung function testing and chest x-ray
The Safe Work Australia guidance recommends that an assessment be done annually during the time a worker is exposed to crystalline silica. It also includes a template for collecting this information.
Health assessments should be done regularly, and by registered medical practitioners with experience in provision in occupational health services.
According to the Royal Australian College of Physicians (RACP), health assessments should include:
- gas transfer, also called diffusing capacity of the lungs for carbon monoxide (DLCO)
- ILO chest x-ray
Spirometry and DLCO are lung function tests, and in some circumstances, other tests may be needed.
Suspected cases should be referred to respiratory physicians with expertise in assessing and managing complex occupational lung diseases, including silicosis or interstitial lung disease. A respiratory physician should coordinate treatment and ongoing health monitoring.