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The TSANZ Position Paper on Respiratory Surveillance: Even One Case of Pneumoconiosis is Too Much?

Debora H Yates*

Over the last 10 years, there has been a resurgence of dust-related lung diseases in Australia. This includes coal workers pneumoconiosis (CWP, otherwise known as black lung), silicosis, and a new rapidly progressive form of silicosis, engineered (or Artificial) Stone (AS) silicosis. These diseases are completely preventable and should not be occurring in the 21st century. This has prompted action among respiratory and occupational physicians, resulting in the publication of new recommendations on respiratory health surveillance and the establishment of a National Taskforce on Dust Diseases. While controlling respirable dust exposure is the foundation of primary and secondary prevention against dust-related diseases, identification of workers with early disease helps to prevent severe disablement and death and enables real world feedback on workplace dust control measures. The suggestions for improvements in respiratory surveillance include an overall reduction in occupational dust levels, better recording of dust exposures, enhanced surveillance testing, improved data collection and interpretation, and the establishment of a national harmonised system. These measures are designed to improve health outcomes for workers in the coal mining and artificial stone industries as well as other sectors where dust exposure occurs.