Introducing Dr Majid Rahgozar, ANZSOM Dust Diseases Liaison Officer
Engineered stone products with high crystalline silica content have become popular and widely used in the stone bench top industry. This appears to be the driver or at least a significant factor in a re-emergence of silica related illnesses amongst workers in the stone bench top industry (stone masons). Considering the fact that silicosis is a preventable disease, this is indicative of failure of policies and procedures in multiple levels, government, regulators, business community and health services providers.
ANZSOM in collaboration with other peak bodies such as Australia Lung Foundation, Thoracic Society, academics, occupational hygienists and union movement, has been advocating for a hierarchy of control approach in addressing this problem through i.e. eliminating the hazard by a ban on import, manufacture and use of engineered stone.
While waiting for such outcome to be realised, ANZSOM is advocating for revamping other available control measures such engineering controls e.g. wet cutting and improving ventilation, administrative controls, e.g. through updating regulations, education and training, revamped health surveillance and use of appropriate PPE e.g. Powered air purifying respirators.
I have been working with the Alfred Hospital Respiratory Department in a newly established Occupational Respiratory Clinic (AORC) for almost a year. In the first truly multidisciplinary health surveillance program, occupational physicians and registrars working alongside respiratory physicians along with close collaboration with radiologists and rheumatologists who are interested in this field, to provide a compressive health surveillance as well as collecting data for better understanding this emerging epidemic amongst stone masons. In this setting we have replaced ILO CXR with a HR CT scan of the chest as well as screening for systematic inflammatory conditions, renal and dermatological conditions that could be attributed to exposure to respirable silica dust.
Establishing national research priorities in silicosis
Lung Foundation Australia has been funded by the Australian Department of Health and Aged Care to establish a Research Network of people interested in or impacted by occupational lung disease. Each year they will facilitate two Research Forums for the Network to come together to agree upon the top priorities for future research which will be fed back to policymakers, funding bodies and the scientific community. In doing so they aim to ensure that future research can be coordinated around the perspectives and expertise of professionals working each day to prevent or manage the impacts of exposure to occupational respiratory hazards as well as those who are impacted most (i.e., patients and at-risk workers).
The focus for 2023 will be on research priorities in silicosis. The Network will help decide which occupational lung disease should be focused on in later years.
The first Research Forum was held in Melbourne on 9 October 2023 and was designed for a multidisciplinary professional audience – including health professionals, workplace health and safety professionals and researchers.
The second Research Forum will be held online and is designed for a consumer audience of patients, their families, and workers at risk of developing silicosis.
National Silicosis Prevention Strategy
Lung Foundation Australia was appointed by the Australian Government Department of Health and Aged Care to facilitate the development of the 2023–2028 National Silicosis Prevention Strategy (NSPS) and accompanying National Action Plan (NAP).
The goal of the NSPS is to prevent and ultimately eliminate silicosis as an occupational disease in Australia. Five priority areas for action were identified to achieve this goal:
Priority Area 1: Workplace risk reduction
Priority Area 2: Education and awareness
Priority Area 3: Health monitoring, screening and surveillance
Priority Area 4: Governance
Priority Area 5: Research and development
Click here for more information about the National Silicosis Prevention Strategy.
Safe Work Australia - Decision Regulation Impact Statement: Prohibition on the use of engineered stone
The Decision RIS recommends a prohibition on the use of all engineered stone, irrespective of crystalline silica content, to protect the health and safety of workers. The report was informed by stakeholder consultation, independent economic analysis, and an expert review of evidence. WHS ministers have agreed to meet again before the end of 2023 to consider the recommendations in the report.
Safe Work Australia has launched a new phase of the Clean Air. Clear Lungs. occupational lung diseases campaign to improve understanding of the hazards of silica dust and duties under work health and safety laws to manage the risks. This includes how to identify hazards and eliminate or minimise the risk of exposure in the workplace. Key WHS information is available in English, Chinese, Arabic, Hazargi, Vietnamese and Korean.
Click here for more information about workplace exposure to silica dust and to download resources
Lung Foundation Australia’s Silicosis Support Services
Lung Foundation Australia, the leading peak body in Australia for lung disease and lung cancer, has recently launched three new services – a Silicosis Support Nurse, Silicosis Social Worker and Peer Support Groups for people living with silicosis, their family and carers.
Silicosis Support Nurse Service: This is a telephone-based service that provides information and support around understanding a silicosis diagnosis and includes symptom management and guidance on relevant support services. For more information about the nurse service you can click here.
Silicosis Social Work Service: This is a telephone-based service that provides information around navigating the practical and emotional impact of living with silicosis, including processing a diagnosis, impacts on relationships and ways to cope with the progression of disease. To learn more about our social work service click here.
Silicosis Peer Support Groups: Our online support groups are also available Australia-wide and can help those impacted by silicosis to connect with others. This service brings together people living with or caring for someone with silicosis, providing a space for members to share their experiences to help navigate the unique challenges faced when living with this condition. More information can be found here.
How To Refer
Health Professionals: To refer clients into Lung Foundation Australia’s Silicosis Support Services, health professionals can complete an Expression of Interest form for our nurse service and our social worker service.
Clients: Clients can also self-refer into Lung Foundation Australia’s Silicosis Support Services by contacting the Information and Support Centre on free call 1800 654 301 (option 3).
New regulations on the processing of engineered stone products came into effect on 1 September 2023 in South Australia to reduce the risk of dust diseases.
All workers involved in cutting, grinding, trimming, sanding, or drilling engineered stone products must be provided with respiratory protective equipment, and use a dust control system such as a water suppressant or exhaust ventilation.
Click here for more information and resources about respirable crystalline silica
The latest WorkSafe Victoria Compliance Code came into effect November 2022. It provides practical guidance for those who have duties or obligations under the Occupational Health and Safety Act 2004 and the Occupational Health and Safety Regulations 2017, in relation to exposure to crystalline silica dust as a result of working with engineered stone.
Click here for more information about managing the risks of respirable crystalline silica from engineered stone in the workplace
Other dust diseases / silicosis resources for health professionals
Keep up to date with the latest on dust disease risks and interventions:
Various ANZSOM online learning modules(member-only access) from previous meetings and conferences, including presentations by leading experts such as Dr Graeme Edwards, Dr Ryan Hoy and Assoc/Prof Deborah Yates.
Lung Foundation Australia deliver the Lung Learning Hub, one of Australia’s most trusted sources of respiratory health training and education for health professionals.
Click here for more information and resources about crystalline silica and silicosis