The report Occupational lung diseases in Australia 2006 – 2019 was prepared by the Monash Centre for Occupational and Environmental Health (MonCOEH). It outlines the current landscape of occupational lung diseases (OLDs) in Australia and presents changes in the extent and incidence of OLDs since the 2006 report Occupational respiratory disease in Australia.
The report draws upon peer-reviewed literature, grey literature and available Australian data sources to estimate the impact of common OLDs and occupational exposures.
It examines current trends of four main groups of OLDs:
1. Work-related asthma (WRA), including:
- occupational asthma, and
- work exacerbated asthma.
2. Chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.
3. Pneumoconioses (fibrotic lung diseases), including:
- coal workers pneumoconiosis (CWP), also known as black lung
- acute, accelerated and chronic forms of silicosis
- asbestosis, and
- other, usually mixed, pneumoconioses.
4. Other OLDs:
- hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis
- toxic pneumonitis, and
- alveolar proteinosis.
The report identifies industries and occupations where workers may be at risk of developing an occupational lung disease, such as the construction, mining and quarrying industries and those working with engineered stone.
The collection and analysis of available data sources for OLDs found that several significant trends have emerged since 2006, including:
- a substantial increase in:
- pneumoconiosis, especially CWP from coal mine work, and
- silicosis from working with engineered stone
- a decline in workers’ compensation claims for asbestos-related OLDs, such as asbestosis
- an increase in understanding of the role of occupational exposures and the risk of developing COPD
- an apparent decline in WRA cases as evidenced by fewer compensation claims, and
- the availability of Australian data on other OLDs such as HP is limited.
Overall, the report demonstrates that OLDs remain an important group of occupational diseases among workers in Australia and they continue to substantially contribute to the burden of lung diseases in Australia.
The report found four key findings:
1. OLDs continue to be a health concern in Australia
WRA, COPD and CWP continue to be OLDs of significance in Australia. Exposure to coal dust in Australian mines and respirable crystalline silica dust in engineered stone workers is of particular concern. This finding suggests that continual education and awareness of these diseases is still required.
Another OLD of importance is HP. Based on overseas findings, HP may be grossly underestimated in Australia because of the lack of Australian data currently available.
2. Further research is needed
Targeted research is needed to help identify patterns of incidence of OLDs in high risk industries and occupations, including:
- analysis of existing health monitoring data to identify cohorts of workers in high risk jobs
- increasing health monitoring programs, and
- conducting longitudinal studies.
3. Thorough application of available data sources will assist in providing a comprehensive national perspective
This review identified a range of data sources on OLDs focused on specific occupations and diseases. The thorough application of these and other available data sources will assist in:
- creating a comprehensive national perspective on OLDs, and
- further enabling industry and WHS regulators to effectively target preventative measures.
4. Data collection and management
The establishment of a national dust disease registry to house data on diagnoses of OLDs will assist in providing a clearer picture of the full scale of the problem and improve future estimates of OLDs in Australia.
How the findings from this report will be used
It is important to note that the workers’ compensation data used to inform this report has some limitations in its ability to reflect current incidence including for long latency diseases, such as asbestosis, and claims that are not collected in the national data set for example, those that are made through other compensation schemes. In addition, workers’ compensation claims data only includes claims by workers who were eligible for, and decided to make, a claim. This results in a dataset that is likely to underestimate the extent of occupational lung diseases in Australia.
The data relating to engineered stone associated silicosis (accelerated silicosis in many cases) was also rapidly evolving during the writing of the report, suggesting that true diagnosed cases may be higher than indicated.
The findings of this report are nationally significant, particularly when considering the likely underestimate of occupational lung diseases in the analysed data. The conclusions of this report will help to inform and shape the continued implementation of Safe Work Australia’s occupational lung diseases workplan.
More broadly, Safe Work Australia will use these findings in developing effective national WHS policy with the aim to reduce the identified burden of disease, and ensure all Australian workers have healthy, safe and productive working lives.