Medicopolitical

Call for national black lung summit


A leading Australian respiratory physician has repeated calls for an urgent national black lung disease summit in the wake of this week’s damning report on the Queensland Coal Mine Workers’ Health Scheme.

And she has warned there might be more cases outside Queensland as it was likely other states’ systems were also inadequate.

“The potential is that in other states of Australia there are other people with symptoms,” Associate Professor Deborah Yates said. “If it can happen in Queensland where there is supposed to be a good system then it could happen elsewhere. As a respiratory physician I am very concerned.”

The independent review into coal workers pneumoconiosis (CWP), also known as black lung disease, revealed widespread system failures that have led to the re-emergence of the disease that was thought to have been eradicated in Queensland.

However in recent months 11 cases of black lung disease have been diagnosed in the state and almost 20 more are under review.

Professor Yates, convener of the Thoracic Society of Australia and New Zealand’s Occupational and Environmental Special Interest Group, said the report’s findings were deeply troubling.

“I should be more surprised than I am,” she told the limbic. “I think the deficiencies that were highlighted were worse than we suspected. These cases simply should not be occurring; it is unacceptable in a modern society.”

Dr Yates, who co-authored an article in this month’s MJA that looked at CWP from an Australian perspective, has treated coal-related lung diseases in the UK and is now a respiratory physician at Sydney’s St Vincent’s Hospital.

She said Australia’s monitoring limits for coal dust were inconsistent and needed urgent review.

Currently standards currently vary between states and are not in keeping with international understanding of the levels of coal dust that cause disease, she said.

“We have already called for a national summit and this is further evidence of the need for it,” she said.

“I think this is something that needs to be addressed urgently and at a national level. We need national standards – a miner is a miner whatever state they’re in.”

Clinicians have come under fire for failure to detect the disease early, and while Prof Yates said there had clearly been some complacency, doctors should not shoulder the bulk of the blame.

“This is a multi-system failure, this is not just one component,” Professor Yates said.

She said the government needed to implement a national screening program for at-risk workers, with use of standardised questionnaires, imaging and lung function testing, and develop appropriate training materials to assist general practitioners in identifying CWP.

A mandatory reporting system should also be used to establish a centralised occupational lung disease register.

In the meantime, she said other states should heed the warning and take steps to ensure all at-risk miners were screened appropriately.

And mines need to prioritise systems to protect miners from the dust in the first place.

“They need to control the dust levels and therefore a surveillance system should be a secondary measure and not a primary measure,” she said.

Professor Yates said she was hopeful this report, along with a growing body of research, would encourage governments and corporations to prioritise a national strategy to address the problems.

“We need to pick the ball up and keep running with it rather than pretending it’s not happening,” she said. “There’s obviously been a failure in the system for some time and I think the worrying thing is we don’t know how bad it might be.”

Related stories: 

National plan needed on coal workers pneumoconiosis: TSANZ

Black lung’s back? How we became complacent with coal miners’ pneumoconiosis

Senate investigates return of pneumoconiosis

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