Public health

Silicosis response: government rejects ‘most obvious solution’ to epidemic

Dr Ryan Hoy

Dr Ryan Hoy

Stonemasons are still being exposed to the risk of silicosis because governments won’t commit to even a delayed ban on artificial stone imports, a respiratory diseases expert is warning.

The message comes after the final report of the National Dust Diseases Taskforce revealed alarming rates of occupational illness in the industry, with over 20% of those working prior to 2018 diagnosed with silicosis or other silica dust-related diseases.

But almost a year on, the Federal Government says it won’t support a recommendation to put the sector “on notice” by threatening a full ban if its safety record does not improve within three years.

In its official response to the taskforce now signed off by the states and territories, the government stressed it would back a crackdown on rogue operators.

Work was already underway on a national code of practice for the artificial stone benchtop industry and systems for workplace monitoring of respirable crystalline silica levels, it added.

And $11 million would be spent on a national awareness and education campaign.

In its response, the government said that by rolling out these measures it was too soon to commit to any sweeping prohibition.

“A ban will only be considered if there are no measureable improvements in compliance and/or preventative measures prove to be ineffective,” the government said.

“Any decision to ban engineered stone products will be dependent on an objective assessment of the requirements established… noting that more time than that proposed by the taskforce may be required to make this assessment.”

Core issue remains

Dr Ryan Hoy, a respiratory physician in Melbourne, said it was clear that more urgent action was needed to protect workers.

“When we think about controlling any occupational hazard, by far the most effective approach will be to eliminate that hazard,” said Dr Hoy, director of The Alfred Occupational Respiratory Clinic.

“So any strategy that doesn’t include a ban will have that limitation to its effectiveness.”

Describing the government’s response as a “good starting point”, Dr Hoy said it was worth acknowledging there had been a major improvement in safety awareness and funding for treatment.

“Going back to 2017-18, I used to have patients coming into the rooms still covered in dust, which was horrendous. You don’t see that now,” he said.

“But the problem is that the core issue is still there, which is the ongoing use of engineered stone given how hazardous that material is.”

“So while there have been improvements, they’ve only taken people from one of the most hazardous work environments you can ever imagine from a respiratory point of view, to one that has improved by is still highly dangerous in my opinion.

He said the taskforce had itself been criticised for recommending deferred action rather an immediate ban, with the Lung Foundation Australia previously arguing for a ban on the material within two years as “the most appropriate and  effective alternative”.

Lung Foundation CEO Mark Brooke declined to say whether he still held that view, telling the limbic last week the organisation was currently contracted with the federal health department to facilitate the national silicosis prevention strategy.

Positive measures

Nevertheless, Dr Hoy said there was reason for some optimism, pointing to the establishment of his own clinic last year with funding from WorkSafe Victoria.

He said the emergence of whole lung lavage therapy as a potential treatment for early disease was also promising, albeit for a limited proportion of patients.

“And there is now really in every state and territory, much better recognition of the diagnosis and the multidisciplinary care required for patients with silicosis, including respiratory physicians, exercise programs, support by psychologists and linkage to smoking cessation services,” he said.

“What we really need is a sustained focus on this issue and on occupational respiratory health generally.”

“We have seen waves of silicosis going back 100 years and there is increased attention whenever there is an outbreak. But that often fades away as quickly as it arrives so the problems of the past end up returning.”

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