Health screening for workers possibly exposed to silica dust

Background

Building products such as kitchen stone bench tops, concretes, and quarry products contain natural-occurring minerals collectively known as crystalline silica. When workers cut, grind or drill manufactured products containing these substances under dry conditions, tiny particles of respirable crystalline silica (RCS) dust can be released into the air. Exposure to RCS dust has been linked to various occupational diseases, including silicosis and kidney diseases.

RCS is a known carcinogen and is listed as a hazardous chemical under the Northern Territory’s work health and safety laws.

See the NT WorkSafe Bulletin ‘Risks associated with Respirable Crystalline Silica’ for more information.

Following a recent increase in the number of silicosis diagnoses across Australia, NT WorkSafe will be undertaking a Territory-wide compliance and enforcement campaign.

It is expected that this campaign will lead to workers presenting to GPs for health screening.

What medical practitioners need to know

Businesses are required to monitor workers’ health if they have been exposed to RCS dust above the occupational exposure standard. All workers’ health monitoring must be supervised by a registered medical practitioner experienced in the occupational medical field or from an appropriately qualified specialist.

As such it is recommended that workers presenting to GPs for RCS-related health monitoring are either referred immediately to the Lung Function Laboratory at the Royal Darwin Hospital or Alice Springs Hospital, to a qualified specialist or to an accredited Occupational and Environmental Physician.

When referring the worker indicate that the worker may have been exposed to industrial dust.  

Additional information

The guide for medical practitioners undertaking health monitoring exposure to hazardous chemicals can be found at: www.safeworkaustralia.gov.au/doc/health-monitoring-exposure-hazardous-chemicals-guide-medical-practitioners

The national guidelines for conducting this monitoring can be found at: https://www.safeworkaustralia.gov.au/doc/crystalline-silica-health-monitoring

In summary it includes:

  • collection of demographic, medical and occupational history;
  • records of personal exposure;
  • standardised respiratory questionnaire to be completed;
  • standardised respiratory function tests to ANZTS standards (e.g. FEV1, FVC and FEV1/FVC); and
  • ILO chest X-ray full PA view.

You can also find information at https://i-med.com.au/about-us/dust-diseases/information-for-practitioners

What to do if initial testing returns a positive result for silicosis or a malignancy of the lungs

A worker who has contracted a disease related to working with silica during the course of their employment is entitled to make a claim for workers compensation and to do this must submit a Northern Territory workers compensation claim form. The treating doctor should provide a letter and supporting documentation that provides evidence of the diagnosis to be submitted along with the claim form.

Claim forms are available on the NT WorkSafe website.

The following diseases are prescribed diseases pursuant to the Return to Work Act 1986 resulting from working with silica:

  • Malignancy of the lungs – all work involving silica dust
  • Respiratory diseases – Silicosis – all work involving silica
  • Infectious diseases – Tuberculosis – a person with silicosis.

The above diseases shall be taken to have been contracted by a worker in the course of employment if the worker was engaged in employment involving silica dust.