When people think of the dangers of mine sites, they often conjure up images of heavy equipment, large haul trucks and explosive blasts. Less thought of are the subtler, long-term hazards that can affect the health and wellbeing of miners, including those that do not reveal their consequences until years later.

Silicosis is the oldest occupational lung disease on record, but despite its age and history, there has been an alarming increase in cases emerging in Australia recently, including a worker at the Boddington gold mine being diagnosed in October 2023.

Silicosis is an irreversible, debilitating and potentially fatal lung disease caused by inhaling crystalline silica particles, commonly found in dust-generating activities such as mining, construction, fabrication, and installation of materials like engineered stone. These silica dust particles are invisible and 100 times smaller than a grain of sand, meaning they can travel deep inside the lungs and wreak havoc.

Alongside this rise in silicosis diagnoses comes an increase in knowledge and awareness of the disease and its causes, and a determination to stop it at the source.

In June 2023 the Federal Government established The National Occupational Respiratory Disease Registry Bill 2023 in the hopes of identifying and eliminating the causes of deadly occupational respiratory diseases like silicosis. The Bill puts in place a national registry for reporting all occupational respiratory diseases and makes the reporting of silicosis mandatory. The Bill is intended to support the identification of industries, occupations, job tasks and workplaces where there is a risk of exposure to respiratory disease-causing agents.

The Thoracic Society of Australia and New Zealand (TSANZ) has some concerns with the parameters and practical elements of the Bill, but has said it firmly supports the government’s introduction of a respiratory disease registry.

The silicosis epidemic

Curtin University estimates that more than 275,000 Australians are now at risk of diseases caused by breathing in silica dust – more than the entire population of Hobart and Launceston combined – and this number is expected to increase.

TSANZ CEO, Vincent So, said that regardless of whether coal, gold, or something else is being mined, it is always embedded in rock and layers of rock need to be cut through to get to the mineral.

“Stone contains silica and the cutting process will liberate this in dust form,” he said.

According to Mr So, there are six reasons miners should care about silicosis:

It is progressive and irreversible

Silicosis is a chronic lung disease that progresses over time. Once silica particles enter the lungs, they cause inflammation and scarring, leading to the formation of scar tissue which causes the lungs to harden and contract. This scarring restricts a person’s ability to breathe properly and often causes breathlessness. There is no cure for silicosis, and the damage it causes to the lungs is irreversible.

It has significant health impacts

Silicosis can have severe health consequences for affected individuals. One of the biggest challenges with the disease is that symptoms often occur late in life, with many sufferers not noticing their onset until much later.

Symptoms typically include a persistent cough, shortness of breath, chest pain and fatigue.

As the disease progresses, however, it can lead to more serious complications like lung infections and failure, and an increased risk of developing other conditions, including tuberculosis, lung cancer, emphysema and some chronic skin and joint problems.

It is an occupational hazard

Silicosis is primarily an occupational disease, affecting workers who are exposed to high levels of silica dust. Industries whose workers are at a high risk of silica dust inhalation include mining, construction and sandblasting. It significantly impacts sufferers’ quality of life The breathing difficulties and reduced breathing capacity caused by silicosis can make it challenging to perform everyday tasks, affecting a sufferer’s physical capabilities and overall wellbeing. As such, the disease can limit a person’s ability to work, participate in activities and enjoy an overall fulfilling life.

It has economic and social implications

Silicosis has far-reaching consequences beyond just an individual level; families are greatly impacted, both emotionally and economically, as they support their loved ones through the difficulties associated with the disease. This economical support may be necessary if silicosis affected individuals face financial hardship due to having to change work, a reduced ability to continue working, and for medical care.

It is preventable with proper measures in place

One of the characteristics contributing to the tragic reputation of silicosis is the fact that it is largely preventable. Through proper workplace controls, such as effective dust control, wet cutting, adequate ventilation, and the use of personal protective equipment, exposure to silica dust can be minimised.

Mr So said that minimising dust generation is important in mining, and one way this can be achieved is by adding water to the cutting process – so called wet-cutting.

“Mechanising the process without workers being in close vicinity would help as well. If possible, extractor fans would reduce dust exposure and finally, exposed workers need to wear adequate personal protective equipment – minimum P2 masks.

“In addition to the dust minimisation, removal, and wearing personal protective equipment, it is good practice to check the functioning of the equipment regularly and conduct workplace air monitoring to ensure that the safety measures in place are delivering the desired result,” Mr So said.

SafeWork Australia, as the national source of information on current regulation, can provide guidance on what more can be done to protect workers.

Preventing silicosis at the source

Mr So said that if these preventive actions are not used, which is frequently the case in Australia, then unnecessary suffering and loss of life may occur.

“We recommend industry liaise with SafeWork Australia, Lung Foundation Australia, and the Thoracic Society of Australia and New Zealand to source appropriate information material for workers and employers to increase their awareness of the potential risks associated with working in mining.

“For the safety of the miners’ families, workers should be advised not to leave the workplace wearing clothing contaminated with dust.”

Mr So said that current cases of silicosis are likely based on past exposures, before the dangers of the disease were fully appreciated.

“Silicosis is preventable and using elimination, removal, and protection measures plus education and awareness should help prevent an increase in new silicosis cases. We are now aware of the problem but need to stop exposures to prevent further disease.”

Mr So recommends miners that are exposed to respirable crystalline silica to contact the SafeWork office in their state and to contact their GP if they display symptoms.

“Silicosis requires long term specialist management. While currently there is no specific treatment for silicosis, there is a lot of ongoing research, and some treatments may come online in the near future. “The best way forward now is for industry, workers, and health professionals to work together to provide the safest workplace for all.”

Vincent So is CEO of The Thoracic Society of Australia and New Zealand (TSANZ). TSANZ is the only health peak body representing a range of professions (medical specialists, scientists, researchers, academics, nurses, physiotherapists, students, and others) across various disciplines within the respiratory/sleep medicine field in Australia and New Zealand.

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