Occupational lung diseases in Australia 2006 – 2019

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.