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Queensland Department of Natural Resources, Mines and Energy (DNRME) and Monash University, Melbourne, Australia Heading link

Project – Queensland Coal Mining Medical Surveillance Evaluation Project

Coal workers’ pneumoconiosis (CWP) had been considered eradicated in Queensland, Australia for more than thirty years. Since 2015, however, many cases of coal mine dust lung disease (CMDLD), including CWP, have been re-identified. After the initial seven cases, the Queensland Department of Natural Resources, Mines and Energy (DNRME) initiated a review of the surveillance procedures of the Queensland Coal Mine Workers’ Health Scheme (the Scheme). We were tasked with identifying deficiencies in the chest imaging component of the Scheme, which may have contributed to the failure to identify early changes of CWP. Our findings illustrate the dangers of complacency in worker health monitoring and surveillance that may affect programs throughout the world.

Main findings:

  • After reviewing 248 chest x-rays (CXRs), we found that 7.3% (n = 18) had opacities consistent with simple coal workers’ pneumoconiosis
  • There were major issues with CXR quality – 19% of the CXRs were quality 3 and 1% were unreadable – which could affect the accurate detection of the small opacities characteristic of pneumoconiosis
  • Only two of the original radiology reports for the positive cases identified abnormalities consistent with pneumoconiosis. Follow-up by medical advisors was not done in these two cases where the original radiologist had identified changes consistent with pneumoconiosis on the CXR.
  • We identified a paucity of training in CXR interpretation