Mine dust lung diseases

Mine dust lung diseases (MDLD) are caused by long-term exposure to high concentrations of respirable dust, generated during mining and quarrying activities.

MDLD include a range of occupational lung conditions including but not limited to:

  • coal workers’ pneumoconiosis (CWP)
  • mixed dust pneumoconiosis (MDP)
  • silicosis (a form of pneumoconiosis from silica dust)
  • chronic obstructive pulmonary disease (COPD)
  • asbestosis
  • cancer.

For more information on disease types, detection and assistance available please visit Miners’ Health Matters.

Resources Safety & Health Queensland (RSHQ) receives reports of disease from a variety of sources including Appointed Medical Advisers (via the Coal Mine Workers’ Health Scheme), Site Senior Executives (SSEs) and the Office of Industrial Relations (OIR) via the workers’ compensation scheme.

The figures displayed below represent cases of disease reported to the agency since 1984, when doctors Rathus and Abrahams completed the last comprehensive survey of the coal mining workforce. Figures are updated and published at the end of each month.

Please note, cases may be reclassified over time as additional information is provided to the agency.

Cases of MDLD reported to RSHQ

Figure 1 – Cases of MDLD reported to RSHQ for all mining since 1984 by financial year (current as at 24 December 2021)

Multiple MDLD: Individual has more than one MDLD. This figure may include cases of CWP, silicosis and mixed dust pneumoconiosis. For exact numbers of pneumoconioses cases, including those located in the multiple MDLD category above, please refer to Figure 4.

Other MDLD: Another type of MDLD or the specific type of lung disease is to be confirmed (cases in this category may be re-classified over time as additional information is provided to RSHQ).

Cancer: Includes mesothelioma from asbestos exposure and other occupational lung cancers.

MDP: Mixed dust pneumoconiosis.

Figure 2 – Cases of MDLD reported to RSHQ for all mining industries since 2014–15 by financial year and disease type (current as at 24 December 2021)

Non-pneumoconiosis conditions include, but are not limited to, COPD, diffuse dust fibrosis, lung cancer and other undefined lung disease. Cases in this category may be re-classified over time as additional information is provided to RSHQ.

Reported cases of CWP have decreased in recent years, while reports of silicosis and COPD cases have increased. This may be attributed to increasing awareness of occupational dust lung disease in the open cut coal mining and mineral mine and quarry (MMQ) sectors. A quality respiratory screening program is in place for Queensland’s underground and surface coal miners under the Coal Mine Workers’ Health Scheme. Free respiratory health screening has been available to retired mine and quarry workers since March 2019. Regulatory changes in 2020 introduced a new requirement for MMQ workers to undertake periodic respiratory health surveillance. With expanded respiratory health screening, a rise in reported MDLD cases is expected.

Figure 3 – Cases of MDLD reported to RSHQ grouped by industry of mining experience, since 2014–15 (current as at 24 December 2021)

The number of reported MDLD cases from the MMQ industry, or for those individuals with substantial experience in both coal and MMQ, is low compared with cases reported for coal miners. This may reflect the longstanding health surveillance program and MDLD reporting arrangements that are in place for Queensland’s coal mining industry.  Increased health surveillance among MMQ workers may identify additional MDLD cases from that sector.

Cases of pneumoconiosis

Figure 4 – Cases of pneumoconiosis reported to RSHQ for all mining, since 1984 (current as at 24 December 2021)

146 pneumoconiosis cases

Mine dust can lead to a range of pathological changes in the lungs. In general terms, the resulting lung changes can be divided into two groups; those which are fibrotic or nodular (example CWP, mixed dust pneumoconiosis and silicosis), and those which are non-nodular (example COPD and lung cancer). Due to being nodular in nature, CWP, mixed dust pneumoconiosis, and silicosis can be graded according to a scale of severity under the ILO classification.

Figure 5 – Cases of progressive massive fibrosis reported to RSHQ for all mining, since 1984 (current as at 24 December 2021)

As at 24 December 2021, RSHQ has been advised that 15 reported cases of MDLD have progressed to the most severe category of progressive massive fibrosis (PMF). This represents a small proportion of the total number of pneumoconiosis cases reported to RSHQ.  Where disease severity has been reported to RSHQ, the vast majority of cases are in the early stages of disease.

Total individuals with MDLD

Figure 6 – Total individuals with MDLD reported to RSHQ for all mining, since 1984 (current as at 24 December 2021)

248 MDLD cases

When reporting on disease, best practice is to report on individuals rather than multiple disease types per person. The above figure represents the number of all individuals with MDLD reported to RSHQ.

Disease detection

Since July 2016, under the Coal Mine Workers’ Health Scheme, all coal mine worker chest X-rays have been dual read to ILO standards.  Recent regulatory changes will ensure that MMQ workers also have chest X-rays read to the same standards.

It is important to note that the chest X-ray classification is one part of a screening process, and that a positive result does not necessarily lead to a disease being diagnosed. Results must be investigated further using the Clinical Pathway Guidelines which provide the recommended process for follow-up investigation and referral to appropriate medical specialists and tests.

Figure 7 – Chest X-ray screening results for coal mine workers (current as at 24 December 2021)

109,512 no disease identified

1,030 abnormal screening

45 disease detected

Estimated prevalence rates for coal mine dust lung disease

Figure 8 — Estimated prevalence rates (per 1,000 coal miners) of coal mine dust lung disease in Queensland (financial year 2019/20) and internationally

As part of Resources Safety and Health Queensland’s ongoing commitment to better understanding mine dust lung disease, Cancer Council Queensland were engaged to undertake a prevalence study. The study focused specifically on coal mine dust lung disease (CMDLD). The study found prevalence of CMDLD in Queensland for 2019/20 to be estimated at 2.1 cases per 1,000 coal mine workers, including both underground and surface miners.

For comparative purposes, international prevalence of coal workers’ pneumoconiosis has been estimated in this study at 34.5 cases for underground miners, and 18 cases for surface miners per 1,000 coal mine workers. Whilst prevalence rate estimates for Queensland coal miners are lower than international pooled prevalence rates, they should be compared with caution due to different methods for calculating prevalence estimates, as outlined in the full report. In addition, international prevalence could only be calculated for coal workers’ pneumoconiosis whereas prevalence in Queensland was estimated for the full range of CMDLDs.

Figure 9 — Estimated prevalence rates (per 1,000 coal miners) of coal mine dust lung disease in Queensland by financial year (up to 2019/20)

Prevalence rate estimates have increased over time, primarily due to an increase in number of diagnosed CMDLD cases, particularly since the early 2000s, and the inclusion of both newly diagnosed and pre-existing cases in the population.

It should be noted that prevalence rate differs from incidence of reported cases as it shows the rate of disease within the current and former mining population. This ‘per-capita’ type calculation is much more informative as prevalence provides context to the incidence rate, considers workforce size changes over time and allows comparisons with other jurisdictions and industries.

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