How the health assessment works

Timing of health assessments

Health assessments are required:

• before a person starts work as a mine worker and when changing employers
• periodically, as decided by the employer's appointed medical adviser (AMA – previously called the nominated medical adviser), but at least once every 5 years
• if the AMA decides it is necessary after receiving a notice under section 49 of the Coal Mining Safety and Health Regulation 2017.

Note: If an employer receives a notice that the level of risk to a coal mine worker's health has increased appreciably, the employer must give a copy of the notice to the AMA, and the worker's exposure to the hazard must be periodically monitored to assess their level of risk.

Changing employers

If workers change employers, a new health assessment is required. Previous medical examinations may be relied upon (e.g. chest X-ray), if in-date and the new AMA considers it appropriate. AMAs must ensure the next health assessment is scheduled to ensure frequency of examinations is within 5 years from the previous examination used.

Multiple employers

When a worker has multiple employers, they will be required to undertake a health assessment for each employer. Workers with multiple employers will have multiple current health assessments however can only have 1 health assessment per employer.

For example, a worker is employed with Company A and has a current health assessment listing Company A as the employer. While employed at Company A, the worker commences employment with Company B. Company B must still arrange, and pay, for this worker to undergo a health assessment. The AMA can reuse previous medical examinations if in-date (e.g. chest X-ray) at their discretion. The worker will now have 2 health assessments (1 with Company A and 1 with Company B)—both are valid while they remain in-date.

A worker does not require multiple health assessments if they work across multiple mine sites for the same employer, or if their employer sub-contracts them to another entity. However, the employer and their AMA should consider any change in risk the new location or role might present, and whether a new health assessment is necessary.

Health assessment process

The employer is required to arrange and pay for their workers' health assessment. This includes referrals, tests and reasonable travel expenses for any further investigations required to complete the health assessment (e.g. CT scans, respiratory physician assessments).

The health assessment is conducted by the employer's AMA using the Resources Safety & Health Queensland (RSHQ) health assessment form on ResHealth in accordance with the Coal Mining Safety and Health Regulation 2017.

Read about the role and appointment of AMAs.

The health surveillance form has multiple sections:

• Employer section is completed by the employer. It includes information about the AMA, the employer, the worker's position (PDF, 380KB), similar exposure groups (PDF, 111KB) and the health risks associated with employment.
• Worker section is completed by the worker. It documents the worker's personal details as well as work and medical history information. Photo ID must be brought to the assessment.
• Examination section is completed by an examining medical officer and details clinical findings.
• Assessment section is completed by an AMA and details clinical and overall findings.
• The health assessment report is completed and signed by the AMA and details fitness for duty, work restrictions and requirements for a subsequent follow-up and assessment of the worker. Only this section is forwarded to the employer.

Note: The AMA only completes  the assessment section when all examinations and follow up investigations, including the chest X-ray examination, are complete.

Health assessment forms

The following health assessment forms were approved by the Chief Inspector of Coal Mines on 17 July 2020.

• Form number CMSHR 2 – Exit assessment form version 5 (first published 10 August 2020). This replaces version 4.
• Form number CMSHR 3 – Former worker assessment form version 2 (first published 10 August 2020) This replaces version 1.

These forms must be used instead of the previous versions for all health assessments commencing on and after 10 August 2020.

Electronic copies of these forms are available from 10 August 2020 from the Health Surveillance Unit by phoning (07) 3818 5420 or via email to HSU@rshq.qld.gov.au.

Form number CMSHR 1 – Health assessment form version 6 is no longer an approved health assessment form as of 1 April 2023. Health assessments for coal mine workers commencing on and after this date must use the approved form CMSHR1e via ResHealth.

The following health assessment form was approved by the Chief Inspector of Coal Mines on 9 March 2023. This form is used when completing online health assessments via ResHealth:

• Form number CMSHR 1e – Health assessment form version 1.2 (first published 13 March 2023). This replaces version 1.1.

This form is available when commencing health assessments on ResHealth from 13 March 2023. For more information, contact ResHealth or phone (07) 3818 5420.

Chest X-ray examination

Health assessments include a chest X-ray to detect coal mine dust lung diseases such as coal workers' pneumoconiosis. Images are dual-read by B-readers who have been accredited by the United States National Institute for Occupational Safety and Health (NIOSH).

These readers examine chest X-rays to the International Labour Organization International Classification of Radiographs of Pneumoconioses (ILO Classification).

Since July 2016, US-based B-readers accredited by NIOSH have provided a dual-reading service to Queensland's coal mine workers.

On 1 March 2019, Lungscreen Australia replaced US-based B-reading for all Queensland coal mine worker chest X-rays. All chest X-rays must now be sent to Lungscreen Australia.

Amendments to the Coal Mining Safety and Health Regulation 2017 that commenced on 1 March 2019 made this a mandatory requirement of the Coal Mine Workers' Health Scheme.

Lungscreen will classify coal mine worker chest X-rays to the ILO Classification and will provide the final ILO report back to the referring doctor.

Other Australian B-readers registered with RSHQ can undertake the first B-read and provide this to Lungscreen to complete the dual-reading process.

If the chest X-ray examination identifies abnormalities, the AMA is required to follow the Mine dust lung disease clinical pathways guideline (PDF, 789KB) for follow-up investigations and referral to appropriate medical specialists. RSHQ will send a sample of chest X-rays and ILO Classification reports to US-based B-readers for audit as part of the ongoing quality assurance program, as recommended by the Monash University review.

Read more about the Two-reader process for chest X-rays (PDF, 265KB).

Record keeping and reporting requirements

When the health assessment is complete:

• for health assessments completed in ResHealth
  • the AMA finalises the health assessment, ensuring that all medical reports (for example, chest X-ray report, spirometry report, CT scan report if applicable) are attached to the health assessment
  • the health assessment report is automatically available to the worker and employer on completion of the health assessment
• for health assessments commenced on the previous 'hardcopy' CMSHR1 form prior to 1 April 2023, or for other assessment types, the AMA sends
  • the completed health assessment form and all medical reports to RSHQ (Health Surveillance Unit)
  • a copy of the health assessment report to the coal mine worker (does not include employer, worker or examination section of the form)
  • the health assessment report to the coal mine worker's employer.
• Note: AMAs are no longer required to lodge the chest X-ray image with the completed health assessment to RSHQ if the final dual-read ILO report was issued by Lungscreen. This new arrangement also applies if the final ILO report was issued by University of Illinois at Chicago (UIC) and that report was facilitated through RSHQ. However, RSHQ may request the AMA to provide a copy of the image in certain instances.

If the employer requires an explanation of a health assessment report about a worker from the AMA, the employer must obtain the agreement of the worker and ensure that the worker is present – see section 47(1)(c) of the Coal Mining Safety and Health Regulation 2017.

AMAs are responsible for keeping all records associated with assessments and reviews they complete for coal mine workers. The records that AMAs must keep and give to RSHQ include a legible copy of the completed form for the assessment or review and the data or information on which it was based, including:

• the digital chest x-ray image file (DICOM) and a copy of the standard clinical x-ray report (see note above about lodging the chest X-ray image. The correct X-ray date must be recorded on the completed form.)
• the spirometry report and spirogram and/or lung function test reports
• ILO classification form
• high resolution computed tomography (HRCT) clinical report
• International Classification of HRCT for Occupational and Environmental Respiratory Diseases report
• any relevant medical specialist reports.

AMAs must give a copy of the records for each assessment and review to RSHQ within 28 days of completing the assessment or review by:

• for health assessments, uploading documents to, and completing the assessment on ResHealth. From 1 April 2023, all health assessments must be commenced on ResHealth
• for other assessments, or for health assessments commenced before 1 April 2023
  • uploading the records to the Coal Mine Workers' Health Assessment portal
  • or
  • sending hardcopy records, including the chest X-ray image file (DICOM) to: Health Surveillance Unit, Resources Safety and Health, GPO Box 1321, BRISBANE CITY  QLD  4001.
• Note: RSHQ strongly encourages AMAs to upload records to the Coal Mine Workers' Health Assessment portal. If you require further information on the Portal, contact the Health Surveillance Unit on AMAPortal@rshq.qld.gov.au or phone (07) 3818 5420.

AMAs must retain all records relating to assessments and reviews that they complete for a period of:

• If the AMA has provided a copy of all documentation for that assessment/review to RSHQ: at least 10 years after the last medico-legal action arising from that assessment, as per the Health Sector (Clinical Records) Retention and Disposal Schedule. The last medico-legal action may occur after the AMA has completed the health assessment report, for example any follow-up actions, checks, reviews, or treatment. The AMA must keep a record disposal log for all records disposed of after this period.
• Records must not be disposed of under this policy unless they have been provided to RSHQ.

AMAs may retain electronic (digital) copies of assessment and review records, and dispose of the original hardcopy records, if the following requirements are met:

• The digital versions provide adequate quality substitutes for the hard-copy originals – that is, they are legible, accurate, complete, and unaltered.
• The digital versions are managed in an IT environment that meets the minimum level of computer and information security acceptable for the 12 standards set out in the RACGPs Information security in general practice. The hard-copy originals are kept for a reasonable checking period after scanning, that period being determined by the AMA.
• The AMA must keep a record disposal log for all original hardcopy records disposed of.

The above retention requirements continue to apply after a doctor ceases to be an AMA for an employer.

Clinical pathways guideline

The Mine dust lung disease clinical pathways guideline (PDF, 789KB) (the Guideline) documents the recommended process for follow-up investigation of mine and quarry workers with abnormal screening results on respiratory examinations.

The Guideline was first published in 2017 in response to the re-identification of mine dust lung disease and was recommended following an independent review of the Coal Mine Workers' Health Scheme by Monash University in collaboration with the University of Illinois at Chicago. The Guideline has been reviewed and updated to incorporate legislative amendments, audit learnings, and feedback from stakeholders.

The Resources Medical Advisory Committee, appointed by the Minister for Resources and Critical Minerals in 2021, has endorsed the Guideline.

The Guideline is applied by AMAs and other medical practitioners registered to offer health services to coal mine workers.