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.
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.
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 Department of Natural Resources, Mines and Energy (DNRME) health assessment form in accordance with the Coal Mining Safety and Health Regulation 2017.
- Read about the role and appointment of AMAs.
For copies of the health assessment form, phone (07) 3818 5420 or email HSU@dnrme.qld.gov.au.
This form has 4 sections:
- Section 1 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.
- Section 2 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.
- Section 3 is completed by an examining medical officer and details clinical findings.
- Section 4 (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 section 4 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 15 February 2019.
- Form number CMSHR 1 – Health assessment form version 5 (first published 1 March 2019). This replaces version 4.
- Form number CMSHR 2 – Exit assessment form version 4 (first published 1 March 2019). This replaces version 3 (Retirement examination form).
- Form number CMSHR 3 – Former worker assessment form version 1 (first published 1 March 2019).
These forms must be used instead of the previous versions for all health assessments commencing on and after 1 March 2019.
Electronic copies of these forms are available from 1 March 2019 from the Health Surveillance Unit by phoning (07) 3818 5420 or via email to HSU@dnrme.qld.gov.au.
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.
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 DNRME 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 Coal Mine Workers’ Health Scheme (CMWHS) Clinical pathways guideline (PDF, 702KB) for follow-up investigations and referral to appropriate medical specialists. DNRME 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, the AMA sends:
- the completed health assessment form and all medical reports (chest X-ray report, spirometry report, CT scan report if applicable) to DNRME (Health Surveillance Unit) (Note: AMAs are no longer required to lodge the chest X-ray image with the completed health assessment to DNRME 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 DNRME. However, DNRME may request the AMA to provide a copy of the image in certain instances.)
- a copy of the health assessment report (section 4 of the form) to the coal mine worker (does not include sections 1, 2 or 3 of the form)
- the health assessment report (section 4 of the form) to the coal mine worker's employer.
If the employer requires an explanation of a health assessment report (section 4 of the form) 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 DNRME 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 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 CT scan report
- any relevant medical specialist reports.
AMAs must give a copy of the records for each assessment and review to DNRME within 28 days of completing the assessment or review by:
- 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, PO Box 467, GOODNA, QLD 4300.
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 DNRME: 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 section 4, 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 DNRME.
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 RACGP’s Computer and information security standards (CISS), 2nd Edition (PDF, 1.5MB).
- 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 Coal Mine Workers' Health Scheme (CMWHS) Clinical pathways guideline (PDF, 702KB) lays out the recommended processes for follow-up investigations and referrals resulting from regular screening.
The guideline was developed by the Coal Mine Dust Lung Disease Collaborative Group, a group of health specialists from the fields of occupational medicine, radiology, and lung health. The guideline has been endorsed by Queensland's Chief Health Officer, the Royal Australasian College of Physicians and its Australasian Faculty of Occupational and Environmental Medicine.
The guideline will be applied by AMAs and other medical practitioners registered to offer health services to coal mine workers.