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Medical assessments for coal mine workers are becoming more precise, thanks to a new set of standards being developed by Dr. David Meredith and colleagues on the Coal Services Standing Health Committee.
The team is carefully reviewing common health conditions to quantify the risks associated with various roles in the mining industry – ranging from haul truck drivers to office workers.
The NSW Coal Mining Industry Respiratory Health Standard was the first in a series of health standards to be released by the Standing Health Committee, whose goal is to bring consistency and accuracy to medical determinations when workers present for their three-yearly medical under the NSW Health Surveillance Scheme for Coal Mine Workers.
“Historically, health advice for mining workers has been inconsistent, largely due to the varying experience levels of occupational doctors, whether clinically or in terms of experience in specific mining fields.
“This inconsistency means that doctors can disagree on the amount of information required to determine whether someone is fit for normal duties or whether they need some restrictions applied to their role to keep them healthy in the workplace.
“It can take considerable time working in the industry to gain a solid understanding of these issues, regardless of the doctor’s prior clinical experience,” Dr Meredith said.
Playing it safe
In the absence of clear guidelines, doctors often take a cautious approach. This can lead to further precautionary testing for workers, resulting in unnecessary time off work or restricted duties.
“When doctors aren’t quite sure what the outcome will be, they tend to seek more information or call workers back early for a medical review or follow-up.”
Dr Meredith says this approach can waste resources and cause operational setbacks.
“Many mine workers have been unnecessarily recalled for medical checks. While it’s not physically harmful to the worker, it creates unnecessary churn in the industry.
“We also see workers who fail to attend their followed up medical review, causing their clearance certificates to lapse and locking them out of the site – sometimes for something that really didn’t need to be addressed early on. All of this can also impact the worker’s mental health.”
Confusion around common chronic conditions
Managing cardiovascular health is a particular challenge. When managing high-risk patients, doctors are sometimes unclear about how different mining roles might elevate the risk of a cardiac event – and what the broader implications may be if one occurs on-site.
“For example, if a haul truck driver were to suddenly lose capacity behind the wheel, it could lead to a serious incident and put multiple lives at risk.”
“But for lower risk roles, like a surveyor or office worker, the situation becomes more ambiguous. As we move further away from the extremes, the lines blur, leading to confusion on how to manage the risk or condition,” Dr Meredith said.
The management of high blood pressure is also complex in occupational medicine, with the approach differing from that of a GP.
“High blood pressure is very common – affecting around 20 percent of the population. Unless someone’s blood pressure is getting to a point where it is potentially dangerous within the next three years, it wouldn’t typically require early Order 43 follow-up or management plans from a GP.
“However, we often see reviews from occupational doctors where they request further information from GPs just a few months later. If they were the treating doctor, that would make sense – but they are not. Instead, they need to decide whether there is an unacceptable safety risk in the worker’s current role as it stands today.”
Expert guidance
To bring more clarity to these issues, the Standing Health Committee consults with experts from both the medical and coal mining sectors.
“We have representation from all areas of the coal industry, the NSW Minerals Council, the Mining and Energy union, a representative from our external doctor network providers, contractors – both surface and underground– and the Primary Health Network.”
The Standing Health Committee also invites subject matter experts for specific standards they are developing.
“At present we’re working on a Cardiovascular Health Standard, and we’ve brought in a professor of cardiology from Saint Vincent’s Hospital to help us. As the subject matter expert, they guide us in understanding the risks and reasoning behind different cardiac conditions, helping us determine whether it’s safe for miners to work, if adjustments are needed to their work roles or where to draw the line.”
Learn more
Talking more about the role of Health Standards in occupational health and safety management, Dr David Meredith will present at the Longwall Conference, held 18-19 March at the Rydges Resort Hunter Valley.
Learn more and register your tickets here.
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