"Indeed, the Cancer Council has estimated that approximately 587,000 people had occupational exposure to silica dust in 2011. Based on that number, the Cancer Council estimated that 5,780 people will have developed lung cancer."

Address to the House of Representatives, BILLS - National Occupational Respiratory Disease Registry Bill 2023, National Occupational Respiratory Disease Registry (Consequential Amendments) Bill 2023 - Second Reading

Monday 7 August 2023

I also rise today to speak in favour of the National Occupational Respiratory Disease Registry Bill 2023. This bill will establish a national occupational respiratory disease registry that will contain specific information on individuals diagnosed with or being treated for occupational respiratory disease such as silicosis. I would like to firstly talk about the disease I just mentioned: silicosis. Silicosis is a long-term lung disease caused by inhaling silica dust over a period of time. It is a silent killer. The particles, once inside the lungs, scar the lungs—this is what causes silicosis. A one-off exposure may not be immediately noticeable, but a career exposed to quartz, sandstone, soil, granite, brick, cement or engineered stone can lead to irreparable damage. In fact, evidence suggests that workers exposed to engineered stone are particularly at risk, as those workers experienced a more rapid disease progression and a higher rate of mortality, despite being exposed to silica dust for a shorter duration. Symptoms may start to appear in the form of shortness of breath, a dry cough and tiredness. These symptoms become worse with time. Worst of all is the fact that there may be no symptoms at all. Eventually, a silicosis sufferer will find walking and climbing stairs more difficult, and they'll start to notice trouble sleeping and will struggle to eat properly.

Last year, Australian Unions published the story of Joanna, which encapsulates just how unnoticeable silicosis can be. Joanna, a mother of two and a wife in her early 30s, was working in an administration role for a quarry belonging to a huge, multinational company that manufactured construction materials. Joanna's actual job had little to do with the manufacturing side of the business. In her role, Joanna oversaw things like purchasing and payroll from her office located around 90 metres from the quarry's crushing plant. The dust thrown up by the action of the crushing plant, however, was so pervasive that Joanna said:

You could taste it on your lips. Every time you'd go home from work you could actually taste it.

In her administrative duties, Joanna would also frequently run the safety meetings for staff—sometimes even tasked with taking the minutes. Nowhere in any of those minutes of any of those meetings was she or any other worker for the company made aware of a substance called silica. After returning from maternity leave, Joanna went for her routine medical, as required by her employer. Following an X-ray, she was informed that there appeared to be something on her lungs. A medical biopsy revealed that the 'something' was silica dust.

Joanna was fortunate. For many Australians who are exposed to silica dust and who develop silicosis, their risk of developing tuberculosis, chest infections, emphysema, kidney damage and lung cancer drastically increases. Indeed, the Cancer Council has estimated that approximately 587,000 people had occupational exposure to silica dust in 2011. Based on that number, the Cancer Council estimated that 5,780 people will have developed lung cancer.

We know today that silicosis cannot be treated, the damage to the lungs cannot be reversed, and only some symptoms can be properly treated to improve quality of life. It was the union movement that successfully campaigned for a National Dust Disease Taskforce and has lobbied successive governments for action since 2019, when members started to flag with their unions that they were suddenly being diagnosed with scarring on their lungs, and healthy workers who'd had long careers in quarries, construction sites, tunnels and masonries were suddenly struggling to breathe, developing lung cancer despite not smoking, and entering retirement stuck to a chair and connected to oxygen. Unions, fearing another asbestos-like health crisis, commissioned reports and surveys and began lobbying hard for government intervention and better outcomes for their workers.

It was these unions that urged governments to introduce a ban on the use of engineered stone products and that highlighted the need for greater leadership from the federal government to avoid the dust disease epidemic reaching the levels of public health challenge that asbestos had. The ACTU declared:

A failure to take these necessary steps will further risk thousands of workers contracting silicosis, an incurable and sometimes fatal lung disease.

I'd like to take this opportunity to acknowledge the coordinated work from the Australian Council of Trade Unions, the Australian Workers Union, the Electrical Trades Union, the Australian Manufacturing Workers Union, the Communications, Electrical and Plumbing Union, and the Construction Forestry Maritime Mining and Energy Union in advocating for their members most at risk of developing respiratory disease.

In April 2019 the Australian government committed $5 million to establish the National Dust Disease Taskforce to develop a national approach for the prevention, early identification, control and management of dust diseases in Australia. This was in response to the emerging trend of new cases of accelerated silicosis. The task force was established in July 2019 and provided some initial advice to the then Minister for Health in December 2019. This advice made 17 findings and five early recommendations. The early recommendations included the development and implementation of a prevention strategy, with an initial and immediate education campaign; the development of a national approach to capture data, information collection and sharing to improve the understanding of occupational dust diseases in Australia, including the staged establishment of a national dust disease registry; and research to better understand accelerated silicosis, with an aim to improve prevention and treatment options.

The task force provided its final report to the minister in June 2021. This final report made seven recommendations. These included: enhanced work health and safety measures; urgently undertaking regulatory impact analysis to identify and decide on measures for implementation that would provide the highest level of protection for workers; developing guidelines to identify people at risk of silica dust exposure and improving the quality, frequency and coverage of health screening for current and former workers; designing and implementing preventative measures; improving support for people affected by dust related diseases, and their families; improving the supports available for the health sector to improve the diagnosis and management of people affected by silicosis; establishing cross-jurisdictional mechanisms to improve communication and information sharing, coordinate response and report on progress; and implementing the National Occupational Respiratory Disease Registry as soon as possible, with an initial focus on mandatory reporting of silicosis, and voluntary reporting of other occupational respiratory diseases.

One of the most confronting statistics that was discovered was that nearly one in four engineered stone workers who've been in the industry prior to 2018 have been diagnosed with silicosis or other silica dust related diseases. This legislation recognises the important work that the states and territories have been doing to keep Australian workers safe in following some of the recommendations that were made in the National Dust Disease Taskforce report, and we can see practical examples of these recommendations being implemented. For example, here in the ACT a number of policy changes have occurred to enhance work health and safety measures. These measures include a ban on the dry cutting of engineered stone; a new minimum standard for safety control that will apply for mechanically cutting engineered stone, concrete, cement, bricks, mortar, masonry and natural stone; and that any future cutting of crystalline silica materials is expressly defined as 'high-risk construction work', and, additionally, that those involved in high-risk cutting must complete mandatory training by 1 October this year. These reforms will be enforced through penalties for individuals and businesses that fail to meet the new mandatory requirements, with fines ranging from $6,000 to $30,000.

Establishing the National Occupational Respiratory Disease Registry was a key recommendation of the National Dust Disease Taskforce. As recommended by the task force, specialists in respiratory sleep and occupational and environmental medicine will be required to notify the registry of every diagnosis of occupationally caused silicosis. They may also notify the registry of other occupational respiratory diseases with a patient's consent.

This bill will establish a registry that will record the incidence of occupational respiratory diseases in Australia, which will therefore inform activities to prevent further workers being exposed to respiratory hazards. With no cure for silicosis, prevention is our best chance to successfully eradicate this disease for future generations of workers. The registry will have a multitude of functions, including: collecting, storing, analysing and publishing information on the diagnosis and progression of occupational respiratory diseases; monitoring the incidence of occupational respiratory diseases and preventive activities and the effectiveness of these activities; informing the identification of the industries, occupations, tasks and workplaces with a risk of exposure to respiratory hazards; providing prescribed medical practitioners with access to individual patient information on the registry to inform that person's health care for respiratory diseases; and supporting research, including through the identification of individuals for clinical trials and observational studies.

By being able to track where cases are coming from, how they're being treated and how they're being prevented, the government can use this data to assist with the formulation of a long-term and robust approach to eradicating silicosis and similar respiratory diseases from workplaces. Consistent with the recommendation of the task force, initially only silicosis will be a prescribed occupational respiratory disease, but the Minister for Health and Aged Care will be able to prescribe other diseases, following consultation with the Commonwealth Chief Medical Officer and each state and territory.

The bill recognises the potential burden that notification will have on physicians and limits the mandatory elements that must be notified to a minimum notification. The minimum notification will include sufficient information to identify an individual with a diagnosed occupational respiratory disease, the disease diagnosed and the details and the likely exposure that resulted in the disease, including the last and main exposures. Further information can also be supplied where the individual consents.

In addition to ensuring notified information is available to the physicians treating the individual, the bill will enable the disclosure of notifications about an individual made to the national registry, including to prescribed Commonwealth, state or territory authorities, state and territory health agencies and work health and safety agencies. The disclosure to state and territory health agencies and work health and safety agencies will increase awareness of the prevalence of occupational respiratory diseases in the state or territory and will enable actions to be taken to reduce further worker exposure to those diseases.

The national registry is about empowering and informing the government's long-term plan to eradicate silicosis. This is not something the country can fix in six months, and, due to the slow nature of the disease, the data suggests that numbers will still rise for some time and that the long-term effects will still be present in generations of workers. But the national registry will help formulate our response and will ensure that future generations of workers do not need to fear developing silicosis in their workplace.

The establishment of the registry will complement actions across all state and territory governments to reduce exposures in the workplace and demonstrates the Albanese government's commitment to keeping workers safe. We cannot cure silicosis, but we can prevent it. I commend this work from the assistant minister and the union movement, and I commend this bill to the House.