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‘Asbestos of the 2020s’: Calls to fast-track silica ban


Morgan Liotta


1/03/2023 4:45:38 PM

Until action is taken, Dr Kerry Hancock says GPs can expect to see more patients at risk of silicosis.

Person cutting stone
It is estimated that one in four people who work with silica products will develop silicosis.

State and territory workplace ministers met this week to discuss proposed bans on engineered stone, specifically products containing respirable crystalline silica (RCS), of which tiny dust particles deposit in the lungs, causing the deadly lung disease silicosis.
 
Described as the ‘asbestos of the 2020s’, Australia is experiencing an epidemic of silicosis diagnoses, most notably among young men who work with the product which is cut or ground to produce stone bench tops. And those diagnoses are expected to rise.
 
At Tuesday’s meeting Federal Workplace Relations Minister Tony Burke, along with state and territory ministers, called for a ban on all engineered stone to reduce risk of exposing workers to silica dust.
 
The governments reached a unanimous decision to ask Safe Work Australia to decide on banning the material, and to scope what a national ban with consistent laws would look like.
 
Minister Burke is calling for a coordinated national response to the issue but says that will take ‘a good 12 months or more’.
 
‘The moment you get to this point, there’s still further delays,’ he said on ABC’s Radio National Breakfast ahead of Tuesday’s meeting.
 
Minister Burke advised that even if a ban was agreed to at the ministers’ meeting, Safe Work Australia would need to consider what the ban would look like, then legislation would be required to pass through each state and territory to enact the ban.
 
Dr Kerry Hancock, Chair of RACGP Specific Interests Respiratory Medicine, has previously warned of the growing harms of silica dust and related diagnoses of silicosis.
 
Speaking to newsGP this week in response to the proposed national ban, Dr Hancock said ‘urgent action’ is required to better protect workers from hazardous exposures and reduce the burden of occupational respiratory disease.
 
‘There needs to be in place arrangements to identify occupational respiratory hazards early and ensure safe workplaces for all people in Australia,’ she said.
 
‘Existing regulatory frameworks have not been effective in protecting workers and urgent reform is required. Current reports indicate the potential for widespread undiagnosed disease in the engineered stone industry, and potentially one-in-four to one-in-five people exposed to RCS will develop silicosis.’
 
If steps are not take to address exposure to RCS, Curtin University epidemiologists are predicting up to 100,000 cases of silicosis in the next 50 years and around 10,000 cases of related lung cancer.
 
They say the ‘best thing’ to do is eliminate initial exposure or set in place a way to stop generating the dust, such as wet cutting.
 
‘This needs to be controlled from the start,’ Professor Lin Fritschi told the ABC.
 
‘We absolutely need a ban – this is so much worse than asbestos. We estimate that one in four people who work with these products over some time will develop silicosis. We shouldn’t have that for this deadly, horrible disease. This is a crisis.’
 
The former National Dust Disease Taskforce, which delivered its final report to the Department of Health and Aged Care (DoH) in mid-2021 and has now ceased operating, issued a deadline of July 2024 if no national ban is put in place before then.
 
In March 2022, federal, state and territory governments released the All of governments’ response to the final report of the National Dust Disease Taskforce. It committed to the taskforce’s recommendations that further decisive action is required to better protect workers in dust-generating industries, to better reduce incidences of silicosis and other dust diseases among workers, and increase quality of life for people impacted by silicosis and their families.
 
Should the issue not be nationally addressed by mid-2024, the Construction, Forestry, Maritime, Mining and Energy Union’s incoming National Secretary Zach Smith has warned its members would refuse to work with silica-containing products.
 
‘If the Government hasn’t implemented a ban on the importation and manufacture of engineered stone by 1 July 2024, our union will act, and we will implement our own workplace ban – I can be really clear on that point,’ he said.
 
‘The Government has no reason to delay … we don’t need further monitoring, we need decisive action now.’
 
Several other health bodies, including the Lung Foundation of Australia, have backed calls to ban silica products with the goal to eliminate exposure to and diseases caused by the dust in Australia as much as possible.
 
Dr Hancock says GPs can expect to see more patients at risk of, or being diagnosed with, silicosis, and points to national guidance documents, which the RACGP provided feedback on, that have specific reference to occupational respiratory diseases associated with engineered stone.
 
‘This guidance was developed to help GPs identify and assess people at risk of silicosis caused by exposure to RCS dust,’ she said.
 
‘It supports GPs and medical practitioners to identify and assess people at risk of silicosis caused by exposure to RCS dust and improve health outcomes for their patients.
 
‘Whilst we patiently wait for these “frameworks” to become more effective, GPs will need to be on the lookout for their patients who have been exposed to RCS or other occupational hazards and ensure that they are referred through the appropriate pathways to be investigated and monitored.
 
‘Taking a good occupational history is just so important.’
 
In addition to the national guidance, Dr Hancock cites a number of resources available to GPs, including an RACGP online education module. The Lung Foundation Australia also has resources for GPs and patients.
 
The DoH has also appointed the Lung Foundation to facilitate development of a 2023–28 National Silicosis Prevention Strategy and accompanying National Action Plan, with the draft Strategy and Action Plan currently open to public consultation until 10 March.
 
Dr Hancock urges for action to fast-track a national ban.
 
‘It is frustrating that, despite all the evidence and consultations and the multiple reports that have been generated over the last few years, workers are still exposed to a substance that causes debilitating respiratory disease and premature death,’ she said. 
 
‘Banning high silica content engineered (artificial) stone surely needs to just happen sooner than later. We really cannot afford to lose more time.’
 
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