Doctor and activist

The Silicosis Epidemic- A Symptom of Wider Regulatory Failure

Dr Arthur Chesterfield-Evans 28 February 2023

The epidemic of silicosis amongst tradespeople working with manufactured stone was predictable, preventable, and an illustration of a broken OHS system across NSW and the rest of Australia.

Until 2011, NSW had a workplace health and safety regulator whose statutory role was to “promote the prevention of injuries and diseases at the workplace and the development of healthy and safe workplaces”. The WorkCover Authority of NSW included specialist sentinel groups that researched, monitored, inspected and educated workplaces for dust diseases, farm and rural health (including pesticides) and noise, amongst other matters. Crucially, WorkCover also employed industrial hygienists and an occupational medicine group. These groups enabled the agency to anticipate many problems before they manifested in the state. The current furore over manufactured stone using powdered crystalline silica would probably have been averted if the dust diseases group were still in place.

For example, manufactured stone was previously produced in NSW, but made with powdered talc or limestone in a fibreglass matrix. The Dust Disease group discovered an employer using the cheaper silica flour and immediately put a stop to that. Similar proactive actions by this group halted the importation of mineral-bearing products adulterated by asbestos, such as brake shoes and gaskets, before they became a problem. Issues raised by the increasing use of carbon fibre and nano particulates would also have been within the purview of the Dust Disease group.

However, following the election of the coalition in 2011, the NSW government’s focus shifted to the financial losses of the workers compensation scheme. The insurance and workers compensation schemes were split from WorkCover with the creation of iCare and the State Insurance Regulatory Authority (SIRA).  Workcover also lost its independent source of premium income.

Limited funding for the remaining inspectorate and other functions such as promoting workplace injury prevention now came from Consolidated Revenue, set by NSW Treasury. Over the next few years WorkCover’s management under John Watson (the generic manager, not the Labor politician) shed many of its professionally qualified staff. New inspectors were less qualified than previously, a rule book replaced comprehensive understanding of occupational health and safety, workplace inspections decreased and in-depth investigations virtually vanished.

WorkCover’s system of Authorised Medical Practitioners, which trained GPs in occupational medicine across the state, was completely abolished. The excellent training manual for AMP’s, better than most textbooks, was written and maintained by Dr Kelvin Wooller at WorkCover. When he left, the regulator would not allow Dr Wooller to continue using the manual to train NSW medical practitioners but did nothing with it. Expertise in occupational medicine has consequently decreased in the wider medical community, making it difficult for many employers to find “a registered medical practitioner with experience in health monitoring”, as specified by the Work Health and Safety Regulation, and for workers to get a definitive diagnosis and compensation for workplace illnesses and diseases.

WorkCover was abolished in 2015, replaced by SafeWork NSW, which is now part of the Department of Customer Service, the department that is all things to all people.  The government seems not to understand what its function should be.

The regulation of workplace health and safety in NSW should be handled by vigilant sentinel occupational disease groups to provide workers with proactive protection and help keep workplaces safe. A core group of government-employed professionals is necessary as a repository for learnings and information that would otherwise be lost. This is the OH&S philosophy that drives other countries.

NSW has few workplace inspections, almost no penalties for appalling workplace practices and a cost-minimisation approach to the treatment of injured workers as the government reduces the premiums of workers compensation to make NSW ‘business-friendly’ at the cost of workers’ lives. There are currently a lot of inspections of benchtop manufacturers and suggested and overdue bans of manufactured stone with silica, but reactive activity in response to a significant epidemic has not fixed the systemic problem.

This needs to be an election issue in NSW. It should also be noted that John Howard’s similar 2007 changes to the Federal government regulator –the National Occupational Health and Safety Commission, (WorkSafe Australia), now Safe Work Australia –meant that that policy/advisory body also has far fewer personnel, less expertise and a less pro-active approach.  The perception of OHS as merely slowing industry’s “progress” has damaged the process nationally in a similar way to that of NSW.  The Federal government also needs to act in this area.

This article was published in John Menadue’s Pearls and Irritations 28 February 2023

Arthur Chesterfield-Evans

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