Executive Summary

The past decade has seen the re-emergence of an entirely preventable occupational respiratory disease that was prevalent in Australia in the 1940s to 1960s: silicosis.1 Silicosis is caused by inhalation of respirable crystalline silica generated when manipulating - cutting, grinding and polishing - material containing silica such as engineered stone. The re-emergence of silicosis has been mostly driven by the popularity of engineered stone material which has been available in Australia since the early 2000s. Every case of silicosis affecting a stone benchtop worker is evidence that businesses, industry and governments need to do more to recognise and control the risks of working with engineered stone.

In 2019, the Taskforce was asked to develop a national approach to the prevention, early identification, control and management of occupational dust diseases. In our Interim Advice, we set out five recommendations for immediate attention. Our Final Report builds on these recommendations. Collectively, they provide a comprehensive program of work designed to fundamentally address the risks facing workers in industries that generate hazardous dust such as silica, with an immediate focus on the engineered stone industry. We recognise that over the past 18 months, state and territory Work Health and Safety (WHS) regulators have taken additional actions to improve education and awareness of the risks and enforce compliance with WHS laws. Many have introduced targeted compliance campaigns and/or have made (or are in the process of introducing) regulatory changes to address the re-emergence of silicosis. While these actions are welcome, their effectiveness is not yet clear and there is not uniformity across jurisdictions.

Reform is urgently required. There is evidence to suggest that nearly one in four engineered stone workers who have been in the industry since before 2018, are suffering from silicosis or other silica dust related diseases.2 Existing WHS regulatory frameworks have not effectively protected people working with engineered stone.

We have listened to a wide range of views from stakeholders, and have had lengthy discussions about the merits of different interventions available to drive change: from improving education, communication and awareness raising, to limiting access to the product, to introducing a ban on the product.

In this Final Report, we have identified specific regulatory and non-regulatory actions designed to have an immediate impact on improving worker health and safety. After careful deliberation, we have decided not to recommend a product ban at this stage. However, all parties need to

1 Royal Australian College of General Practitioners (2019) Explainer: What is Silicosis?, accessed 20 January 2021 2 Data from Queensland and Victoria indicates that out of 1,509 workers screened, 362 were found to have silicosis: Sources: (i) “WorkCover screening outcomes” as at 31 May 2021 (https://www.worksafe.qld.gov.au/ claims-and-insurance/work-related-injuries/types-of-injury-or-illness/work-related-respiratory-diseases/ silicosis last checked 27/06/2021); (ii) “Silica-associated lung disease health screening research: Phase one final report” as at November 2020 (https://www.worksafe.vic.gov.au/resources/silica-associated-lung-diseasehealth-screening-research-phase-one-final-report last checked 27/06/2021) Note: this data does not include workers who have been exposed but are yet to be diagnosed or to develop the disease.

consider themselves to be on notice: the majority of Taskforce members agree that if the measures we have recommended do not achieve the expected significant improvements in worker safety within the next three years, then immediate action must be taken to ban the product. Industry and governments must urgently demonstrate that engineered stone can, in fact, be used safely. Additional regulatory controls are required to address gaps in both policy and implementation to ensure safe work environments. A regulatory impact analysis (RIA) must urgently be undertaken to specifically consider effective measures, including the introduction of licensing schemes to ensure that only those persons conducting a business or undertaking, who are able to meet the required standards or competencies developed and introduced as part of such a scheme, have access to the product. Enforcement activities must also be adequately resourced to ensure compliance with WHS laws. The importance of prevention activities, identified in our Interim Advice, has only been confirmed. The introduction of licensing schemes should effectively achieve many prevention goals. More generally, there needs to be a greater focus on, and investment in, prevention activities, including the immediate finalisation and implementation of a National Silicosis Prevention Strategy, and the associated national education campaign.

There are also significant opportunities to improve health monitoring, surveillance and screening. Improvements in these areas will support better case identification and enable early intervention which is critical to ensuring better health outcomes for workers exposed to respirable crystalline silica, including those who have left the industry. The establishment of the National Occupational Respiratory Disease Registry (National Registry) will support the capture of notifications of silicosis, as well as other dust diseases, from all jurisdictions, allowing for earlier detection of hazards as well as new cases of disease. In addition, the National Registry will help further define the magnitude and importance of the problem.

We were deeply moved by the stories of affected workers and their families about the difficulties they have experienced accessing the full range of supports they need. We understand the terrible impact that a positive diagnosis or being characterised as ‘at high-risk’ of developing a disease, has on all areas of people’s lives. All governments should review and tailor return-to-work programs to better aid affected workers and their families. Whilst we acknowledge the recent investment by the Commonwealth Government and other governments in silicosis research, much remains to be understood about the disease, both clinically and non-clinically. Additional funding is required to build the evidence base as well as the capability of the research sector.

Throughout our deliberations, the Taskforce has been mindful of the terrible history and legacy of asbestos in Australia. The risk of asbestos dust was first recognised in the 1930s, however, a complete ban on the use of asbestos was only implemented in 1984, after tens of thousands of individuals had been exposed, and many thousands of Australians dead from mesothelioma, lung cancer and asbestosis.3 We do not want a repeat of this experience in relation to silica dust.

3 Arthur W (Bill) Musk, Alison Reid, Nola Olsen, Michael Hobbs, Bruce Armstrong, Peter Franklin, Jennie Hui, Lenore Layman, Enzo Merler, Fraser Brims, Helman Alfonso, Keith Shilkin, Nita Sodhi-Berry, Nicholas de Klerk (2019)

‘The Wittenoom Legacy’, International journal of epidemiology, 49(2):467-476, doi.org/10.1093/ije/dyz204

Immediate action is required to better protect workers from hazardous exposures, reduce the burden of occupational respiratory disease, and ensure Australia has strong, responsive and fit for purpose arrangements that identify occupational respiratory hazards early and ensure safe workplaces. History cannot be allowed to repeat. All the information gathered by the Taskforce has informed the development of this Final Report. The recommendations set out a comprehensive program designed to drive real, measurable change to make workplaces safer for those working with material containing harmful substances such as silica, minimise risks associated with exposure to these substances, and provide better support to those affected.