The NSW Dust Diseases Scheme is a no-fault scheme for NSW workers who have developed a dust disease from occupational exposure to hazardous silica dust. The main focus of the Dust Diseases Scheme is on workers in the engineered/manufactured stone industry. The review of the NSW Dust Diseases scheme was referred for the purposes of section 27 of the State Insurance and Care Governance Act, 2015, where the Law and Justice Committee was designated to supervise the operation of the insurance and compensation schemes established under New South Wales workers’ compensation and motor accidents legislation. The 2021 review provided the opportunity to evaluate the progress of the recommendations made in the 2019 review on the management of silicosis in the manufactured stone industry.
Engineered stone is made from quartz (polymorph of crystalline silica), which is mixed with resins and pigments to form an engineered stone slab. The slab is prepared or fabricated, to order and is typically used for kitchen or bathroom benchtops. The fabrication of engineered stone is a separate and independent process to the supply of the products. It is performed by independent companies, businesses or sole traders (stonemasons), which provide fabrication services for builders on behalf of end-users. There are approximately 1000 fabrication businesses in Australia employing more than 7000 individuals and supporting 20000 indirect jobs. Currently, individuals are not required to obtain any formal training or qualification to work for or as a fabricator. The requisite fabrication skills and techniques are learned through experience and ‘on the job training’ which invariably differs between fabricators.
There is a very high content of silica in engineered stone products. Manufactured stone products, such as kitchen and bathroom benchtops are produced from crushed stone and/or sand and can contain up to 95% of crystalline silica which is an aggressive, lung damaging dust. It is generated when workers cut, crush, drill, polish, saw or grind crystalline stone products, or during projects involving the handling of crystalline silica products.
The risk of high-level exposure to crystalline silica from manufactured stone may occur during all stages, fabrication (stone cutting, shaping and finishing), assembly and installation. Uncontrolled dry cutting of manufactured stone is prohibited in NSW under existing WHS legislation, however since July 2020 it has been subject to a specific on-the-spot fine. When respirable crystalline silica particles are deposited in the lung tissue, the resultant inflammation and scarring can lead to a decrease in lung capacity which can eventually lead to chronic breathing problems and diseases of the lung, the most common being silicosis. There is also compelling evidence that silicosis constitutes a major risk for lung cancer.
Timeline of key events in the manufactured stone industry in NSW and Australia.
2000 – Introduction of manufactured stone to Australia.
2010 – Peak use of manufactured stone product commences.
2013 – Cases remain low and stable for the next five years.
2015 – First NSW case series linked to manufactured stone industry reported in literature.
2016 – Youngest known case admitted to hospital due to silicosis.
2017 – First NSW case linked to manufactured stone industry reported in literature and SafeWork NSW lists crystalline silica as 2nd of the top 10 priority chemicals.
2018 – SafeWork NSW commences targeted workplace inspections and iCare NSW introduces CT scans for workers with significant levels of exposure.
2019 – Cases increase to 17 new cases linked to the manufactured stone industry.
2020 – Case increase to 71 new cases linked to manufactured stone industry screen, silicosis becomes notifiable mid-2020 and workplace exposure standard for silica dust is halved.
2021 – First 6 months of notifications identify 12 new cases from manufactured stone industry.
Given below is a summary of the responses and feedback of the 15 different organizations that participated in the submission for the 2021 NSW Review of the Dust Diseases scheme.
Australian Lawyers Alliance (ALA) emphasized on its 2018 submission that the list of diseases in Schedule 1 of the Workers’ Compensation (Dust Diseases) Act 1942 (‘the Act’) requires updating. At the time of their 2021 submission it had not been done. While there are 14 dust diseases listed in Schedule 1, almost all compensation recipients suffer from just five of those diseases, those being the asbestos related diseases and silica-related diseases. The ALA submits that the definition of a dust disease covered by the Scheme should be extended to include diseases such as occupational asthma including reactive airways dysfunction syndrome (RADS), dust-induced pulmonary fibrosis, chronic obstructive pulmonary disease (COPD) related to dust, fume and mist exposure. ALA acknowledged the positive initiatives developed as a result of SafeWork NSW’s Dust Strategy 2020-2022, including the awareness education and the development of the NSW Dust Disease Register.
The Australian Workers’ Union (AWU) submission focused on the silicosis epidemic in tunnelling, quarrying, cement work, mining and construction amongst those facing the greatest risk from silica exposure in the workplace. They also emphasized the importance of the need for ongoing vigilance for other dust disease risks such as asbestosis and mesothelioma. Further, the use of the word ‘silicosis’ for the purpose of their submission included silicosis and silicosis related diseases such as COPD, kidney disease and renal failure, scleroderma, rheumatoid arthritis, tuberculosis, eye irritation and eye disease. Their sentiment was that, silica dust does not discriminate based on what industry you work in. NSW will experience high cases of silicosis in the coming years and decades if swift preventative, regulatory and compensatory measures aren’t quickly adopted to protect workers exposed to silica dust. There is need for an overhaul of the Work Health and Safety Act 2011 and Work Health and Safety Regulation 2017 to provide protections for all workers involved in high-risk silica work, based on the Victorian regulatory model.
Carers NSW focus was on the role of the Dust Diseases Scheme in supporting carers and on opportunities to continue to promote carer recognition and inclusion within the Scheme. Carers NSW commended and encouraged iCare’s practice of sponsoring and participating in community awareness events frequented by persons impacted by dust diseases, their families and carers. Carers NSW acknowledged the ongoing partnership with iCare which has led to expansion of the Mentoring Carers Program to carers of individuals covered by the Dust Diseases scheme. Continued community-based promotion of the Dust Diseases Scheme and available carer supports will align with the NSW Carers Charter, assisting carers to access appropriate services and supports that aim to facilitate optimal outcomes for their health and wellbeing.
RACP raised deep concern about the current and growing epidemic of accelerated silicosis. Their feedback highlighted the need for implementation of a free and comprehensive case finding program as a matter of urgency. They raised the need to provide an increased guarantee that all relevant businesses and sites are known and overseen by SafeWork NSW. Provisions for adequate funding for retraining and vocational support for those workers diagnosed with a silica-related condition and wish to leave the industry. Need for funding for research projects to prevent, manage and treat silicosis including funding for a cost benefit analysis of preventative measures. Making information publicly available on number of silicosis cases identified, number of compliance breaches issued along with how many employers have received them, information on importers of manufactured stone along with the list of sites for all manufactured stonework in NSW and data about return-to-work rates of diagnoses cases, the types of retraining that has been provided and to which new jobs/industries these workers are returning.
The Cancer Council and Lung Foundation Australia continue to advocate for improved protections of workers in particular the protection from dust lung disease including silicosis and lung cancer. Despite progress on many of the recommendation from 2019, it is clear that further reforms are required. To ensure improvements in the response to silica dust exposure in the manufactured stone industry they highlighted the need for a national ban on the importation of engineered stone products to prevent exposure to silica dust. The ban is because workers handling and processing this product have close to a one in four chance of developing silicosis, a disease which is progressive, incurable and can be fatal, in addition to an increased risk of developing lung cancer. The push is for a health-based workplace exposure standard as workers continue to be exposed to harmful levels of silica dust in the workplace despite increased efforts to raise awareness and improve compliance. Low dose high resolution CT scans required for manufactured stone workers as a more effective imaging tool to detect early onset of changes of lungs indicative of silicosis. A nationally consistent approach to silica regulation is required to remove all doubt and provides duty holders with clarity about the risk control measures necessary for high risk silica processes.
AIOH supports the implementation of a licensing scheme operating to a uniform national standard. There needs to be a level playing field and a list of reputable fabricators that sufficiently control their workforce dust exposure in the supply chain to developers and builders. NSW Government is urged to provide an appropriate level of additional annual funding to SafeWork NSW to strengthen its regulatory enforcement and monitoring of health and safety standards in silica using or generating industries such as construction, quarrying, tunnelling and demolition. Greater focus be placed towards education of workers and employers in high risk industries to complement awareness-raising activities. There is need to apply a Code of Practice for basic competencies of those who undertake air monitoring for RCS along with the process and interpretation of air monitoring and testing of the efficacy of on-site dust control mechanisms. AIOH recommended a database to capture exposure surveillance and collect of information on workplace control systems and work conditions, possibly medical surveillance data.
The CFMEU acknowledged that the incidence of silicosis amongst workers in NSW continues to rise. The CFMEU is of the view that the incidence of silicosis in the engineered stone sector is probably underreported in NSW, partly due to a lack of onsite health monitoring. In practice, many small business installers are either ignorant of and/or do not follow the regulations and health advice. It is simply unacceptable, and should really be unthinkable, that somewhere between 10 and 25% of workers engaged with manufactured stone are slowly being killed by products which are imported into Australia. Silicosis is an entirely preventable injury. Important and urgent work remains to be done by the NSW Parliament. In their unwavering plea, CFMEU states that the existing WES standards are dangerously misleading and send the message that working in relatively high density levels of RCS is safe when in fact federal and state governments know that working in such exposures can lead to death or disability. NSW needs to lead the way in implementing a timetable ensuring that expeditious technological advances are made in monitoring, supporting a further halving of the WES within the next 12 months.
A.St.A registered its firm support for all health and safety initiatives that governments are taking to manage airborne silica levels in processing engineered stone and other silica/quartz based products. Agglomerate and engineered stone products contain a mixture of marble, quartz, granite and other natural stones, together with pigments and a polyester resin binder. Crystalline silica is a mineral found in these source materials as well as in other common materials such as sand, cement, ceramics, concrete and sandstone. Airborne silica levels from cutting all types of silica-containing compounds can pose adverse health risks depending on the workplace environment, the quantity of activity and practices utilised. A.St.A aims to support businesses that use and fabricate engineered quartz and agglomerated marble in implementing best practice in training and equipping their employees.
MVSA recommendations focused on the hierarchy of controls. Elimination was pointed out as an impracticable control as it would have dire consequences on the stonemasonry industry and would negatively impact various parties and threaten the livelihood of not only workers, but that of the overarching industry and supply chain. Substitution will be difficult MVSA reckons, this is due to the abundant nature of crystalline silica in the earth’s crust although the possibility couldn’t be ruled out with technological advances. There are various engineering control measures which can be introduced to minimise workers exposure to crystalline silica. These include local exhaust ventilation and wet processes. It is highly recommended that the stonemasonry workers be consulted to get more practicable, cost effective and sustainable engineering control measures. MVSA proposes that administrative control will play a major role in the prevention of future silicosis cases. Education of the workforce combined with well thought through systems and procedures to empower and protect the worker must form part of the culture being cultivated and encouraged. MVSA recommends that each worker gets an Occupational Risk Exposure Profile which must be supplied to the medical practitioner.
SafeWork built its recommendations on a strong legislative framework to provide practical guidance on how to effectively manage risks associated with working with engineered stone, and minimise the incidence of silica-related diseases. SafeWork has put in long-term, evidence-based strategies which set the direction for its educational, compliance and enforcement activities in relation to dust hazards. The 2017-2022 Hazardous Chemicals and Materials Exposure Baseline and Reduction Strategy (Hazardous Chemical Strategy) aims to identify and reduce the level and impact of workplace exposures to hazardous chemicals. The Hazardous Chemicals Strategy has four key components – awareness, interactions, research, and legislation – and identifies silica as a priority chemical for in these areas. The Hazardous Chemicals Strategy is supported by the NSW Dust Strategy which aims to prevent occupational diseases by providing workers and businesses with a co-ordinated approach for the safe handling of materials that generate hazardous dust including asbestos, silica and wood. SafeWork’s Centre for Work Health and Safety has completed Phase One of a research project on the development of real-time silica detection devices, Significant testing has shown that the technology is able to accurately monitor silica dust exposure in real-time. This device and the technology within will now follow a fast-tracked path to commercialisation.
Maurice Blackburn lawyers gave the Government’s response to the Committee’s 2019 recommendation a D-grading. There simply has not been sufficient urgency applied to the implementation of the life-saving measures explicit in the recommendations. It appears the current regulatory framework and hygiene standards relating to crystalline silica may be insufficient to protect against the current wave of silicosis in the artificial stone In terms of future reviews of the NSW Dust Diseases Scheme, Maurice Blackburn urges the Committee to now broaden its view on workplace silicosis from tight focus on stonemasons, to all sectors and occupations where workers are contracting these insidious diseases. Maurice Blackburn offered suggestions to continue advocating for full and immediate implementations of all recommendations from the 2019 review. There is need to utilise the Committee’s position to advocate nationally for the rapid finalisation of the strategies and priority areas for action identified by the National Dust Diseases Taskforce, and the implementation of their recommendations.
Unions NSW has been extremely concerned about the increase in diseases such as silicosis over recent years. Unions NSW raised that it is unclear how many SafeWork Inspectors specialise in silica and silica compliance. Given the dismantling of SafeWork NSW or the ‘re-alignment’ of SafeWork NSW into one regulatory department Unions NSW is concerned that the specialised knowledge that once existed within WorkCover NSW may no longer exist. Unions NSW strongly supported recommendation 49 of the McDougall Review. ‘The responsible Minister for SafeWork NSW should conduct a public review of that agency’s performance of its regulatory and educational functions under the Work Health and Safety Act 2011. Unions NSW supports this recommendation, and they are of the view that lives should be saved were a thorough review of this Regulator be undertaken.
Caesarstone fully supports and is grateful for the efforts to date of SafeWork Australia, State SafeWork agencies, the NDDT, cognate State Taskforces and the Committee in combatting occupational lung diseases such as silicosis. Caesarstone believes systematic change can only occur if there is a national, consistent and unified approach by governments. Without a unified system, Australia will become subject to regulatory arbitrage whereby those operating in this highly competitive environment may restructure their operations to avoid unfavourable regulation. This will further endanger the lives of workers. Caesarstone’s Policy Paper, “Tackling Occupational Lung Disease – the pathway forward” sets out a proposed national reform package, implementation plan and a process to measure the reforms’ effectiveness. The Policy Paper outlines a coordinated and collaborative response from governments, industry and regulators, provides a clear pathway to effect the NDDT’s recommendations and tackle occupational lung disease in Australia. Given the reform process will involve implementing change in multiple States and Territories, in the midst of an ongoing national health crisis and during a Federal election, the date on which the NDDT recommended a ban should be considered (July 2024) is extremely premature. Caesarstone suggests a reform review should occur five years after the date of commencement of the national licensing scheme.
iCare has partnered with SafeWork NSW to assist with its Roadmap 2022 program which includes visits to 9000 businesses in NSW over the next 5 years to reduce worker risks and eliminate injuries and silicosis disease associated with exposure to RCS. The Dust Diseases Board (DDB) has implemented a 2020-2024 strategy to guide its vision to make a positive difference to those impacted by hazardous dust exposure and dust diseases. The strategy is delivered by four funding streams, ideas to action, focus, fellowships and scholarships and support organisations. The current DDB grant portfolio consists of 15 ideas to action grants studying asbestos related diseases with most investigating mesothelioma using basic research methods, 4 focus grants researching silica exposure and related diseases, 2 fellowships and 2 scholarships and funding for 2 support organisations. iCare has allocated funding for the 2022/23 financial year for focus grants into research to investigate the unique needs of younger people with silicosis, with particular focus on psychological health, health literacy and long-term chronic care to optimise quality of life. iCare has established processes to provide vocational support to all workers diagnosed with silicosis and eligible for the Dust Disease Care Scheme and they work with a number of vocational rehabilitation providers across NSW.
Smartstone strongly believes that engineered stone is a safe product when correct safety measures are employed. Smartstone has long argued that State governments should implement a licensing scheme for stone masons and their workers, to improve industry practices, workplace health and safety, and allow for better monitoring of the industry. It supports the development of a regulatory framework to reduce, and indeed eliminate the risk of silicosis associated with the fabrication and installation of engineered stone. There is a need for a nationally coordinated approach. They acknowledge that while a nationally accredited scheme is preferred, state-based licensing schemes can likely be established more easily and quickly. The licensing system described will need to be accompanied by a robust compliance and enforcement regime. They also raised the requirement of an independent audit of control plans prior to the granting of a license, establishment of a publicly available database of license-holders so that parties selling or buying controlled products can ensure they are dealing with valid license-holders and prohibiting the purchase of controlled products from unlicensed fabricators, not just the sale of these products to unlicensed fabricators. Smartstone does not believe that a ban on the importation is a proportionate or practical response to the issue under consideration.
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