Occupational Dust Diseases

Introduction

An important update for Medical Practitioners – Western Australian Legislation

On 15 January 2021, Western Australian legislation was passed for chest CT to replace chest x-ray as the radiological screening test for occupational exposure to silica.

Schedule 5.3 (OSH Amendment Regulations 2021)
Low dose high resolution computed tomography of the chest at less than 1 millisievert (mSv) equivalent dose for the entire study. The study must image the whole of each lung on inspiration at 1.5 mm slice thickness or less, without an interslice gap, and must include expiratory imaging. The images must be of adequate quality to detect subtle abnormalities, including ground glass opacities and small nodules.

A standard diagnostic HRCT chest scan is not suitable due to the higher radiation exposure. Chest x-ray can no longer be used for silica health surveillance in Western Australia.

Perth Radiological Clinic provides silica CT scans that meet the requirement of this new legislation.  At Perth Radiological Clinic, silica CT scans are reported by Western Australia’s largest team of specialist chest radiologists.

Who is at risk?

  • Engineered stone workers
  • Stonemasonry (natural stone) and other processing of natural stone
  • Workers in the construction industry (eg. concrete cutting, shotcreting, tunnelling, demolition)
  • Workers in abrasive blasting, fire assay lab (ore sample crushing) and other industries (quarrying, mining)
  • Workers in foundry casting

Medical practitioners are encouraged to adopt a very low threshold for investigating individuals who are at risk and to contact WorkSafe WA for the latest guidelines.

Requirements for silica CT screening of high risk workers in WA

Engineered stone workers (category A): 2-yearly chest CT
Other industries (category B): 5-yearly chest CT

Silicosis screening CT requirementsEngineered stone workerOther silica dust industries with 5 or more years exposure
InitialIf clinically indicated or prior exposureIf clinically indicated or prior exposure
Repeatevery 2 yearsevery 5 years
Leaving the industryRequired if previous CT scan was more than 2 years prior to leaving industry*Required if previous CT scan was more than 2 years prior to leaving industry*

*Individuals who exited a high-risk industry prior to 2020 should be considered for their past personal history. Contact WorkSafe WA for latest advice.

Why choose Perth Radiological Clinic?

Perth Radiological Clinic provides silica CT screening to meet the requirement of this new legislation:

• low dose, high resolution CT chest scan for silica health surveillance
• Dose limit of 1 mSv or less (dose included in the report)
• CT chest scans are exclusively read by Western Australians largest team of RANZCR registered experts in occupational dust lung disease
• Modified Kusaka ICOERD classification included
• Long term storage of imaging and reports since 2006
• Appointments available within 24 hours
• Competitive rate

WA’s largest team of Specialist Chest Radiologists

At Perth Radiological Clinic, all silica CT scans are reported by Western Australia’s largest team of specialist chest radiologists who are Experts in Occupational Dust Lung Disease (RANZCR EODLD register).

Perth Radiological Clinic’s specialist chest radiologists are locally based in Perth, Western Australia and are available to discuss cases with medical practitioners:

Dr Roche Helberg
Dr Jeanne Louw
Dr Stephen Melsom
Dr Anuj Patel
Dr Bann Saffar
Dr Ramon Sheehan
Dr Arjuna Somanathan
Dr Mark Teh

How to refer for silica CT screening

Perth Radiological Clinic provides Occupational Dust Disease Referral Forms. ‘Occupational Chest Imaging’ referral forms
Practice manage software templates are available on request.
If standard referrals are used, please include the following details:

Location guide

Not all CT scanners can perform chest CT scans at the WorkSafe WA required dose with adequate image quality.  At Perth Radiological Clinic, silica CT scans are available at the following clinic locations with more coming soon.

Engineered stone and silica dust

The introduction of engineered stone companies into the Australian market since the early 2000s has led to the emergence of an accelerated form of silicosis among young workers.

Engineered stone, also known as artificial or composite stone, is made up of a very high silica content and polymer resin. This new stone product is widely used for kitchen and bathroom benchtops.

Compared to natural granite (25-60% silica content), engineered stone (up to 95% silica content) is cheaper, easier to cut and polish, giving rise to wider exposure for workers.

Pathology of silicosis

Respirable crystalline silica (RCS) particles penetrate deep within the lungs. Particles that reach the alveoli are ingested by macrophages resulting in the formation of tiny silicotic nodules. Over time, coalescing nodules can then form larger nodules and fibrotic masses.

Silica is also carried to the lymph nodes in the hilum. Enlargement and calcification of the lymph nodes can develop.

Silicosis is associated with increased risk of chronic bronchitis, tuberculosis, rheumatic disorders, sarcoidosis and lung cancer.

Further information

Please contact your Customer Relations Manager for a quote or any further information about silica surveillance at Perth Radiological Clinic.

https://www.commerce.wa.gov.au/worksafe/silica-dust-respirable-crystalline-health-surveillance-guide-medical-practitioners

https://www1.health.gov.au/internet/main/publishing.nsf/Content/ohp-nat-dust-disease-taskforce.htm

NOTE: The information provided on this page is intended for medical practitioners. To speak to a DMIRS occupational physician or inspector, phone 1300 307 877 or safety@dmirs.wa.gov.au.