Contributed Papers
Ten years on: Transforming respiratory health surveillance following the re-identification of coal workers' pneumoconiosis in Queensland
Dianah A-lzzeddin, Evan Pengally
Outline:
In 2015 the re-identification of coal workers’ pneumoconiosis in Queensland marked a turning point for the protection of mine and quarry workers’ health. This led to improved prevention and detection of occupational lung diseases (OLD) as well as support for affected workers. Driven by the recommendations of the independent review undertaken by Monash University in collaboration with the University of Illinois at Chicago, wide ranging reforms have taken place that have reshaped respiratory health surveillance to better detect disease in its early stages.
Over the decade since these reforms commenced, more than 750 current and former mining and quarrying workers have been diagnosed. Importantly, the majority of diagnoses have occurred while diseases are in their early stages, enabling earlier access to treatment, support and compensation.
During this period, the collective understanding of occupational lung disease among industry, medical practitioners, and the regulator has continued to mature. While conditions such as coal workers’ pneumoconiosis and silicosis continue to be diagnosed, there is an increasing recognition of the broad range of lung diseases that occupational exposures cause. There is also a growing awareness of the cumulative respiratory impacts of airborne contaminants, including vapours, gases and fumes, as well as dust.
Changes in reported disease patterns underscore the value of high-quality, evidence-based health surveillance programs that are designed to detect disease early among all workers. However, ongoing refinement of clinical pathways, and sustained education across the sector remain essential.
Objectives:
This presentation reflects on a decade of reforms to mine and quarry respiratory health surveillance in Queensland, examining how improved systems have delivered early detection, how disease profiles have evolved, and future enhancements to continue protecting the respiratory health of Queensland’s mine and quarry workers.
Schedule 8 psychoactive medications for neurodevelopmental disorders in safety-critical workplaces: A clinical and governance framework
Graeme Edwards
Outline:
The prescription of a Schedule 8 (S8) psychoactive medication for a neurodevelopmental disorder in a safety-critical worker triggers a structured, multi-party governance process extending well beyond the treating clinical relationship. This presentation proposes a five-step framework addressing clinical threshold determination, control status classification, dosing architecture, disclosure obligations, responsible PCBU governance, and ongoing review, with reference to the Australian rail and mining regulatory context and the National Standard for Health Assessment of Rail Safety Workers 2024.
Objectives:
Participants will be able to:
1. Distinguish well-controlled from satisfactorily-controlled status and apply the requirement that control be demonstrated under operational challenge, not merely under routine clinical conditions
2. Classify treatment regimes across three dosing architectures of rising clinical severity and identify the governance implications of each
3. Describe the disclosure and governance obligations of the worker, treating practitioner, occupational physician, and responsible PCBU, including in employer-provided residential accommodation
Identifying candidate measures for occupational blast overpressure surveillance: Results from a prospective military phase 1 study
Antony Sutherland, Kurt Mudie, Zoe Jenkins, Jemma Coleman, Jessica Palling
Outline:
Repetitive low-level blast exposure is a pervasive occupational hazard of military training, but it remains unresolved which exposure metric and which functional measure should anchor a monitoring program, and whether reported effects withstand adjustment for pre-existing differences between individuals. The prevailing single-event, peak-pressure (<4psi) risk paradigm is increasingly challanged by evidence that accumulated exposure predicts neurological risk. Two questions remain unresolved; which exposure metric best tracks functional change, and which functional endpoint is most sensitive yet resistant to confounding - since symptoms self-report overlaps heavily with psycholgoical stress.
Objectives:
The study was conducted as the first phase of an Australian Defence Force occupational blast-monitoring program. Its aims, as stated in the manuscript include:
1. Identify the exposure metric - to determine which prospectively measured blast-exposure metric (e.g. cumulative impulse, peak-exposure metric (e.g. cumulative impulse, peak overpressure, exposure days, number of events) is most closely associated with functional change.
2. Identify the functional endpoint - to establish which objective cognitive measures and subjective symptoms measures are most responsible to cumulative blast exposure
3. Test for a genuine dose-response - critically, to establish whether any exposure-outcome association reflects a true within-person dose-response after accounting for each participant's pre-exposure baseline, rather than stable differences between individuals or cohorts.
4. Generate preliminary estimates - to provide preliminary dose-response estimates to inform the design of an adequately powered Phase 2 longitudinal study.
The a priori hypothesis was that cumulative impulse - not peak overpressure - would be associated with slowing of reaction time, even where individual blast events remained below the conventional 4-psi threshold.
Managing workplace heat stress: Choosing the right assessment tools and controls
Ross Di Corleto
Outline:
The presentation examines occupational heat stress as a growing workplace safety challenge. It explains the potential variability of heat stress and discusses a potential approach. This includes the evolution of three-tier assessment methodology and the 2025 AIOH guidance. It compares frontline screening, environmental assessment, predictive modelling and physiological monitoring, supported by a practical heat-exposure scenario.
Objectives:
Explain the significance of occupational heat exposure in a warming climate.
Introduce the AIOH three-tier assessment methodology.
Compare the benefits and limitations of available assessment tools.
Demonstrate how predictive modelling can evaluate work/rest regimes and engineering controls.
Encourage risk controls that reduce heat exposure at its source.
Stroke in pilots - a case report and aeromedical considerations
Joseph Nguyen
Outline:
This case report describes a recreational pilot who was diagnosed with an ischaemic stroke and was found to have non-significant vertebral artery stenosis, and reviews the aeromedical considerations for certification following recovery from a stroke, with a review of the recent literature.
Objectives:
- Explore aeromedical decision making for cases of stroke and TIA using an example of a case report
- Identify the primary risks associated with stroke on flying status including recurrence risk and potential for persistent sequelae
- Review current Australian civil aviation standards for stroke and TIA
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