Jul 05, 2023

Action on silicosis stalled as surveillance program estimated to miss 200 workers with deadly disease

As calls to ban engineered stone kitchen benchtops grow louder, a surveillance program in NSW is estimated to have missed a staggering 200 workers who have developed the crippling work-related lung disease silicosis but have not been diagnosed.

The figures, calculated by respiratory physician of 30 years Deborah Yates and occupational hygienists Kate Cole and Maggie Davidson, were published on Friday in response to a recent study by Monash University that found one in four stonemasons in Victoria who worked with artificial stone benchtops developed silicosis. It is a similar figure to a survey undertaken in Queensland.

Yates says they attempted to calculate the rough number of workers who were likely to have been missed using the current surveillance system in NSW, which only requires workers to get chest X-rays, which aren't as accurate as CT scans.

Hak Kim was in his mid-20s when he started noticing changes in his body while working on demolition sites in Sydney.

But the actual number of workers who have silicosis in NSW and Australia more broadly is unknown due to a lack of comprehensive and coordinated screening.

It means the number of workers who have died from silicosis in Australia is also unknown.

For instance, illegal workers exposed to silica dust may have symptoms but don't get treatment because they are scared of being deported.

Yates says some patients have told her the workplace conditions breach all the rules but they are too scared to come forward for fear of losing their job. She says some come in for treatment when they are in the late stages of silicosis, but some don't return.

There is also an issue with communication. A third of workers who work with engineered stone in NSW don't speak English as a first language. The culturally and linguistically diverse workforce is often the most vulnerable in our community.

Silicosis is a work-related disease that is entirely preventable. But it is on the rise due to weak regulation, a failure of the lawmakers to make uniform reforms across the states, operators putting profits before safety and workers not understanding that the shiny kitchen benchtops they cut and grind and install contain high levels of silica — up to 95 per cent. That dust can be deadly when inhaled and then become embedded into the lungs.

In Victoria and Queensland, there are at least 80 legal cases, pending or filed, while dozens have been filed or are pending in NSW.

Some cases target the employers, often small fabricator outfits, as well as the manufacturers, which include Caesarstone, which pioneered engineered stone slabs for benchtops in 1987 and started importing them to Australia in the late 1990s, without proper warning stickers.

Caesarstone's latest annual report details 56 pending lawsuits in Australia relating to silicosis claims, up from 38 in the previous year.

What is shocking about silicosis and the slowness of authorities to crack down is that the first known death in Australia was back in 2019 when 36-year-old stonemason Anthony White died. It shocked politicians into promising immediate action to sort out the industry.

Weeks after Mr White died, the government created the National Dust Disease Taskforce to develop an approach to the control and management of dust diseases including silicosis.

The incurable lung disease, caused by the inhalation of silica particles, has received increasing attention amid calls for a ban on engineered stone bench tops, but silica's presence in ceramics is less commonly known.

The report, released in 2021, recommended that "further decisive action is required to better protect workers in dust-generating industries and to support affected workers and their families".

A national register is set to be rolled out this year — four years after the first death — and air monitoring in workplaces that use engineered stone is still not required.

As the numbers continued to rise, and calls grew louder to ban the product after a series of media investigations earlier this year, along with a mounting campaign by unions including the CFMEU and the ACTU, state and federal governments asked Safe Work Australia to investigate the feasibility of banning or licensing artificial stone.

It was told to look at three options: an outright ban, a ban on products with more than 40 per cent silica, or a ban on products that contain more than 40 per cent silica and the introduction of a licensing regime as well.

It is worth noting that the 40 per cent level of silica, which is almost half the current levels found in engineered stone, still causes significant disease.

Six months on, speculation is rife that the report is imminent and will be handed to the state and federal governments for discussion before being made public.

It means between now and then, lobbying will go into overdrive to influence the final outcome. Many of the submissions to SafeWork were anonymous, asking it not to pursue a ban as jobs would be lost.

Whatever the decision, the reality is these shiny stone benchtops are not a necessity and too many of our tradies who work with them are getting sick or dying. There are alternative materials including wood, marble, porcelain, steel and so on.

The brutal reality is that in factories and worksites around the country, where cutting and grinding takes place, many outlets are failing to offer their workers safe work practices.

Queensland was thought to be rid of black lung disease, however the potentially-fatal disease is among a number of new cases diagnosed in the state's coal mine workers.

In NSW, a series of documents released to parliament earlier this year under standing order 52 showed a failure to keep proper checks on operators, despite SafeWork NSW believing it has done a good job and made silica compliance a priority since 2017.

Scratch the surface and while the safety regulator may have increased the number of breaches or improvement notices served up to companies, there is little evidence it changed employer behaviours.

For instance, one company was given multiple improvement notices — a notice that allows a business to continue operating while it addresses the contraventions — despite the regulator finding an unsafe workplace including workers not wearing proper protective equipment, no training or health monitoring and evidence of silica dust everywhere including the toilet.

Two years later, the regulator inspected the factory and found conditions hadn't changed. It was fined $3,600. Two years after that, workers were diagnosed with silicosis. The regulator returned for another inspection and found further breaches.

Maurice Blackburn partner Jonathan Walsh says cases of silicosis continue to flood in and he believes we are now at a point of saying regulatory interventions have failed to reduce diagnoses.

He is in the school of thought that a ban is the only meaningful way to prevent deaths. "I don't believe a ban on engineered stone will lead to the decimation of the industry," he says.

The ball is now in state and federal government courts to determine the best plan of attack: ban or not ban. It is a choice between life and death.