The condition known as ‘black lung’ (a form of pneumoconiosis affecting coal miners), long thought to be no longer a problem in the coal industry in Australia, has been found to have recurred. An ABC report (http://www.abc.net.au/news/2015-12-01/’black-lung’-makes-comeback-in-queensland-coal-mines/6990842 viewed 24/12/15) says that this was thought to have been eradicated 60 years ago.
One aspect of the legislative controls over coal dust exposure is the requirement to conduct X-rays on miners every five years. These are sent to the relevant Government department for monitoring. It is reported that many thousands of them have not been evaluated and that there is severe shortage of doctors trained to read these x-rays for the early signs of black lung. (7:30 Report, ABC TV, 1/12/15)
More coverage occurred on the ABC on 23/12/15. Local doctors were not seeing the problem on X-rays but when the same images were sent to doctors in the USA more expert at recognising the appearance of black lung the diagnosis was changed. Consequently, more people with black lung are being found.
According to the report the Queensland exposure limit for breathable coal dust is 3mg per cubic metre of air on average over an 8 hour shift and the report says that many Queensland mines exceed this value. It is reported that the USA limits are half of this.
Whether the media reports are accurate or not, it is evident that some miners are being found with the disease in an advanced stage and there is a concern that more will be found.
This is interesting from a risk management point of view and it illustrates a point made in the introduction to Chapter 11(page 185): Risk management practices need to be maintained year after year and require a continuity of attention and effort that is hard to achieve in the dynamic and restless human environment of typical organisations, with people entering and leaving and little recognition of the need for corporate memory.
In fact, really ‘doing’ risk management is much like breathing – once you have finished one breath you need to start doing it all over again; pretty soon after implementing one control measure, you have to start checking it (the inspection period referred to in Chapter 10) and soon after that reassessing it to see if it is both doing what was intended and whether it could be done in a better way.
One can imagine that 60 years ago control measures were put in place and adhered to for a while until time took its toll – aware people moved on, new people gradually become unaware, new problems attract their attention. The function still occurs – X-rays are taken and sent in as required but nothing happens to them and as no-one is expecting any report from them the absence of it is not noticed. I have little doubt that in the 60 years since this was a headline item the coal mines themselves have had several new owners, a multitude of new managers and probably several different approaches to ‘safety’. Chapter 10 explains the mathematics of this decay in compliance (Figure 10.3, page 176).
It would be encouraging to know that during this time the coal mines continued monitoring and reporting on dust exposures and developing dust control measures. It would be encouraging also to know that the fact that the USA had a lesser exposure standard had been recognised and resulted in a review of the local standard. It would be encouraging to know that dust exposure remained on the agenda of all those responsible for the management and administration of the health of mine workers – after all dust is neither unusual, unknown or new as a hazard in the mining industry.
On a personal note, this news item remind me of the first time I was affected by the safety practices of an employer. I was a vacation student on a gold mine on the Witwatersrand in South Africa. While my work, such as it was, was on the surface, I was given the opportunity to experience what was known as a ‘dusty shift’ in order that I could then be checked medically to see if I was able to withstand exposure to dust. Accordingly, I spent one day underground at a depth of about 6000ft. I recall the heat very well, the confines and dustiness of the chambers where ore was being mined and the noise levels. I don’t recall the use of either hearing or respiratory protection. The following day I had an appointment in the mine medical centre, where a doctor listened to my lungs and proclaimed me to be fit for work in dust. I was silly enough to be impressed by that. Quite why the doctor went through that charade is beyond my understanding: just doing what he’d been told to do I suppose, like me.
The recent Sim report focuses downstream and targets the failure of reactive health surveillance controls. This is redolent of cause-effect accident theory and the problem of re-emergence is systemic.
Upstream preventive controls such as mechanical extraction ventilation and dust suppression techniques were obviously ineffective, especially when cutting faster to meet production targets and mining in development areas.
Another recent incident in July 2016 at Bankstown-Lidcombe hospital neo maternity ward resulted in the death of a new-born child and left another in a critical condition after they were administered nitrous oxide instead of oxygen because of incorrectly connected gas cylinders.
Discussions with a colleague indicates this had happened previously in South Africa approximately 15 years ago and corrective actions were implemented world-wide to prevent re-occurrence. The late Trevor Kletz often re-iterated that organisations have no memory.
An all encompassing industry association risk management approach is required similar to the German Berufsgenossenschaften scheme. This is discussed further in Chapter 11 of Occupational Risk Control.
Under coal mining health and safety legislation, senior site executives and superintendents have duty of care obligations. I am sure dust exposure issues would have been raised repeatedly by employees, safety advisors and hygienists during site leadership team meetings. What action was taken to address these concerns?
It appears production targets and performance bonuses have taken precedence and we encounter the production v protection dichotomy detailed by James Reason’s Managing the Risks of Organizational Accidents.
There is an analogy with the finance sector, unsecured loans and the GFC and to quote RH Tawney from Religion and the Rise of Capitalism……”A reasonable estimate of economic organisation must allow for the fact that, unless industry is to be paralysed by recurrent revolts on the part of outraged human nature, it must satisfy criteria, which are not purely economic.”
Recent media reports concerning the Bankstown-Lidcombe hospital incident are indicating the dichotomy of operational risk and general OHS risks is surfacing.
It is most interesting to see how scourge of black lung has unfolded in the US and the following links provide access to some interesting articles:
https://www.publicintegrity.org/environment/breathless-and-burdened
http://www.ecology.com/2016/01/06/black-lung-appalachia-scourge-returns/
Since 1975, the department of labor in the US has paid out over US$45billion in compensation payments, which is a lot of hospitals and other infrastructure.
The Queensland parliament select committee public inquiry into coal workers’ pneumoconiosis is drawing to a close and will report to the legislative assembly on 12/04/2017. Almost 30 public hearings have been held throughout Queensland with approximately 40 submissions provided. There have been 19 confirmed cases in Queensland and one in NSW. Somewhat surprisingly, the Safety Institute of Australia, our peak safety body, did not provide a submission.
In the US, since 1975, the DOL has paid out over $US 45 billion in compensation payments relating to black lung claims. This blog is one of the few sites where this significant OHS and public health issue has been raised. Most other sites are focussing on soft systems change management, behavioural safety, zero harm, safety culture and generating obscurantist drivel and agnotology to promote their psychology based nostrums.