New registry an (overdue) breath of fresh air

3 minute read

Experts have been calling for an occupational respiratory disease registry for a decade. Now we’re getting one, but it can’t be a token effort.

The Albanese government has introduced legislation to establish a National Occupational Respiratory Disease Registry with $2.4 million for its operation through to 2025-26, but it can’t be a box-ticking exercise, say experts.

The registry was a key recommendation of the National Dust Diseases Taskforce, set up after increasing numbers of new cases of accelerated silicosis among people working in the engineered stone benchtop sector.

Reporting of occupationally caused silicosis will be mandatory for specialists in respiratory, sleep, occupational and environmental medicine, while they may also notify the registry of other occupational respiratory diseases, with the patient’s consent.

Dr Ryan Hoy, a respiratory and sleep physician in Melbourne and a senior research fellow at Monash University’s Planetary Health department, told ARR that although GPs were not involved in the collection of the registry’s data, their engagement with it was vital to its success.

“GPs have a really important role in this,” he said. “They are the frontline that identifies a person with a potential occupational lung disease.

“GPs won’t have to worry about doing the administration side of it, but I can’t register somebody unless they’re referred to me.

“We’re very hopeful they’ll be engaged with the activity of the registry so they are given information about what type of occupational lung diseases are emerging, where they are, what they should be looking out for.

“There should be a lot of valuable information that they will receive from [the registry].”

In a paper published last week in Occupational and Environmental Medicine, Dr Hoy and his colleagues reported that out of 544 stone benchtop industry workers who had worked in Victoria before 2021, 95% had worked with artificial stone; 86% had worked in an environment where dry processing of stone had been performed; 76% (414) of that group were determined to be at elevated risk, so also had CT chest imaging and assessment with a respiratory physician; 117 out of 414 (28.2%) that had a CT chest performed were diagnosed with silicosis, which included 21 with more advanced complicated silicosis.

“Hopefully, governments and policymakers will take note of that evidence,” Dr Hoy told ARR.

The new registry, he said, had been a long time coming.

“We’ve been advocating for this for many years now – this is not a new idea’” he said. “It’s an idea that has come from strong advocacy work.

“In the early 2000s, there was an occupational registry that was run through Monash University and provided some valuable insights into occupational respiratory conditions occurring in Victoria, Tasmania and New South Wales.

“But since then we’ve had no insights at all in terms of occupational lung disease that have been occurring. So that’s why we’ve been strongly advocating for this.”

Funding for the registry is only guaranteed, so far, through 2025-26.

“It must be extended for it to be a worthwhile exercise,” said Dr Hoy.

“The registry, first and foremost, is an early warning system for emerging occupational lung diseases, hazards in the workplace.

“The key thing is, and this is what we keep pushing, that this is not a number counting exercise. This is not about just recording five cases of silicosis here and 10 of asbestos disease there.

“It’s really about this being a living, breathing activity, where physicians are encouraged to engage with the registry, and the physicians and workers and businesses see the outcomes from that.

“We don’t want to see this just being a reporting system, which doesn’t actually go anywhere, or help anyone.”

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