Michael McCormack (Riverina, National Party, Shadow Minister for International Development and the Pacific) Share this | Link to this | Hansard source

I give this address on behalf of the Deputy Leader of the Opposition. This package of legislation—the National Occupational Respiratory Disease Registry Bill 2023 and the National Occupational Respiratory Disease Registry (Consequential Amendments) Bill 2023—delivers on a recommendation of the National Dust Disease Taskforce, established by the former coalition government in 2019, to create a National Occupational Respiratory Disease Registry in response to the growing incidence of silicosis amongst Australian workers. Silicosis is an irreversible fibrotic lung condition caused by inhaling very fine silica dust. While it is preventable, there is currently no cure.

The coalition will support this package of legislation, because it builds on important work that the coalition commenced in government to address the worrying issue of occupational dust diseases in Australia and respond to the growing incidence of silicosis. The National Occupational Respiratory Disease Registry Bill 2023 will create a legislative framework to establish and manage the National Occupational Respiratory Disease Registry, which will collect data on the incidence of respiratory diseases that are thought to be occupationally caused or exacerbated. The national registry will capture key details, including the industry, occupation, main job task and place of business where the exposures are believed to have occurred. The registry will collate respiratory health data to assist in the detection of new and emerging threats to workers' respiratory health and inform incidence trends. The registry will also disclose information on occupational respiratory diseases in Australia to state and territory authorities, reflecting their ongoing role and responsibilities in understanding and responding to occupational respiratory diseases in their jurisdictions.

The National Occupational Respiratory Disease Registry (Consequential Amendments) Bill 2023 makes consequential amendments to existing federal legislation in order to support the effective implementation of the National Occupational Respiratory Disease Registry Bill 2023. The bill amends the Freedom of Information Act 1982 to exempt protected information included in the National Occupational Respiratory Disease Registry from disclosure under the act and protect individuals' privacy or commercial interests. As I said, these bills deliver on the recommendation of the National Dust Disease Taskforce to establish a national registry on this very important issue.

All Australians, regardless of their occupation or how they are engaged, have the right to healthy, safe and well-designed work. However, it is estimated that one in four people who work with silica products will develop silicosis. The rapid emergence of new cases of accelerated silicosis, particularly amongst those working with engineered stone, is of deep concern. That is why the former coalition government established the National Dust Disease Taskforce on 26 July 2019 as part of our $5 million election commitment. We committed to investigate the growing number of silicosis cases among individuals working in the engineered stone industry and to develop a national approach for the prevention, early identification, control and management of occupational dust diseases in Australia. In establishing the task force, the former coalition government committed $5.1 million to support its critical work, including funding for new research to better understand, prevent and treat preventable occupational lung diseases. This funding included $1.6 million for the development of a national dust disease registry. We recognise the government's decision to progress our commitment through the package of bills before us today. The task force's final report was published on 12 July 2021 following extensive consultation with a broad range of stakeholders.

The former coalition government worked with the states and territories to develop a nationally coordinated, all-of-government response to the task force's final report, which was endorsed on 4 April 2022. We also invested $11 million over four years, as part of our 2022-23 budget, to address key recommendations from the task force's final report. This funding package supported an enhanced focus on prevention activities, improved support for affected workers and their families, and a strengthened evidence base and research capability. We also supported upskilling and improving the expertise of medical professionals in relation to dust diseases to ensure the right knowledge was available to provide adequate care and support for affected patients. This package of bills complements all of this work that we undertook in government to respond to this important issue, particularly to protect workers across Australia at risk from dust diseases. This includes—and it's important that we recognise it—the work of former ministers Greg Hunt and Senator Michaelia Cash.

The coalition remain strongly committed to reducing the incidence of silicosis and other dust diseases amongst workers and increasing the quality of life for affected workers and their families. Given our longstanding commitment to this issue and our extensive work undertaken while in government, we recognise the importance of this legislation. The National Occupational Respiratory Disease Register will play a critical role in addressing the growing incidence of silicosis and other occupational respiratory dust diseases in Australia. Once again, the coalition will support this package of bills, which builds on our work to address the increased incidence of silicosis and other occupational respiratory dust diseases in Australia.

Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

Australians remember with sadness when multiple news stories surfaced of the devastating effects of silicosis—so many workers exposed to silica in their workplace handed a death sentence just for doing their job. All those labourers cutting, grinding, sanding and polishing engineered stone benchtops for so many kitchens—one household's bright and shiny pride and joy becoming another household's pain and misery. I was standing in my kitchen near my engineered stone benchtop when I heard about these otherwise fit and healthy workers struggling to breathe, facing the heavy, crushing burden of knowing there was no cure or treatment that would reverse the damage done to young lungs by simply breathing in silica dust. I know that in Queensland the industrial relations minister, Grace Grace, acted swiftly. Back in 2018, the day after some of those stories were aired, she issued a safety alert and then quickly put in place industry-wide safety measures, because this was a relatively unknown risk and it was in an industry that was not particularly well regulated or unionised, so there really was no health and safety watchdog there.

We know that today the rates of silicosis and other occupational respiratory diseases are unacceptably high in Australia. I stress that these are entirely preventable illnesses that, sadly, all too often lead to entirely preventable deaths. The Albanese Labor government is committed to tackling occupational respiratory diseases and is undertaking a suite of reforms to ensure that Australia's prevention and treatment measures are world-class. The Labor Party is always committed to protecting workers from unacceptable health risks. That's why the Labor Party was formed out of the labour movement. We're developing a national silicosis prevention strategy and national action plan in collaboration with health professionals, unions and industry. We'll be investing in educational campaigns for employers, workers and health professionals to improve prevention, detection and treatment; we will explore measures to limit the use of engineered stone, including an import ban; and we will be working with states and territories to ensure that we have a coordinated approach to keeping our workers safe.

The National Occupational Respiratory Disease Registry Bill 2023 delivers on the recommendation of the National Dust Disease Taskforce to establish a national occupational respiratory disease registry—and I do acknowledge the work of the coalition in that process. This follows an increase in silicosis in stonemasons working on engineered stone benchtops. The national registry will capture information relating to respiratory diseases believed to have been occupationally caused or exacerbated. We support the use of this information to understand the true scale of these diseases in Australia and to take action to reduce further exposure in the workplace.

Under this bill medical specialists in the fields of respiratory and sleep medicine and occupational and environmental medicine who diagnose certain occupational respiratory diseases will be required to notify the diagnosis, patient and exposure details to the national registry via an online portal. These physicians may also notify of other occupational respiratory diseases where that individual provides consent. This is consistent with the recommendation of the task force. Initially only silicosis will be a prescribed occupational respiratory disease; however, the Minister for Health and Aged Care will be able to prescribe other diseases following consultation with the Commonwealth Chief Medical Officer and each state or territory.

We understand the potential burden that this new notification system will have on physicians. We recognise this fact, and the bill limits the mandatory elements that must be notified to a minimum notification. That will include sufficient information to identify an individual with a diagnosed occupational respiratory disease. Once diagnosed, the details on the likely exposure that resulted in the disease, including the last and main exposure, will be included. Further, additional information can also be supplied where the individual provides consent. This may include relevant medical tests, demographic and lifestyle information—for example, including their smoking history and their employment status—as well as details of each job where the individual believes that they had an exposure to a respiratory-disease-causing agent.

In addition to ensuring notified information is available to the physicians treating the individual, the bill will enable the disclosure of notifications about an individual to that national registry. This will include to the prescribed Commonwealth state or territory authorities and health agencies and workplace health and safety agencies. This disclosure to all these agencies will increase the awareness of the prevalence of occupational respiratory diseases throughout Australia and will enable actions to be taken to reduce further worker exposure to these diseases—like a canary in the coalmine, so to speak.

This bill recognises several jurisdictions that already have these registry functions currently in operation. This bill does not exclude or limit the operation of those processes. Where notification is mandatory in a state already, the bill provides for notification to occur through the national registry, should the state allow it. This will remove duplication, so a physician won't have to notify twice, and you won't have the case of having to notify the national register and the state register. Obviously, sensible Commonwealth governments don't pick fights with states and territories. It's better that we work together for the health and safety of employees. The establishment of this national registry will complement actions across all Australian governments to reduce exposure in the workplace, and it demonstrates the Albanese government's commitment to keeping workers safe. The national registry will provide information to support workplace health and safety compliance actions and aid in understanding the disease within each area.

The introduction of this bill is intended to provide adequate time for states with existing registries, such as in Queensland, to consider potential amendments to their own legislation. The unions are very supportive of the introduction of a national registry and have already indicated a desire for it to be expanded. As I mentioned before, the minister will be looking at including other diseases to the register after consultation with experts and stakeholders. This bill creates mechanisms that can support the expansion of the registry. Peak medical bodies also support it. Understandably, they remain concerned about the potential burden of reporting on physicians. Personally, I still have some concerns about the privacy elements, but the minister has addressed many of those.

The bill outlines a minimum notification information approach limited to that necessary to meet the objectives of the national registry, while providing opportunity for physicians to notify further information with the patient's consent. I repeat: the patient would give that extra consent. We can't simply sit and do nothing as people keep suffering. Worse, there still may be workers out there being exposed to the dangers of silica dust, which could develop into severe respiratory problems and even an early death. This change is overdue, and the Albanese government is stepping up and doing something to protect Australian workers in their workplaces. I commend the legislation to the House.

Russell Broadbent (Monash, Liberal Party) Share this | Link to this | Hansard source

It's an honour for me to speak on this bill. It gives me an opportunity that we don't often get—to speak about the parliament's background in a number of areas regarding respiratory illnesses. In this case, it's silicosis. The major one for me has probably been asbestosis, which we've been considering for a long time.

Why are these bills important? New innovation, new technology, silicosis. For a long time, we've known about the effects of prolonged exposure to dust. In every carpenter's room or where there was indoor carpentry work going on, there were always dust filters pulling out the sawdust all the time. It wasn't in the early days, but, as we got into the sixties and seventies, we realised there was a problem with the dust, because the dust of the wood would literally sit on the chests of those that were working in that industry and kill them. These are not inflammatory diseases, to my knowledge. These are diseases actually causing a cancerous reaction to prolonged exposure to silica, asbestos or other forms of invasive breathing in the lungs.

The government has rightly—and I commend them for that—introduced a National Occupational Respiratory Disease Registry. This bill makes that work right across the country. It's good to be early on this, not waiting for each state to put together their particular legislation and then have to try and mould together all that they've already done. As we heard from the member for Moreton, in Queensland they already have this registration. I enjoy that it's with the agreement of each state; there's no demand. To report, you must have the consent of the employee or worker because consent is important in all areas. I won't go into the other areas where consent needs to be sought and given.

These respiratory diseases were noticed quite quickly. It's mostly kitchen or bathroom renovations or new bathrooms or kitchens that have the silica stone, which is so popular in all new homes right across Australia. No-one thought that we might have an asbestosis problem or silicosis problem. I had a friend who had retired, and he was using his lathe in the shed all the time, and had dust from the lathe in the shed. They realised that he was quite ill, and it was a fact that he was breathing in the sawdust himself. Once he had a big rest from his lathe and the woodworking in the shed, his body was able to repair itself quite quickly, and he's quite well. But, with silicosis and asbestosis, it's just not that easy. It embeds and it can spark a cancerous growth within the lungs.

This is being addressed across the nation by the health industry. It is important to us as a parliament to protect those people who are exposed to such detrimental air in workplaces. In just about every workplace that I know of now, all of those bases are now covered. We are no longer cowboys without a mask. We're having to clean air in these factories. It's very important how they go about their work. The occupational health and safety standards have gone through the roof in the silica area.

Why is the bill important? It's a good guide to how we should go about health care right across Australia. Importantly for the nation, while the state agencies are responsible for the delivery of the health service, the direction given by government and the opportunity to work together as a nation on a particular problem, such as silicosis, is given to us here. Here we are in the parliament actually doing something exactly about that situation. I commend the bill to the House, and I look forward to its passing.

Michelle Ananda-Rajah (Higgins, Australian Labor Party) Share this | Link to this | Hansard source

I never thought I would see silicosis in my lifetime. It was a disease I read about in textbooks, but it has made a resurgence thanks to our addiction to engineered stone. Gleaming stone benchtops in kitchens and bathrooms harbour a dark secret. They are killing young Australians, thanks to primitive work health and safety conditions. The first reported case of silicosis associated with engineered stone was in 2015. In 2022, just last year, 579 cases had been identified, but these are the tip of the iceberg. The true numbers may be closer to 83,000 to 103,000 people with silicosis, based on research commissioned by the ACTU. New South Wales and Queensland have dust diseases registers for a range of occupational diseases. Last year, Queensland reported 40 cases of silicosis, including four cases of black lung disease associated with coal, from a total of 269 cases.

Silica is ubiquitous in the environment, but it becomes deadly when made airborne through the cutting of engineered stone, which is 90 per cent silica. Unlike natural stone, engineered stone contains a far higher content of crystalline silica compared to granite, which is 30 per cent, and marble, which is just 13 per cent. A ministerial task force estimated that one in four people exposed to silica from engineered stone before 2018 has silicosis. That is a shockingly high statistic and underlies the deep anxiety and uncertainty experienced by exposed workers. There is evidence suggesting that silicosis from exposure to engineered stone may have a more accelerated course and a higher mortality than silicosis associated with natural stone. In any event, the prospect of lung transplantation is hardly comforting. As a scarce intervention which is rationed, there is no guarantee that it will be an option to patients with advanced silicosis, aside from the fact that it is a gruelling intervention that confers life but not necessarily a normal life expectancy. I know this because I cared for lung transplant patients, dealing with their infections and their infection risk, as part of a team at the Alfred Hospital.

Given the hidden scale of the problem, its deadly effects and the absence of a definitive treatment, the Albanese government is determined to act. The National Occupational Respiratory Disease Registry Bill 2023 delivers on the recommendation of the National Dust Disease Taskforce to establish a national registry. The registry will capture and share data, because you can't manage what you can't measure. Data variables captured in the registry will include the agents causing the disease; the number of cases; the last and main exposures, such as business, industry, occupation and specific task; and other types of health data. Additional information requiring patient consent includes relevant medical tests; clinical details, like smoking history; employment status; and details of the actual job which may have contributed to the exposure. I strongly urge patients and practitioners to disclose this information, as it will aid national efforts to prevent, diagnose and treat patients, along with national efforts to identify poor practices early on.

The bill will enable the sharing of information with state and territory health agencies and work, health and safety agencies to increase awareness and enable further action to be taken. In New South Wales and Queensland, where existing state-based registers operate, double notification will not be required, because the national register will take precedence. Medical specialists from sleep, respiratory and occupational medicine will be compelled to notify patients via an online portal, making these notifiable diseases under the law. Initially, silicosis will require mandatory reporting, but the registry will be open to other respiratory threats as and if they evolve.

There is complementary work under way, including: a National Silicosis Prevention Strategy to take a whole-of-government approach; grants for training materials to support the identification and classification of silicosis for radiologists—and I reckon artificial intelligence will have a role to play here; targeting education for doctors on the diagnosis and management of workers affected by silicosis, because awareness is poor; investment in an education campaign for employers, workers and health professionals; support for research; establishment of a national rapid response guideline; and work with the states to ensure we have a coordinated approach. Questions, however, must be asked as to how this catastrophe occurred. Where was the watchdog? We have Safe Work Australia, which begs the question as to what they were doing when reports started to emerge of this issue both domestically and internationally. No one is above scrutiny, which is why I would like to ensure that our national safety watchdog and its legislative remit are fit for purpose. It has relevance not only to silicosis but also to other airborne threats, whether they be future pandemics or non-infectious threats like pollution or smoke.

I can't overemphasise the importance of prevention. The hierarchy of controls for work health and safety should be standard operating procedure in at-risk work places. Unions and advocates are calling for a ban on engineered stone. I agree. It is a vanity item that has good alternatives. There really is little justification for its use given the prognosis of silicosis, its irreversibility and its very limited therapeutic options. The minister has tasked Safe Work Australia with developing further advice on the ban of engineered stone products—we await their guidance. I thank unions, work health and safety experts, and families, carers and friends of affected people past and still here for their years of advocacy. We have heard your concerns.

Finally, consumers have a role to play. Turn your backs on this deadly product and explore alternatives. When we strengthen work health and safety protections for one high-risk group, other groups like nurses and fire service personnel will also benefit. I commend this bill to the House.

Monique Ryan (Kooyong, Independent) Share this | Link to this | Hansard source

I rise to speak to the National Occupational Respiratory Disease Registry Bill 2023. This bill will create a legislative framework for the establishment and ongoing management of the National Occupational Respiratory Disease Registry. It is planned that this registry will capture and share data on the incidence of respiratory diseases thought to be occupationally caused or exacerbated, their causative agents, and exposures to those causative agents. The national registry will also capture respiratory health data to aid in the detection of new and emerging threats to workers' respiratory health, to inform incidence trends, and to help with targeting and monitoring of the effectiveness of interventions and prevention strategies.

Specifically, this registry will require respiratory and occupational physicians to notify diagnoses of occupationally caused silicosis. It will also allow for the voluntary notification of other occupational respiratory diseases. It is anticipated that the voluntary notification of those other diseases, which are thought to be occupationally caused or exacerbated, will help with the identification of new and emerging occupational risks to workers' respiratory health. While silicosis will initially be the only disease for which notification will be mandatory, the bill does provide for other occupationally caused or exacerbated respiratory diseases to be prescribed, subsequent to further development by the minister and the chief health officers of the states and territories.

This registry has been established to support the National Dust Disease Taskforce in developing a national approach to the prevention, early identification, control and management of occupational dust diseases in Australia. It will help us identify disorders, occupations, job tasks and workplaces in which there may be risk of exposure to respiratory disease-causing agents. It will provide the first ever national overview of the prevalence and types of occupational respiratory diseases in Australia. That's great data to have. The register will enable preventative action to be taken to reduce further worker exposure and to assist with the identification of suitable individuals for participation in clinical trials and observational studies. It will facilitate research on the causes, incidence, prevalence, nature, extent and trends specifically of occupational respiratory diseases.

This bill comes in response to the significant number of stonemasons who have been exposed to the tiny particles of crystalline silica dust, which is released every time they cut, grip and shape engineered stone, like Caesarstone, into kitchen benchtops and bathroom vanities for the homes of Australia. One study into silicosis by Curtin University, commissioned by the ACTU, estimated that as many as 275,000 Australian workers had been exposed to high levels of crystalline silica. Disturbingly, that union estimates that as many as one in four stonemasons working with engineered stone have developed silicosis.

Mr Speaker, this bill adds to the web of disease registries that aim to identify the incidence and prevalence of medical conditions in Australia, and which track the epidemiological traits, follow their management, assess responses to treatment and identify patients for clinical trials. By improving the quality of our healthcare data, the existence of patient registries like this one should improve the government's ability to allocate our finite and precious healthcare dollars to the best effect.

There is a bigger issue, though, with this piece of legislation. It deals with a single respiratory disorder. There is no doubt that this condition, silicosis, is a tragic one. It is entirely worthy of scrutiny. And we should, as a country, do everything we can to protect workers in their workplaces, limit the risk and improve the treatment of all occupational diseases. This registry is really important, given the significant prevalence of this severe industrial disease and its devastating impact on those people affected by it.

But there are many life-threatening medical conditions. Just this morning, I met with Breast Cancer Network Australia to hear their call for improvements to the collection and reporting of metastatic breast cancer in this country. It's a worthy cause and one which is worthy of support. I have just come from a meeting with representatives of the diffuse intrinsic pontine glioma community. They're in the House as we speak. DIPG is a relatively rare disorder of early childhood, but 25 Australian children die every year from the complications of DIPG. We don't have a national registry for DIPG. Australian children are enrolled in the American registry, and our oncologists, our cancer specialists in this country, keep track of patients themselves. But DIPG has not been subjected to or received the same amount of attention or support as silicosis. It's not a lottery, nor is it fair.

Next week I will meet in this House with representatives of the Children's Tumour Foundation of Australia, who represent patients and families affected by another rare disease, neurofibromatosis. One in 3,000 people are affected. It's rare but often severe and also worthy of research and support. Separately, next week in this House, my colleague the member for Macarthur and I will meet with representatives from Spinal Muscular Atrophy Australia. This is another severe, devastating disease associated with high mortality, and, again, it is worthy of support. We will also meet with community representatives affected by Duchenne muscular dystrophy, another rare disease. One in 5,000 boys is affected. It's devastating and severe. All of those representatives from these various communities are advocating for better quality data collection to facilitate improved care and research into these diseases.

In my previous professional life, when I was director of the neurology department of the Royal Children's Hospital in Melbourne and head of the Australasian Neuromuscular Network, I established the Australian Neuromuscular Disease Registry. Neuromuscular diseases affect one in 1,000 people in Australia. They are relatively common cumulatively. They are severe and often life-threatening. My colleagues and I established that registry to better understand the history of those disorders and how to monitor and treat them, improve our service provision, identify subjects for clinical trials and bring those clinical trials to Australia. That registry, which is now up and running—it's been going for three years now—represents a platform for patients, clinicians, researchers and industry to work together to develop new therapies and to advance scientific knowledge of those rare diseases. Was it funded by the government? No. It was funded by pharma and by donations from patient groups and support groups. It had no government funding at inception and it has had no government funding since.

Australia has a comparative advantage in our potential for data collection, which puts us in an exceptional position to set up registries like that which is under discussion today and like the registry that I established in 2020. They can be established as an extension to our world-class universal healthcare system, Medicare. We should be able to collect the data that we'll collect as a result of the bill we are debating today much more efficiently, effectively and cheaply. It is wasteful and inefficient to be reinventing the wheel for every one of the thousands of serious diseases that our medical professionals see and manage. Healthcare data collection in this country has been problematic for a long time. It's piecemeal and it's patchy. The government must look to improving the quality of our data collection on this and other rare diseases. It should look to making the best of the Medicare system and the data that it collects. We're not doing that in a way which is intelligent, which is forward thinking and which is going to optimise healthcare provision in this country.

So although I'm very happy to support this bill, and I support the government's efforts in increasing and improving support for patients affected by occupational respiratory diseases, I also ask this government to show the vision that it needs to show to approach data collection within the Medicare system in a more holistic fashion, to look at better collating and assessing the manifold data that our medical professionals collect, to put together the many hundreds of individual disease registries that medical professionals in this country have already established, and to give us a vision for how health care and medical research—and the nexus between the two of those—can be improved in the future. I commend this bill to the House.

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

I'd like to thank my colleague the member for Kooyong for her comments about data. In the age of the 21st century, data is gold in health. When I was first elected to parliament, in 2016, I was very upset that the Australian government had sold off the rights to the Australian cancer registry to a private organisation, Telstra Health. I thought that was a very bad decision then, and I think it was a very bad decision now. I hope that further disease registries will be kept in public hands. That's really important for how we approach health care in the 21st century.

I thank the Assistant Minister for Health and Aged Care for moving this legislation, and I thank the assistant minister, the Minister for Health and Aged Care and the Minister for Employment and Workplace Relations, and their teams, for putting it together.

Ensuring workplaces in Australia are safe is a crucial role of any government, and I'm proud to be part of one that identifies the unacceptably high rates of occupational respiratory diseases and the urgent need to tackle this crippling health issue. I am very worried about it. My cousin, Dr Julian Lee, was a longstanding medical member of the Dust Diseases Board in New South Wales, and I had many discussions with him—unfortunately, he's passed away—about asbestosis, mesothelioma and dust disease illnesses in New South Wales and in Australia. Julian had long felt that Australia had been very tardy in taking action to reduce the incidence of dust diseases. Some of the concerns of this government, and some of my concerns, relate to the slow pace of change in this area. Of particular concern, of course, is the increase in the incidence of silicosis in workers in the manufactured stone and stone-carving industry for benchtops and housing embellishments. As outlined by the assistant minister, silicosis is a lung disease that is irreversible and scars the lungs of workers exposed to silica dust.

It's important to note that silica is the most common material in the Earth's crust. It's the most common type of solid material that workers in many, many industries encounter. Silicosis is a lung disease caused by the breathing in of small particles of silica, which is found in minerals such as sand, quartz, granite and sandstone, and many workers are exposed not just in the bench top industry but in tunnelling, in other forms of manufacturing such as ceramics and in other forms of the building industry. It is a hazard that people can be unaware of. In mining and construction the bigger firms and companies—the tier 1 construction firms—are well aware of it. They screen their workers and have dust reduction strategies. But in the smaller industries, such as the manufactured stone industry for bench tops and things like that, the quarrying industry and some of the smaller subcontractors in the tunnelling industry, people can be exposed without their knowledge and without the knowledge of preventive strategies.

Unfortunately, silicosis is irreversible. Silica dust causes an irreversible inflammatory process that not only causes scarring in the lungs but can be associated with other lung diseases. It increases the risk of tuberculosis, for example, and tuberculosis in people who have silicosis is often worse. There's an increased risk of lung cancer. There's an increased risk of renal failure because of silicosis and an increased risk of heart issues, as well. Silicosis is exacerbated by smoking, so it's very important that people who are diagnosed with it are stopped from smoking, and I suspect that vaping is the same. It's an insidious disease, so people may until quite late have very mild to no symptoms, even though they have significant silicosis. People may not present until they have the shortness of breath and the persistent cough that people present with. I've seen a number of workers who've come to see me with silicosis who are relatively young and otherwise fit and healthy men. They present breathing quickly, with chronic coughing, unable to sit still because their oxygen levels are low and are very agitated. Unfortunately, there is no really effective treatment. The only effective treatment that we have, apart from symptomatic treatment, is heart- lung transplant. These can be relatively young men. We know that there are literally thousands of people in our industries who are exposed to silica dust.

We've spoken a lot about the building industry and manufactured stone for bench tops, but for people involved with tunnelling, particularly in Sydney, tunnelling through sandstone, which is mostly silica, can have a major effect. Building the foundations of Sydney through Sydney sandstone is often a very dusty environment, and these people can be exposed without really knowing what they're being exposed to and the risks. I've seen construction workers with their masks around their necks, not over their face and mouth, because they don't like wearing the mask. They are being exposed to this very dusty environment, and they are a tragedy waiting to happen.

It's a painful disease. The average loss of life for people diagnosed with silicosis is after 11 to 12 years, so people are often dying far too young. Health screening conducted by some of the major companies in recent years says that almost 25 per cent of those working with stone, particularly in the manufactured benchtops, or stone carvers et cetera are suffering from silicosis. That is a dreadful statistic.

This bill is an important one as it builds upon the findings and recommendations of the National Dust Disease Taskforce, including the need to establish a National Occupational Respiratory Disease Registry. That is so important. We need to know the data. We need to know what we're dealing with. These are quite large numbers of workers that are exposed—thousands every day—and it is very important that this is a first step. There is much more to be done. I have been encouraged by the actions of the Albanese government but there's much more to be done, and we need to hurry up and do it.

I'd like to see all construction workers screened for silicosis. I'd like to see inspections of all major building and tunnelling sites, to make sure that appropriate precautions are being undertaken. I believe we need to educate our health workforce, to make sure that they're aware of the dangers and incidence of silicosis. I think we need to make sure that those workers affected are appropriately compensated for the severe injuries to their health and the loss of their longevity because of silicosis.

In the asbestos field, years ago, my very well-respected relative Julian Lee stressed the importance of making sure that people with asbestosis and mesothelioma, the type of cancer caused by asbestos disease, were adequately compensated. They weren't until very recently. It was a huge fight by a number of people, including the most well known, who has now passed away, Bernie Banton, who, you will all remember, fought for adequate compensation for people with occupational lung disease.

Whilst this bill and the registry is the first part of dealing with silicosis in our communities, we should not be tardy in introducing other measures to deal with this. My belief is that we should not have an industry that deals with materials that put people so much at risk. I'd like to see, in particular, engineered stone—with extraordinarily high levels of silica—banned from use in Australia. Whilst we can introduce some precautions, we know that it's difficult for workers to always use those precautions, and we know that the damage can occur before symptoms occur. I think that there are measures we need to continue to take to keep Australian workers safe.

The minimum notification information sets the base for this registry. It puts the onus on health workers, particularly respiratory physicians, to notify the registry that they've diagnosed a person with silicosis. I think that's important. I also think it's important that we educate our primary care workforce, our GPs, our health nurses, our occupational health and safety medical workforce, about the importance of thinking about the diagnosis of silicosis in people who have been exposed. The additional notification information includes providing material, where the individual involved gives consent, so that better health data about asbestosis can be found. This may include the relative medical tests, including heart and lung testing, smoking history or employment status. It's important that employers are made aware of people who have worked for them and have developed silicosis, so they can take precautions, and that additional notification materials are disclosed to a whole range of people, including state and territory authorities and health agencies, work health and safety agencies.

Under this bill, the minister for health will be provided with the power to create rules ordering which occupational respiratory diseases require notification, and I think there are more to come—as are other occupational illnesses. As such, with the various means of notifying authorities of these developments and recording them on official registries, more research can be done into the causes and modifying effects that can be put in place.

We know that, tragically, there are many workers who are suffering from silicosis and dying from silicosis and other respiratory illnesses that may be work related. We should have learnt our lessons from the past with dust diseases. It is incredible to me that we are still arguing with the industry about what should be done. Really, if we look at our construction workers, who are in every community, we should be protecting them from occupationally caused diseases such as silicosis. And there needs to be much more public awareness of this. My eldest son is a tunnelling engineer, and I'm constantly reminding him of the importance of maintaining proper precautions. Luckily, he's worked for companies that do take adequate precautions and do screen their workers on a regular basis for lung disease such as silicosis—but not every company does; particularly, as I've said, in the lower-tier companies. I think that we, as a government, need to make sure that all workers, no matter who they work for, have protections and screening made available to them.

I think there's much more to be done in the occupational health and safety space and I am very proud to be part of a government that believes in protecting all workers. I think this this legislation is way overdue. I hope it's the first part of what will be a more comprehensive program of protecting workers—particularly workers who are at risk of dust diseases—so that we can make sure, even if they work in these industries, that they are able to live long and productive lives. I thank the minister and the assistance minister and I commend the bill to the House.

Libby Coker (Corangamite, Australian Labor Party) Share this | Link to this | Hansard source

Did you know Australia's first case of engineered stone related silicosis was identified in 2016, just seven years ago. This is truly surprising, because silicosis can be deadly. It's silent, it's hidden, it's insidious and it has harmful long-term health impacts that can shorten life expectancy. It is painful and it can seriously affect quality of life, with no remedy apart from a lung transplant. What we do know is silica has been a common component of man-made stone for more than two decades. But the data to quantify the true extent of silicosis is fragmented, at best. That's why today, I stand in support of the National Occupational Respiratory Disease Registry Bill 2023.

The bill proposes the establishment of a registry of all those who have suffered, or will suffer, from silicosis and other respiratory diseases. This registry is vital because, while we know rates of silicosis and other occupational respiratory diseases have reached unacceptably high levels, we do not currently have a clear picture of just how widespread this condition is throughout our workforce. A clearer picture means we can make workplaces safer. It means young people considering a trade can feel assured that their career won't shorten their life. That's what this bill is all about. It's about making sure workers now and into the future are protected from an entirely preventable condition—a condition that, tragically, kills. Right now, we don't know the exact figure, nor do we fully understand the impact of the condition. What's at stake is clear. We must act now. Silicosis is typically but not exclusively caused by high exposure to respirable crystalline silica found in workplaces that crush, cut, grind, polish and demolish silica-containing products. These processes are particularly common in our quarries.

In introducing this bill, the Assistant Minister for Health and Aged Care told the tragic story of a 34-year-old woman named Joanna who worked at a quarry. After she returned from maternity leave, Joanna was asked to undergo a fit-for-work test. It was through this testing that Joanna was diagnosed with silicosis. Joanna largely worked in a reception role at the front office of the quarry, yet through her work she was exposed to dangerous silica dust. Joanna said it would be all over her clothes, all over her skin. She added: 'What I've since learnt about silicosis is that there is no cure, and you just don't know how it will progress. At the moment I'm feeling healthy, but I don't know if that will be the case in one year, let alone five or 10 years. As a mum of two young daughters, that terrifies me. I fear this will affect my life and my family's life, and I am angry. I should never have been exposed to this disease.' Stories like these are not easy to hear, and I wholeheartedly agree with the assistant minister, the member for Cooper, that Joanna should never have been exposed to this disease.

For Joanna and so many other workers across our nation, continuous exposure to respirable crystalline silica, no matter their job, can lead to silicosis. But it should be noted that this issue is not one just facing our nation; it's a global phenomenon that must be addressed. I certainly would encourage our government and our parliament to consider what more we can do to look at silicosis, whether it is banning the product or anything else can we do, because it is a silent and deadly disease, and we must do more.

The rise has been driven largely by the introduction of high levels of silica in man-made stone benchtops. These benchtops have become increasingly popular due to their cost effectiveness, but it comes at the price of workers' health. But, as previously stated, we do not have an accurate picture of just how many workers develop silicosis until later in life. The latency of the disease, or the time lag between the first exposure to the hazard and the clinical diagnosis, makes it incredibly challenging to determine the exact number of affected individuals, even in cases of accelerated silicosis.

Gathering accurate data across various disconnected sources such as businesses, work health safety regulators and medical professionals has been identified as a major challenge. That's why this bill aims to establish the comprehensive National Occupational Respiratory Disease Registry, which will contain specific information on individuals diagnosed with occupational respiratory diseases such as silicosis. Additionally, the registry may also contain information on individuals receiving treatment for occupational respiratory diseases. This valuable resource will facilitate the collection, analysis and publication of statistics relating to respiratory diseases, identifying the incidence of such disease in Australia and informing the design and evaluation of preventative actions.

To achieve its purpose, the bill is structured into four parts, with the key components focusing on the establishment of the registry and its notification requirements, as well as provisions for accessing and using the information within the registry. It's essential to emphasise that the bill will not be limited to capturing data on dust related diseases alone. Instead, it enables the collection of information on various causative agents, industries, tasks and occupations posing high risks of exposure to respiratory-disease-causing agents. For instance, information available from the Department of Health and Aged Care suggest the registry would encompass contributing agents, like passive smoking, welding fumes and acrylates.

Occupational lung diseases pose a significant health burden in Australia, and it's estimated that around 38 per cent of the burden of the disease in 2018 could be preventable through reducing exposure to risk factors. The leading risk factor contributing to death was tobacco use, while occupational exposures to silica, for example, ranked ninth for males. It is crucial to note that some occupational lung conditions, including silicosis, show concerning signs of resurgence, particularly among workers who are inhaling dust from engineered stone. Occupational lung disease encompasses various conditions, including asbestosis, silicosis, the breathing in of coal dust by coal workers, chronic obstructive pulmonary disease and lung cancer. Currently the number of people living with occupational lung disease in Australia remains unknown due to various factors impacting their identification, such as delayed diagnosis and similarities between work-related and non-work-related exposures. To address this lack of data, the proposed National Occupational Respiratory Disease Registry will play a crucial role in enhancing preventative measures and identifying high-risk industries, occupations, workplaces and tasks that cause silicosis.

This bill acknowledges the need for data protection and privacy. While medical practitioners who are diagnosing a person with a prescribed occupational respiratory disease will not require their consent to notify the Commonwealth Chief Medical Officer, the bill safeguards sensitive information from unauthorised access and disclosure. Protected information, including workplace identifying information and commercially sensitive details, will be handled with care, and access will be allowed only under specified circumstances, such as for the purpose of the registry, health care, enforcement activities or as required by law.

Furthermore, the bill recognises the importance of ongoing research and surveillance in understanding and addressing occupational respiratory diseases. The registry's data will provide valuable insights into emerging threats, incident trends and the effectiveness of preventative interventions. This information will empower policymakers, health professionals and employers to develop evidence based strategies to, importantly, protect workers and to reduce exposure to disease-causing agents. The bill will provide clear guidelines and provisions for the reporting of respiratory diseases by medical specialists. It requires specialists in the field of respiratory and sleep medicine and occupational and environmental medicine who diagnose certain occupational respiratory diseases to notify the national registry, via an online portal, of the patient and the exposure details.

Additionally, the bill empowers the minister for health to make rules prescribing which occupational respiratory diseases require notification. Initially, only for silicosis will notification be prescribed as mandatory, but the bill acknowledges that future threats to workers' respiratory health may necessitate further consultation and the inclusion of other diseases. To ensure the comprehensive collection of data, the bill allows respiratory and occupational physicians to notify the national registry of information about an individual who is being diagnosed with a non-prescribed occupational respiratory disease where the individual provides their consent. This consent-based approach respects individual privacy while enabling the registry to gather valuable information on a broader range of respiratory diseases.

In closing, the National Occupational Respiratory Disease Registry Bill 2023 represents a significant step forward in safeguarding the health and safety of our workers. This is a priority of our Albanese government. I'd like to commend the Assistant Minister for Health and Aged Care for her work on this bill, along with the Minister for Health and Aged Care. By establishing a robust registry and integrating comprehensive data collection, we have an unwavering commitment to addressing and preventing occupational respiratory disease.

I believe that we need to do more than just the registry. This is an issue that we must tackle, but the registry is certainly a significant step in the right direction to support our workers and ensure their safety. The Albanese government stands with workers in our commitment to protect their health and wellbeing.

Rob Mitchell (McEwen, Australian Labor Party) Share this | Link to this | Hansard source

Today I proudly rise in support of the National Occupational Respiratory Disease Registry Bill 2023. It is a big step in providing support for those affected by the terrible scourge of silicosis and related diseases. The bill is about protecting our workers around the nation. I've had the privilege of meeting with workers impacted by this dreadful disease and have seen the effects firsthand. So I know, and the House should know, just how important this is. The rates of silicosis and other occupational respiratory diseases are unacceptably high.

Some of us will have seen the ABC report this year showing that, despite the increased awareness, there are still many Australian workers missing out on diagnosis in Australia. The bill is a step in consolidating resources and making sure that the disease will be harder to miss, allowing more Australians to get the care they need. We should all also know that dust-borne diseases are entirely preventable illnesses. Bad workplace practices and lack of oversight within the industry mean that workers are often put in danger. Too many young Australians are diagnosed with this preventable illness and all too often suffer an entirely preventable death.

Dust-borne diseases impact workers from a wide range of industries, including construction, manufacturing, tunnelling, mining and quarrying. Sadly, we know the numbers will rise, given workers' exposure to very high levels of crystalline silica in the engineered stone industry since the early 2000s. Medical experts have warned that the time it takes from exposure to the time of diagnosis means the number of cases will more likely increase over the next few years.

The rapid re-emergence of accelerated silicosis has raised concerns about the adequacy of, and compliance with, existing workplace safety arrangements in Australia. Substantial work has already been undertaken to address silicosis by Safe Work Australia. Jurisdictions have also taken immediate steps to address the increases in silicosis cases, including through legislative changes, the development of codes of practice, education, awareness campaigns and compliance audits and the establishment of collaborative mechanisms such as the heads of workplace safety authorities working group on silicosis. This is all good work, but there is a need to maintain this momentum and ensure the safety of workers. The working group has presented a comprehensive set of recommendations, and the implementation will require further cohesive sets of actions by all stakeholders, including governments.

With all that said, let's go back to basics on what we're talking about. Silicosis is a lung disease mainly caused by inhaling silica, a mineral commonly found in certain types of rock and soil. Silica dust is created when cutting, drilling, grinding or polishing certain types of stone, rock, sand and clay. Over time inhaling silica dust causes inflammation which leads to scarring of the lung tissue, which causes a stiffening of the lungs, making it difficult to breathe. Silica dust particles are a hundred times smaller than a grain of sand—so small that you can't see them with the naked eye. When inhaled these particles become trapped and will cause irritation throughout the lungs—causing an irritation that your immune system will try to attack. The attack will be unsuccessful and cause the immune system cells to die, which then causes inflammation and scar tissue on the lungs. The development of scar tissue inhibits a person's ability to breathe and they show signs of silicosis and, in very severe cases, autoimmune disease as well.

It's pretty clear why we need to be proactive in responding to this disease: because of the devastating and debilitating effects this has on workers. A study from Curtin University shows that between 80,000 and 100,000 people may be affected by silicosis. The Cancer Council estimates roughly 600,000 workers have the potential for exposure each year across a wide range of industries, whether it be cutting marble for those fancy benchtops or from the dust of cut rocks in the mines. Silicosis is not often diagnosed until it's in its advanced stages. Approximately 350 Australians contract silicosis a year. Of that, around 230 people are diagnosed with the advanced prognosis. That ABC report I mentioned earlier noted that a surveillance program in New South Wales missed some 200 workers.

One of the reasons I stand to speak on this bill today is the advocacy of the ACTU and the conversations we have had with those affected by silicosis. In November last year, I met with an ACTU delegation and heard directly from workers impacted by and living with silicosis on how it affects their lives. One story in particular stood out to me. After returning from maternity leave, Joanna was asked to undergo a fit-for-work test. That test changed her life, and not in a good way. This is a 34-year-old mother of two girls, and she was diagnosed with silicosis. When Joanna sat with me in our office, she explained that the unknown was the terrifying part. There is no cure. There are no clear steps that show how the illness will progress. She could be fine for the rest of her life and then have a rapid decline at any given point. She said: 'At the moment, I'm feeling healthy, but I do not know if that'll be the case in one year, let alone five years or 10 years. As a mum of two daughters, that terrifies me.'

She contracted silicosis while working at a quarry in Montrose in Victoria. It's a quarry I've been to myself. She predominantly worked in the administration of that quarry. I think what she said was poignant: 'No matter where you were in the plant, you would be exposed to dust. It'd be all over your clothes and all over your skin.' There's no escaping it—there was no protection for the workers, who were there doing an honest day's work for an honest day's pay. She talked about how there was no information about the danger from her employer. Despite it being a multinational company, there was no education and no warning about the risk. Understandably, she talked about her anger when she said: 'I fear this will affect my life and my family's life. I'm angry, and I should never have been exposed to this disease.'

After this meeting, I wrote to the minister for workplace relations, imploring him that more needs to be done. I'm very proud that the Albanese Labor government has been responsive and made great strides on this important issue. We've always been the party that fights for and protects workers, and this government, the Albanese government, is no different. Whether it's in our commitment to education on occupational respiratory diseases or providing better resources for essential record keeping, this is what this very bill will do.

Importantly, we are putting our money where our mouth is. The government has committed an extra almost $10 million to tackle silicosis in the recent budget. This additional investment, on top of the $3.9 million already invested at the beginning of the year, will go a long way to combatting this deadly dust. Together with the education campaigns and working with states and territories on more decisive bans, we are fixing the legislative and educational holes that have left workers to fall through cracks. Standing up for workplace rights is what brought me here, and I'll always stand up for the rights of workers for as long as I'm lucky enough to serve in this place.

Let's have a look at some of the details of this. The National Occupational Respiratory Disease Registry Bill delivers on the recommendation of the National Dust Disease Taskforce to establish a National Occupational Respiratory Disease Registry. This national registry will provide for better record keeping on a national scale, and it gives experts and policymakers an opportunity to see the trends of occupations that have caused or exacerbated this disease. It will also give us a firm understanding of the true scale of the disease in Australia and help pave the way for us to equip our healthcare system to provide the support that is needed. Based on the recommendations from the task force, at the start, silicosis will be the only prescribed occupational disease for the purpose of the register. But this bill keeps a door open to allow the minister, in consultation with chief health officers, to be able to prescribe more diseases as they raise their ugly heads.

In addition to ensuring information is available to doctors treating the people affected, the bill will also enable the disclosure of notifications about an individual made to the national registry, including to prescribed Commonwealth, state or territory authorities, their health agencies and their work and health safety agencies as well. So the measures will allow state and territory health and work safety agencies to have more awareness of the occupations with the most risk for occupational disease and the prevalence of these diseases in our communities.

The result of this will be reducing the risk to workers and ensuring workers and workplaces are adequately supported in all future policymaking decisions. I'm proud to be part of a government that is committed to the safety of workers right across this nation. We will always stand up for working Australians and be proactive in bringing forward legislation that creates the best outcomes for workers.

I have here the Deadly Dust magazine, which is a very interesting read. It goes through a whole range of stuff, including a joint statement that was done with unions and businesses, talking about how we go forward, how we move to the next stage, what the things are that we need to do. I think we need to continue working on this and ensure that we do everything within our power to limit the opportunities for people to be impacted, having a more regulatory approach that removes all doubt and provides duty holders with clarity about the risk control measures necessary for high-risk silica processes.

These are the sorts of things, with these national registers, that are important. They're important for making sure that people like the group that came and sat with me in my office and talked about the issues they're facing, because of silicosis, get the support and help they need. It's also important that we learn from this and make sure that we don't have it happen again. No-one deserves to be 34, 54, 64 or 24—whatever age—and put in a workplace that's unsafe and that brings a situation where you go home one day and are never the same person again. We must stop that. We must make sure that we do everything in our power.

What we've seen is the government working with businesses and the unions, to get together and say, 'This is a problem we have and it's about us getting together, in a tripartite response, to address this problem and help people like Joanna.' She deserves our full support. She deserves us working together, as hard as we can, to make sure that we deliver for her future and for everyone else's.

I thank the ACTU, particularly Liam O'Brien who raised this with me. I've had many conversations with Liam about it. He knows how keen I am to see this done. It's an important thing we need to do, and we need to work together. We need to look at other diseases, such as mesothelioma, and how we can fast-track drugs like Keytruda that has benefits for this. I've seen that through one of my constituents, Lou Williams, who sadly passed away. She got access to this medication and it made her life so much better for another year. She was healthier, fitter and able to move around.

That's something we should always remember when we come in here: our job is to make this country better than what it was when we first got here. By doing that, working with unions, working with businesses and working together, we can keep building on this great nation and make workplaces safer for all Australians. I commend this bill to the House.

Gordon Reid (Robertson, Australian Labor Party) Share this | Link to this | Hansard source

What we are talking about today is the rates of silicosis and other occupational respiratory diseases being too high. With regard to this National Occupational Respiratory Disease Registry Bill 2023, I will focus on silicosis and silica related lung disease, which comes under the umbrella of pneumoconiosis, a broad term used to describe occupational lung disease.

The issue for patients with occupational lung disease—silicosis, in particular—is that it's quite the spectrum of disease profile. We sometimes have patients early in their disease course who are detected in routine screening or on routine chest imaging, whether that be through chest X-ray or high-resolution CT or whatever the case may be. Alternatively, we have patients that have gradual-onset dyspnoea, which is quite significant breathlessness—initially on exertion, all the way to people being breathless almost as if they've run a marathon and they're only lying in bed. So it is quite the spectrum of disease and is quite the burden of disease on patients, particularly with regard to silicosis and silica disease. Patients can also have quite a significant chronic cough or productive cough and also wheezing. Those patients are more predisposed to conditions like pneumonia, where a patient can become quite septic and can deteriorate and require intensive care.

So those occupational lung diseases like silicosis are extremely debilitating and lethal to patients. Not only that but those diseases and those illnesses require significant amounts of staffing support not only in those acute care settings but also in the chronic care settings and in the home environment. So it's quite a significant cost to our health service and also the economy more broadly.

Looking to those occupational lung diseases like silicosis, we've seen that patients have an increased risk of other diseases as well. So this isn't just a single medical issue that we're looking at. This is a multi-comorbid issue. This is complex chronic disease. It's something that's really costing our patients both in morbidity and mortality. If we look at the fact there's an increased risk of connective tissue disease and vascularity problems with the veins and the arteries in the body, we know there's an increased risk of lung malignancy—lung cancer—COPD, chronic obstructive pulmonary disease and also chronic renal failure. It's not a commonly discussed topic in these settings when we talk about these diseases, but patients can have pulmonary renal syndrome, where the kidneys start to shut down, and patients will require quite significant renal replacement therapy, in the form of dialysis and other medications as well.

From there, we look at the management of that disease and we look at things like oxygen and the ongoing need for pulmonary rehabilitation, multiple different medications and ongoing support from their respiratory physician, which, again, is not only debilitating for the patient but is also costing the patient as well. They're going to the GP more frequently; they're going to their specialist more frequently. That's costing the patient, and that's costing our health economy more broadly.

So that's just a bit of background about silicosis and silica disease and occupational respiratory-related lung diseases—something that I see quite frequently in the emergency department on the New South Wales Central Coast. It wasn't an exaggeration about that patient who I was talking about in the acute bed. It looks like they have run a marathon and they are simply lying in bed. They're attached to all degrees of monitoring and apparatus to ensure that we're monitoring input and output—in particular, those oxygen levels. There are staff everywhere, making sure that that patient is safe and protected against further injury and disease.

That needs to stop. That cannot be the case. The rates of silicosis and other occupational respiratory diseases are unacceptably high in Australia. That is true. Everyone in this chamber knows that. Business knows that. The unions know that. Our healthcare professionals know that. That is why the National Occupational Respiratory Disease Registry Bill 2023 is so important. That's why it is so vital. We are talking about the morbidity and mortality of people. We are talking about our constituents. We are talking about lives, at the end of the day.

These respiratory illnesses caused by occupational exposure are preventable. We have an inciting factor. We have the issue there. That's what's causing the problem. All too often, the deaths that result from these respiratory conditions and the complications that ensue are entirely preventable. That's where this bill starts that journey in addressing these respiratory diseases. Our government, the Albanese Labor government, in consultation with community, with business and with the unions is committed to tackling these respiratory diseases and those occupational diseases that we see—in particular, silica-related lung disease and silicosis.

We're undertaking a suite of reform to ensure that Australia's prevention and treatment measures are world class and that our workers—the workers that make sure our economy ticks and hums—are protected from these unacceptable health risks. So, what we're doing, firstly, is developing a national silicosis prevention strategy and a national action plan, in collaboration with health professionals, with unions and with industry and business, and we're investing in quite significant education campaigns for employers, workers and health professionals to improve prevention, detection and treatment. From the health professional perspective, for a patient who is breathless, or dyspneic, with some other issues, such as chronic fatigue, the list of differential diagnoses is quite significant. Because the rates of those occupational related respiratory diseases are so high in this country, we need to ensure that our frontline healthcare providers, whether in the primary care setting or the acute care setting, consider occupational respiratory diseases at the top of that differential diagnosis. That's so important.

We're also going to be exploring measures to limit the use of engineered stone, including an import ban. And we're going to be working with states and territories to ensure that we have a coordinated approach to keep our workers safe.

The National Occupational Respiratory Disease Registry Bill 2023 delivers on the recommendation of the National Dust Disease Taskforce to establish a National Occupational Respiratory Disease Registry. This follows an increase in silicosis, particularly amongst stonemasons working on engineered benchtops and the like. There are some other incidences of silicosis and silica related lung disease, particularly when silica is heated—molten metal found in foundries or from naturally occurring geological processes. There's exposure to silica in multiple different forms, whether in quarrying and foundries, as I was just saying, or toilet bowls, sinks, ceramic manufacturing, counter tops and benchtops, with abrasive blasting, and cement cutting in construction. So, it is really quite prolific throughout that industry base. That's why it's so important that we protect our workers there and also make sure that our employers are armed with the tools they need to keep their workers safe.

Furthermore, the national registry will capture information relating to respiratory diseases that are believed to have been occupationally caused or exacerbated and will support the use of information to understand the true scale of these diseases in Australia and take action to reduce further exposures in the workplace—so, really making sure that we are gathering that patient data and looking at the true problem within our country of occupational respiratory disease, particularly silicosis. It's going to require medical specialists in the field of respiratory and sleep medicine and occupational environmental medicine who diagnose certain occupational respiratory diseases to notify to the national registry, via an online portal, the diagnosis, the patient and exposure details, to let people know. This is particularly important for our medical staff who are seeing high volumes of patients, particularly in our respiratory and sleep clinics, both in the community and in hospitals. An online portal is important to make sure there is manoeuvrability in that regard. These physicians may also notify of other occupational respiratory diseases, where the individual provides consent. I spoke about pneumoconiosis earlier. That is a broad umbrella term for various other conditions relating to occupational exposure. So we look at things like asbestos, chronic beryllium exposure, making sure that the individual's consent is provided, and then they can notify about those additional diseases as well.

This is consistent with the recommendation of the task force. Initially only silicosis will be a prescribed occupational respiratory disease, and the Minister for Health and Aged Care will be able to prescribe other diseases, following consultation with the Commonwealth Chief Medical Officer and each individual state and territory across the country. In particular, this bill recognises the potential burden that notification will have on physicians and limits mandatory elements that must be notified in a minimum notification. A minimum notification will include sufficient information to identify the individual with the diagnosed occupational respiratory disease—whatever that exposure might be; in this case, silica—and the respiratory disease diagnosed as a result, and details on the likely exposure that resulted in that disease, including the last main exposure. We need to know when that last exposure happened. That's really important.

Additional information can also be supplied where the patient is able to provide consent, which may include relevant medical tests. I was talking previously about pulmonary renal syndrome, where there's an issue in the lungs due to silica, and the kidneys could also be playing up. A patient can supply those medical test results, whether lab biochemistry or further medical imaging through CT or X-ray. They can supply demographic and lifestyle information to look at those comorbid factors and whether the patient smokes or the like. There's their employment status, socioeconomic status and details of each job where the individual believes they've had exposure to that individual agent causing that respiratory issue.

In addition to ensuring notified information is available to physicians treating the individual, the bill will enable the disclosure of notifications about an individual made to the national registry, including to a prescribed Commonwealth, state or territory authority and state and territory health agencies and work, health and safety agencies. The disclosure to those health agencies across the states and territories in Australia is going to increase the awareness of the prevalence of occupational respiratory diseases in the states and territories. It will enable actions to be taken to reduce further worker exposure to those diseases. It will make sure that the workers are protected while also arming the employers to ensure they're protecting their workforce.

Establishing the national registry will complement actions across all Australian governments to reduce exposure in the workplace and demonstrate the government's commitment to keeping workers safe. That's what this bill is about, fundamentally—it's about making sure that we are protecting our workers and, once they've had a diagnosis, protecting our patients and ceasing those occupational exposures. In this case, it's silica. We know it has a profound effect on the human body. It's not only limited to the lungs. It has a wide-ranging systemic effect that not only affects the health of the patient but also affects the health of the family and, ultimately, the community.

Joanne Ryan (Lalor, Australian Labor Party) Share this | Link to this | Hansard source

It's my pleasure to follow the member for Robertson. I don't for a moment suggest having the medical knowledge he does, but that's what good government is about. Good government is about listening to our medical experts, listening to our workers' representatives in the form of unions and ensuring that we are ahead of the game rather than playing catch-up. So I rise today to commend this bill to the House.

This bill is about establishing a registry that will act across the country on work sites as an awareness campaign. It raises the issue. It gives it a national profile. We're legislating this because we want to stop the practices that are seeing silicosis increase in numbers. We know that, for instance, engineered stone is a cause. So this registry will help assist GPs and the medical industry. Bringing in the register will also mean that we can measure what we care about, and that is workers' health, so that we can put further preventative measures in place through legislation if required.

I join my colleagues today in commending this bill to the House. I commend the government for taking action on something that is impacting workers across Australia and, I know, Victoria. At what cost is an engineered kitchen benchtop? The answer will be in this register. My response is: it's too expensive. People's lives are much more important than a fancy kitchen benchtop.

Sharon Claydon (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

The debate is interrupted in accordance with standing order 43. The debate may be resumed at a later time. If the member's speech was interrupted, they will granted leave when the debate is resumed.