The Coal Mine Workers' Health Scheme (CMWHS) is used to determine fitness for work, and to provide early diagnosis and intervention for respiratory diseases like coal mine workers' pneumoconiosis and silicosis. It does this by:

• screening coal mine workers to detect early signs of disease
• referring workers for follow-up, diagnosis and management, if required
• reducing dust exposure for workers with respiratory abnormalities
• collecting, analysing and reporting data to support reviews of dust exposure levels and occupational exposure limits for coal mines.

Who the scheme applies to

The scheme applies to workers employed in high-risk tasks in Queensland coal mines. This includes workers employed on coal exploration permits, mineral development licences and mining leases. (Check schedule 3 of the Coal Mining Safety and Health Act 1999 for a definition of the term 'coal mine'). Workers employed in low-risk tasks (e.g. office work) are not covered by the scheme.

Coal mine workers who are permanently retiring from the coal mining industry can request an exit assessment as part of the scheme.

Roles and responsibilities

The Queensland Government works with employers, medical practitioners, unions and mine workers to deliver the scheme. The scheme is overseen by Resources Safety & Health Queensland (RSHQ). The roles and responsibilities of all stakeholders are listed below.

Timing of health assessments

Health assessments are required:

• before a person starts work as a mine worker and when changing employers
• periodically, as decided by the employer's appointed medical adviser (AMA – previously called the nominated medical adviser), but at least once every 5 years
• if the AMA decides it is necessary after receiving a notice under section 49 of the Coal Mining Safety and Health Regulation 2017.

Note: If an employer receives a notice that the level of risk to a coal mine worker's health has increased appreciably, the employer must give a copy of the notice to the AMA, and the worker's exposure to the hazard must be periodically monitored to assess their level of risk.

Changing employers

If workers change employers, a new health assessment is required. Previous medical examinations may be relied upon (e.g. chest X-ray), if in-date and the new AMA considers it appropriate. AMAs must ensure the next health assessment is scheduled to ensure frequency of examinations is within 5 years from the previous examination used.

Multiple employers

When a worker has multiple employers, they will be required to undertake a health assessment for each employer. Workers with multiple employers will have multiple current health assessments however can only have 1 health assessment per employer.

For example, a worker is employed with Company A and has a current health assessment listing Company A as the employer. While employed at Company A, the worker commences employment with Company B. Company B must still arrange, and pay, for this worker to undergo a health assessment. The AMA can reuse previous medical examinations if in-date (e.g. chest X-ray) at their discretion. The worker will now have 2 health assessments (1 with Company A and 1 with Company B)—both are valid while they remain in-date.

A worker does not require multiple health assessments if they work across multiple mine sites for the same employer, or if their employer sub-contracts them to another entity. However, the employer and their AMA should consider any change in risk the new location or role might present, and whether a new health assessment is necessary.

Health assessment process

The employer is required to arrange and pay for their workers' health assessment. This includes referrals, tests and reasonable travel expenses for any further investigations required to complete the health assessment (e.g. CT scans, respiratory physician assessments).

The health assessment is conducted by the employer's AMA using the Resources Safety & Health Queensland (RSHQ) health assessment form on ResHealth in accordance with the Coal Mining Safety and Health Regulation 2017.

Read about the role and appointment of AMAs.

The health surveillance form has multiple sections:

• Employer section is completed by the employer. It includes information about the AMA, the employer, the worker's position (PDF, 380KB), similar exposure groups (PDF, 111KB) and the health risks associated with employment.
• Worker section is completed by the worker. It documents the worker's personal details as well as work and medical history information. Photo ID must be brought to the assessment.
• Examination section is completed by an examining medical officer and details clinical findings.
• Assessment section is completed by an AMA and details clinical and overall findings.
• The health assessment report is completed and signed by the AMA and details fitness for duty, work restrictions and requirements for a subsequent follow-up and assessment of the worker. Only this section is forwarded to the employer.

Note: The AMA only completes the assessment section when all examinations and follow up investigations, including the chest X-ray examination, are complete.

Health assessment forms

The following health assessment forms were approved in accordance with the Coal Mining Safety and Health Act 1999.

• Form number CMSHR 2 – Exit assessment form version 7 (first published 11 March 2025) was approved by the Chief Executive Officer of RSHQ on 3 March 2025. This replaces version 6.
• Form number CMSHR 3 – Former worker assessment form version 3 (PDF, 803KB) (first published 18 March 2024) was approved by the Chief Inspector of Coal Mines on 16 February 2024. This replaces version 2.

These forms must be used instead of the previous versions for all health assessments commencing on and after the respective published dates.

Electronic copies of these forms are available from the Health Surveillance Unit by phoning (07) 3818 5420 or via email to HSU@rshq.qld.gov.au.

Form number CMSHR 1 – Health assessment form version 6 is no longer an approved health assessment form as of 1 April 2023. Health assessments for coal mine workers commencing on and after this date must use the approved form CMSHR1e via ResHealth.

The following health assessment form was approved by the Chief Executive Officer of RSHQ on 3 March 2025, effective 11 March 2025. This form is used when completing online health assessments via ResHealth:

• Form number CMSHR 1e – Health assessment form version 1.4 (first published 11 March 2025). This replaces version 1.3.

This form is available when commencing health assessments on ResHealth from 11 March 2025. For more information, contact ResHealth or phone (07) 3818 5420.

Chest X-ray examination

Health assessments include a chest X-ray to detect coal mine dust lung diseases such as coal workers' pneumoconiosis. Images are dual-read by B-readers who have been accredited by the United States National Institute for Occupational Safety and Health (NIOSH).

These readers examine chest X-rays to the International Labour Organization International Classification of Radiographs of Pneumoconioses (ILO Classification).

Since July 2016, US-based B-readers accredited by NIOSH have provided a dual-reading service to Queensland's coal mine workers.

On 1 March 2019, Lungscreen Australia replaced US-based B-reading for all Queensland coal mine worker chest X-rays. All chest X-rays must now be sent to Lungscreen Australia.

Amendments to the Coal Mining Safety and Health Regulation 2017 that commenced on 1 March 2019 made this a mandatory requirement of the Coal Mine Workers' Health Scheme.

Lungscreen will classify coal mine worker chest X-rays to the ILO Classification and will provide the final ILO report back to the referring doctor.

Other Australian B-readers registered with RSHQ can undertake the first B-read and provide this to Lungscreen to complete the dual-reading process.

If the chest X-ray examination identifies abnormalities, the AMA is required to follow the Mine dust lung disease clinical pathways guideline (PDF, 789KB) for follow-up investigations and referral to appropriate medical specialists. RSHQ will send a sample of chest X-rays and ILO Classification reports to US-based B-readers for audit as part of the ongoing quality assurance program, as recommended by the Monash University review.

Read more about the Two-reader process for chest X-rays (PDF, 265KB).

Record keeping and reporting requirements

When the health assessment is complete:

• for health assessments completed in ResHealth
  • the AMA finalises the health assessment, ensuring that all medical reports (for example, chest X-ray report, spirometry report, CT scan report if applicable) are attached to the health assessment
  • the health assessment report is automatically available to the worker and employer on completion of the health assessment
• for health assessments commenced on the previous 'hardcopy' CMSHR1 form prior to 1 April 2023, or for other assessment types, the AMA sends
  • the completed health assessment form and all medical reports to RSHQ (Health Surveillance Unit)
  • a copy of the health assessment report to the coal mine worker (does not include employer, worker or examination section of the form)
  • the health assessment report to the coal mine worker's employer.
• Note: AMAs are no longer required to lodge the chest X-ray image with the completed health assessment to RSHQ if the final dual-read ILO report was issued by Lungscreen. This new arrangement also applies if the final ILO report was issued by University of Illinois at Chicago (UIC) and that report was facilitated through RSHQ. However, RSHQ may request the AMA to provide a copy of the image in certain instances.

If the employer requires an explanation of a health assessment report about a worker from the AMA, the employer must obtain the agreement of the worker and ensure that the worker is present – see section 47(1)(c) of the Coal Mining Safety and Health Regulation 2017.

AMAs are responsible for keeping all records associated with assessments and reviews they complete for coal mine workers. The records that AMAs must keep and give to RSHQ include a legible copy of the completed form for the assessment or review and the data or information on which it was based, including:

• the digital chest x-ray image file (DICOM) and a copy of the standard clinical x-ray report (see note above about lodging the chest X-ray image. The correct X-ray date must be recorded on the completed form.)
• the spirometry report and spirogram and/or lung function test reports
• ILO classification form
• high resolution computed tomography (HRCT) clinical report
• International Classification of HRCT for Occupational and Environmental Respiratory Diseases report
• any relevant medical specialist reports.

AMAs must give a copy of the records for each assessment and review to RSHQ within 28 days of completing the assessment or review by:

• for health assessments, uploading documents to, and completing the assessment on ResHealth. From 1 April 2023, all health assessments must be commenced on ResHealth
• for other assessments, or for health assessments commenced before 1 April 2023
  • uploading the records to the Coal Mine Workers' Health Assessment portal
  • or
  • sending hardcopy records, including the chest X-ray image file (DICOM) to: Health Surveillance Unit, Resources Safety and Health, GPO Box 1321, BRISBANE CITY  QLD  4001.
• Note: RSHQ strongly encourages AMAs to upload records to the Coal Mine Workers' Health Assessment portal. If you require further information on the Portal, contact the Health Surveillance Unit on AMAPortal@rshq.qld.gov.au or phone (07) 3818 5420.

AMAs must retain all records relating to assessments and reviews that they complete for a period of:

• If the AMA has provided a copy of all documentation for that assessment/review to RSHQ: at least 10 years after the last medico-legal action arising from that assessment, as per the Health Sector (Clinical Records) Retention and Disposal Schedule. The last medico-legal action may occur after the AMA has completed the health assessment report, for example any follow-up actions, checks, reviews, or treatment. The AMA must keep a record disposal log for all records disposed of after this period.
• Records must not be disposed of under this policy unless they have been provided to RSHQ.

AMAs may retain electronic (digital) copies of assessment and review records, and dispose of the original hardcopy records, if the following requirements are met:

• The digital versions provide adequate quality substitutes for the hard-copy originals – that is, they are legible, accurate, complete, and unaltered.
• The digital versions are managed in an IT environment that meets the minimum level of computer and information security acceptable for the 12 standards set out in the RACGPs Information security in general practice. The hard-copy originals are kept for a reasonable checking period after scanning, that period being determined by the AMA.
• The AMA must keep a record disposal log for all original hardcopy records disposed of.

The above retention requirements continue to apply after a doctor ceases to be an AMA for an employer.

Clinical pathways guideline

The Mine dust lung disease clinical pathways guideline (PDF, 789KB) (the Guideline) documents the recommended process for follow-up investigation of mine and quarry workers with abnormal screening results on respiratory examinations.

The Guideline was first published in 2017 in response to the re-identification of mine dust lung disease and was recommended following an independent review of the Coal Mine Workers' Health Scheme by Monash University in collaboration with the University of Illinois at Chicago. The Guideline has been reviewed and updated to incorporate legislative amendments, audit learnings, and feedback from stakeholders.

The Resources Medical Advisory Committee, appointed by the Minister for Resources and Critical Minerals in 2021, has endorsed the Guideline.

The Guideline is applied by AMAs and other medical practitioners registered to offer health services to coal mine workers.

In response to the identification of coal workers' pneumoconiosis, a number of standards have been introduced to improve the quality and consistency of health screening for coal mine workers. We have also developed some resources to help employers complete the health assessment form.

Standards

Clinical pathways guideline

The Mine dust lung disease clinical pathways guideline (PDF, 789KB) documents the recommended process for follow-up investigation of mine and quarry workers with abnormal screening results on respiratory examinations.

X-ray standards

In November 2023, Resources Safety and Health Queensland released the updated Standards for acquiring digital chest radiography images for medical surveillance of Queensland mine and quarry workers (chest X-ray standards) (PDF, 38KB). Changes include:

• inclusion of respiratory health surveillance for mineral mine and quarry workers under the Mining and Quarrying Safety and Health Regulation 2017
• requirement to use digital radiography (DR) imaging equipment
• removal of information that is only relevant to computed radiography imaging equipment and not for DR imaging equipment
• additional information on common image quality issues, including example chest X-ray images.

The updated chest X-ray standards apply to all chest X-ray images acquired for mine and quarry workers from 1 January 2024.

Earlier version of X-ray standards

• 2017 X-ray standards: Standards for acquiring digital chest radiography images for medical surveillance of Queensland coal mine workers (PDF, 1.8MB)

Chest X-ray image quality

High quality chest X-ray imaging and reporting is crucial for detecting issues indicative of mine dust lung diseases. Resources Safety and Health Queensland (RSHQ) has published A practical guide to improving chest X-ray image quality (PDF, 224KB) to provide technical considerations you may consider when looking to improve image quality. The guide contains information for both radiologists and radiographers on addressing noise, contrast, and resolution, along with additional considerations for providers.

TSANZ standards for spirometry

On 31 March 2022, the Thoracic Society of Australia and New Zealand (TSANZ), in partnership with RSHQ, released the 2022 Standards for the delivery of spirometry for resource sector workers (PDF, 1MB) and the Standards for spirometry training courses companion document (PDF, 374KB) (2022 Standards).

From 1 March 2023, all spirometry for Queensland mine and quarry workers and spirometry training must be conducted in accordance with the 2022 Standards.

The 2022 Standards

These standards:

• align with updates to the American Thoracic Society (ATS) and European Respiratory Society (ERS) Standards 2019 (PDF, 927KB) and ERS and ATS guidelines for interpretation
• address the outcomes of the clinical spirometry audit undertaken by TSANZ and the accreditation program previously undertaken by Quality Innovation Performance Limited
• align with the Mine dust lung disease clinical pathways guideline (PDF, 789KB) by removing the separate 'Algorithm for Interpretation of Spirometry in Coal Workers' in the previous version of the standards
• address feedback received by RSHQ during consultation on the draft revised standards
• have also been updated to note their application to resource sector workers generally, aligning with legislative changes relating to respiratory health surveillance in the mineral mining and quarrying industry.

2022 TSANZ standards

• 2022 Standards for the delivery of spirometry for resource sector workers (PDF,1MB)
• 2022 Standards for spirometry training courses companion document (PDF, 374KB)

2017 TSANZ standards

• TSANZ Standards for the delivery of spirometry for coal mine workers (PDF, 567KB)
• TSANZ Standards for spirometry training courses (PDF, 280KB)

Similar exposure groups (SEGs)

Similar exposure groups (SEGs) are used to identify groups of workers who have the same general exposure to risks.

The SEG information sheet (PDF, 111KB) has guidance on establishing site-specific SEGs, as well as SEG listings you can use for reporting personal respirable dust monitoring data.

Position list for coal mine workers

Coal mine workers' position titles need to be provided by employers when completing the Employer section of the approved health assessment form.

The Standardised coal mine worker position list (PDF, 380KB) has a list of position titles and categories, as well as guidance on how to classify a position.

More information

Read about the Queensland Government's response to mine dust lung disease.

From 1 January 2017, retiring coal mine workers may be eligible for an exit assessment (previously called a retirement examination) consisting of a respiratory function examination and a chest X-ray examination.

Retiring coal mine workers can ask their employer for a voluntary exit assessment if each of the following apply:

• the worker is intending to permanently retire from working as a coal mine worker
• the worker has worked as a coal mine worker for a total of least 3 years (for any employer)
• the worker's last routine health assessment which included chest X-ray and respiratory examinations was more than 3 years ago.

Requests can be made within a 6-month period starting 3 months before retirement (i.e. 3 months either side of the retirement date).

Exit assessment process

If an eligible worker asks for an exit assessment, their employer is obliged to arrange and pay for the assessment, including any additional tests or follow-up investigations needed to complete the health assessment.

The exit assessment is conducted by the appointed medical adviser (AMA) within the 6-month period (see above) using the Resources Safety & Health Queensland (RSHQ) exit assessment form in accordance with sections 49A and 49B of the Coal Mining Safety and Health Regulation 2017.

• Read about the role and appointment of AMAs.

For copies of the exit assessment form, phone (07) 3818 5420 or email HSU@rshq.qld.gov.au.

This form has 4 sections:

• Section 1 is completed by the employer. It includes information about the employer, the worker's position, and the requirement for retirement examination.
• Section 2 is completed by the worker. It lists personal and work history information. Photo ID must be brought to the examination.
• Section 3 is completed by an examining medical officer and details clinical findings.
• Section 4 (the retirement examination report) is completed and signed by the AMA. Only this section is forwarded to the employer.

Note: The AMA only completes Section 4 when all examinations and follow up investigations, including the chest X-ray examination, are complete.

Chest X-ray examination

Exit assessments include a chest X-ray to detect coal mine dust lung diseases such as coal workers' pneumoconiosis. Images are dual-read by B-readers who have been accredited by the United States National Institute for Occupational Safety and Health (NIOSH).

These readers examine chest X-rays to the International Labour Organization International Classification of Radiographs of Pneumoconioses (ILO Classification).

Since July 2016, US-based B-readers accredited by NIOSH have provided a dual-reading service to Queensland's coal mine workers.

On 1 March 2019, Lungscreen Australia replaced US-based B-reading for all Queensland coal mine worker chest X-rays. All chest X-rays must now be sent to Lungscreen Australia.

Amendments to the Coal Mining Safety and Health Regulation 2017 that commenced on 1 March 2019 made this a mandatory requirement of the Coal Mine Workers' Health Scheme.

Lungscreen will classify coal mine worker chest X-rays to the ILO Classification and will provide the final ILO report back to the referring doctor.

Other Australian B-readers registered with RSHQ can undertake the first B-read and provide this to Lungscreen to complete the dual-reading process.

If the chest X-ray examination identified abnormalities, the AMA is required to follow the Mine dust lung disease clinical pathways guideline (PDF, 789KB) for follow-up investigations and referral to appropriate medical specialists.

RSHQ will send a sample of chest X-rays and ILO Classification reports to US-based B-readers for audit as part of the ongoing quality assurance program as recommended by the Monash University review.

• Read more about the Two-reader process for chest X-rays (PDF, 265KB).

Record keeping and reporting requirements

When the exit assessment is complete, the AMA sends:

• the completed health assessment form and all medical reports (chest X-ray report, spirometry report, CT scan report if applicable) to RSHQ (Health Surveillance Unit) (Note: AMAs are no longer required to lodge the chest X-ray image with the completed health assessment to RSHQ if the final dual-read ILO report was issued by Lungscreen. This new arrangement also applies if the final ILO report was issued by University of Illinois at Chicago (UIC) and that report was facilitated through RSHQ. However, RSHQ may request the AMA to provide a copy of the image in certain instances.)
• a copy of the exit assessment report (section 4 of the form) to the coal mine worker (does not include sections 1, 2 or 3 of the form)
• the exit assessment report (section 4 of the form) to the coal mine worker's employer.

If the employer requires an explanation of an exit assessment report (section 4 of the form) about a worker from the AMA, the employer must obtain the agreement of the worker and ensure that the worker is present - see section 47(1)(c) of the Coal Mining Safety and Health Regulation 2017.

AMAs are responsible for keeping all records associated with assessments and reviews they complete for coal mine workers. The records that AMAs must keep and give to RSHQ include a legible copy of the completed form for the assessment or review and the data or information on which it was based, including:

• the digital chest x-ray image file (DICOM) and a copy of the standard clinical x-ray report (see note above about lodging the chest X-ray image. The correct X-ray date must be recorded on the completed form.)
• the spirometry report and spirogram and/or lung function test reports
• ILO classification form
• high resolution computed tomography (HRCT) clinical report
• International Classification of HRCT for Occupational and Environmental Respiratory Diseases report
• any relevant medical specialist reports.

AMAs must give a copy of the records for each assessment and review to RSHQ within 28 days of completing the assessment or review by:

• uploading the records to the Coal Mine Workers' Health Assessment portal
• or
• sending hardcopy records, including the chest X-ray image file (DICOM) to Health Surveillance Unit, Resources Safety and Health, GPO Box 1321, BRISBANE CITY 4001.

RSHQ strongly encourages AMAs to upload records to the Coal Mine Workers' Health Assessment portal. If you require further information on the Portal, contact the Health Surveillance Unit on AMAPortal@rshq.qld.gov.au or phone (07) 3818 5420.

AMAs must retain all records relating to assessments and reviews that they complete for a period of:

• If the AMA has provided a copy of all documentation for that assessment/review to RSHQ: at least 10 years after the last medico-legal action arising from that assessment, as per the Health Sector (Clinical Records) Retention and Disposal Schedule. The last medico-legal action may occur after the AMA has completed the section 4, for example any follow-up actions, checks, reviews, or treatment. The AMA must keep a record disposal log for all records disposed of after this period.
• Records must not be disposed of under this policy unless they have been provided to RSHQ.

AMAs may retain electronic (digital) copies of assessment and review records, and dispose of the original hardcopy records, if the following requirements are met:

• The digital versions provide adequate quality substitutes for the hard-copy originals – that is, they are legible, accurate, complete, and unaltered.
• The digital versions are managed in an IT environment that meets the minimum level of computer and information security acceptable for the 12 standards set out in the RACGPs Computer and information security standards (CISS), 2nd Edition (PDF, 1.5MB).
• The hard-copy originals are kept for a reasonable checking period after scanning, that period being determined by the AMA.
• The AMA must keep a record disposal log for all original hardcopy records disposed of.

The above retention requirements continue to apply after a doctor ceases to be an AMA for an employer.

Retired and former Queensland coal mine, mineral mine and quarry workers (former workers) may be eligible for a free lung health check every 5 years, through the Former Worker Assessment program managed by Resources Safety and Health Queensland.

You don't have to have worked 'at the face' to be eligible for a free lung check. If your job involved work anywhere on the mine site, you may be eligible. For example, if you were cleaner or an administration officer at the mine.

You are eligible for a free lung check if all of the following apply:

• You have permanently stopped being a coal mine, mineral mine or quarry worker.
• You were a coal mine, mineral mine or quarry worker for at least 3 years in total over your lifetime, with at least 6 months of this work experience in Queensland.
• It has been at least 5 years since your most recent assessment.
  Note: Your most recent assessment can be less than 5 years ago if a doctor has recommended a sooner assessment, as shown in your last health assessment record or a medical certificate.

Free lung checks are completed via local authorised clinics or on the HEART5 Mobile Health Unit. Phone our Mine Dust Health Support Service helpline (1300 445 715) to discuss your eligibility and find out what options are available to you.

Upcoming HEART5 Mobile Health Unit schedule

What does a former worker assessment include

A former worker assessment includes:

• lung function test by spirometry
• chest X-ray dual-read to ILO standards by B-readers approved by Resources Safety and Health Queensland (RSHQ)
• health examination with a RSHQ-approved doctor
• and
• subsequent diagnostic assessments and reviews, if required, as recommended by the RSHQ-approved doctor and in accordance with the Mine dust lung disease clinical pathways guideline (PDF, 798KB).

Applying for a former worker assessment

Retired and former Queensland mine and quarry workers are encouraged to contact the Mine Dust Health Support Service (MDHSS) to discuss eligibility and how to apply for a former worker assessment, via:

• phone: 1300 445 715
• email: info@minedusthealthsupport.com
• website: Miners' Heath Matters.

The MDHSS, a joint initiative of RSHQ, WorkCover Queensland and the Office of Industrial Relations, provides confidential information on the former worker assessment, as well as information on current and former mine and quarry workers, and their families, on respiratory health screening, compensation and support services if diagnosed with a mine dust lung disease.

You can also apply for an assessment using the former worker assessment application form (PDF, 803KB). Send the completed form to FormerWorker@rshq.qld.gov.au. For help completing the application form, contact the Health Surveillance Unit by phoning (07) 3818 5420 or email to FormerWorker@rshq.qld.gov.au.

Completing a former worker assessment

Once deemed eligible, RSHQ will arrange and pay for the cost of your former worker assessment to be completed with an RSHQ-authorised program partner. You will be informed of the available RSHQ-authorised program partners who will arrange your appointments with the relevant service providers including:

• RSHQ-approved fixed clinics which are located throughout Queensland, as well as other states. If you choose to attend an RSHQ-approved fixed clinic your appointments will be arranged at the closest provider to where you reside.
• HEART5 Mobile Health Unit which is operated by Heart of Australia and travels throughout regional and remote Queensland, equipped with state-of-the-art medical equipment to complete your assessment. If you choose to attend HEART5 you will be advised of available dates at a location near to where you reside.

Travel expenses

When travelling to and from your appointment(s) as part of your assessment, RSHQ can help with travel expenses, in accordance with the Domestic travel expenses policy (PDF, 219KB). Travel expense reimbursements can be made by completing the Travel expense claim form (PDF, 245KB). For more information on the Travel expenses policy, contact the Health Surveillance Unit on (07) 3818 5420.

Record keeping and reporting requirements

For former mine and quarry workers, the assessment will be completed using the approved former worker assessment form in accordance with section 49F of the Coal Mining Safety and Health Regulation 2017.

When the former worker assessment is complete, the supervising doctor sends:

• the completed former worker assessment form and all associated medical reports to RSHQ (Health Surveillance Unit)
• a copy of the former worker assessment report (section 3 of the form) to the former worker.

The supervising doctor must keep the data on which the assessment was based and a copy of the approved form that was completed for the assessment.

The privacy of medical records is protected by government privacy provisions, as well as the confidentiality requirements of section 52 of the Coal Mining Safety and Health Regulation 2017.

Only section 4 of the health assessment report and the exit assessment report may be disclosed to the employer.

An appointed medical adviser may disclose the contents of a medical record to the coal mine worker or someone with the worker's written consent.

The Chief Executive Officer of Resources Safety & Health Queensland must disclose the contents of a worker's records to the worker upon receipt of a written request. The Chief Executive Officer may also disclose records to:

• another person with the worker's consent
• a doctor or hospital without the coal mine worker's consent if the information is needed to treat the worker and the worker is unable to give consent
• a person, such as a doctor, without the coal mine worker's consent to enable the person to carry out an assessment or review (e.g. comparative assessment of spirometry)
• an appropriately qualified person for approved research (i.e. approved by a Human Research Ethics Committee under the Public Health Act 2005 or similar body) without the coal mine worker's consent.

Read our frequently asked questions (PDF, 180KB) about matters involving confidentiality of medical records.

Employers pay for the coal mine worker's health assessment and exit assessment (for eligible retiring workers). This includes referrals, tests and reasonable travel expenses for any further investigations required to complete the health assessment (e.g. CT scans, respiratory physician assessments).

The employer receives only a copy of the health assessment or exit assessment report (section 4 of the completed form). The employer is not responsible for payment of any treatment required as a consequence of the assessment or examination.

Workers have the right to a second health assessment if the first assessment indicates they are unfit for a designated job. Workers are responsible for the cost of any second assessment. This does not apply for exit assessments.

Resources Safety & Health Queensland (RSHQ) has established an Australian-based dual-reading program for chest X-rays.

Lungscreen and other Australian B-readers will complete the dual-read and adjudication process of classifying coal mine worker chest X-rays to the ILO Classification.

Employers are responsible for paying Lungscreen and other Australian B-readers to read X-ray images.

If there are conflicting health assessments, section 48A of the Coal Mining Safety and Health Regulation 2017 may apply; in this case RSHQ pays for the costs of a medical specialist to provide a final decision.

A former worker assessment is paid for by RSHQ, including any additional tests or follow-up investigations of abnormal screening results.

The Mine dust lung disease clinical pathways guideline (PDF, 789KB) lays out the recommended processes for follow-up investigations and referrals resulting from regular screening and, if appropriate, reaching a confirmed diagnosis.

Depending on the type of health problem, the appointed medical adviser (AMA) may place some restrictions on a worker to minimise their risk (and risk to others) and prevent further injury or illness. Restrictions are detailed in the Health Assessment report of the approved health assessment form and are explained to the worker by the AMA when the approved form is completed.

Restrictions do not necessarily preclude the worker from working, if they are still able to undertake the job safely. However, it is up to employers to determine whether these restrictions can be accommodated.

Right to additional health assessments

Workers have the right to undergo a second health assessment if a health assessment report about a coal mine worker shows that the worker is unable to carry out the worker's tasks at the mine without creating an unacceptable level of risk.

The employer must give the worker a reasonable opportunity to undergo a further health assessment from an approved supervising doctor registered with Resources Safety & Health Queensland (RSHQ) or relevant medical specialist chosen by the worker before the employer takes action to terminate or demote the worker. The worker must give the second health assessment to the employer. When the employer receives the second health assessment, they should forward it to their AMA, who will review it and report back to the employer and the worker. The worker is responsible for the costs of the second health assessment.

The option of a second health assessment or examination does not apply to job seekers who have not yet been employed or to exit assessments.

Sometimes an original and a second health assessment report disagree. If the differences between the 2 reports cannot be resolved, the worker or the employer can, within 28 days of being given a review report, refer the matter to the Chief Executive Officer of RSHQ.

The Chief Executive Officer will then appoint a medical specialist to review the conflicting health assessment reports and if necessary re-assess the worker. The appointed medical specialist's decision will be final. The cost of the review will be met by RSHQ (section 48A of the Coal Mining Safety and Health Regulation 2017.

Completed health assessment and exit assessment forms (including the health assessment and exit assessment reports) are the property of Resources Safety & Health Queensland (RSHQ). The confidentiality of these forms and reports is protected by law.

Who we can release copies to

RSHQ can release copies of completed forms and reports to:

• the worker, or another person with the consent of the worker
• a doctor or hospital without the coal mine worker's consent if the information is needed to treat the worker and the worker is unable to give consent
• to a person, such as a doctor, without the coal mine worker's consent to enable the person to carry out an assessment or review (e.g. comparative assessment of spirometry)
• an appropriately qualified person for approved research (i.e. approved by a Human Research Ethics Committee under the Public Health Act 2005 or similar body) without the coal mine worker's consent.

How to request copies

Workers can obtain additional copies of their completed health assessment or exit assessment form from the appointed medical adviser (AMA). The AMA may charge for this service.

RSHQ can also supply copies of completed forms and reports free of charge. Workers, and those wanting to obtain records where the worker's consent is required, must make a request in writing using the medical record release form (PDF, 965KB) and include:

• the worker's full name and date of birth
• where to send the medical (name and address)
• the worker's signature and date of the request.

Workers and third parties can email the application to HSU@rshq.qld.gov.au. AMAs are required to upload via the Coal Mine Workers' Health Assessment portal.

RSHQ aims to action and return requests for medical records as soon as possible, while also complying with  legal requirements in supplying records.

There are several ways medical providers and other entities can support efficient and timely processing of requests. To find out more, read about requests for medical records (PDF, 140KB).

Comparative assessments and research

To obtain a copy of a worker's previous spirometry for purposes of comparative assessment, complete the medical record release form (PDF, 965KB) and upload via the Coal Mine Workers' Health Assessment portal. Worker's consent is not required for these applications.

To discuss potential access to medical records for approved research, email HSU@rshq.qld.gov.au.

Employers are required to appoint one or more medical practitioners as their appointed medical adviser (AMA).

An AMA who has been appointed by one employer does not have AMA status for other employers. A written contract between each employer and the AMA is required.

Role of the AMA

The AMA's role is to carry out, supervise and report on health assessments and retirement examinations for the employer's coal mine workers.

The AMA will apply the Mine dust lung disease clinical pathways guideline (PDF, 789KB) in referring on, or following up, coal mine workers whose screening examinations show irregularities.

Only the employer's appointed AMA can complete and sign the Health Assessment report of the relevant health assessment form for the employer's coal mine workers. However, the examination section of the forms can be completed by an examining medical officer approved by Resources Safety & Health Queensland (RSHQ) working under the supervision of the AMA.

Finding a doctor to appoint as an AMA

From 1 March 2019, employers must only appoint supervising doctors from the RSHQ register of doctors and medical providers as their AMA.

These doctors have been assessed as having met qualification and experience standards for assessing coal mine workers. Doctors on the register are required to participate in an annual training program.

Contracts appointing AMAs

Employers must appoint the AMA in writing.

The written contract must include requirements for the AMA to:

• have a discussion with both the employer and coal mine worker (or the worker's representative) and advise about appropriate duties for the worker in the health assessment report of the forms (the health assessment report)
• discuss the worker's health assessment with another doctor nominated by the worker, if requested by the coal mine worker
• give a copy of the health assessment report to the employer
• give a copy and explanation of the health assessment report to the worker.

The contract must also include:

• term of the AMA's appointment
• commercial details, such as a schedule of fees.

Notification requirements

AMAs must notify us of any changes to their contact details. Email or post your notice to the Health Surveillance Unit:

Health Surveillance Unit
Resources Safety & Health Queensland
GPO Box 1321
BRISBANE CITY QLD  4001
HSU@rshq.qld.gov.au

Employers can complete their AMA appointment notification requirements through ResHealth. When completing your AMA appointment in ResHealth you will require the following details of the appointment:

• AMA name
• Start date
• End date

Medical assessment by specialist radiologists

Examining medical officers or appointed medical advisers (AMAs) who order chest X-rays are required to provide sufficient information to the radiologist, outlining the worker's coal dust exposure and the need to assess the X-ray for pneumoconiosis to the International Labour Organization (ILO) International Classification of Radiographs of Pneumoconioses (ILO Classification).

Two-reader process for chest X-rays

Since July 2016, US-based B-readers accredited by the National Institute for Occupational Safety and Health (NIOSH) have provided a dual-reading service to Queensland's coal mine workers.

X-rays are read to the ILO Classification, which provides a rigorous screening process for reporting on the potential presence of disease.

Sending X-rays to US-based B-readers through the University of Illinois at Chicago (UIC) was an interim solution until an Australian-based dual-reading service was established.

On 1 March 2019, Lungscreen Australia replaced US-based B-reading for all Queensland coal mine worker chest X-rays. All chest X-rays must now be sent to Lungscreen Australia.

Amendments to the Coal Mining Safety and Health Regulation 2017 that commenced on 1 March 2019 made this a mandatory requirement of the Coal Mine Workers' Health Scheme.

Lungscreen will classify coal mine worker chest X-rays to the ILO Classification and will provide the final ILO report back to the referring doctor.

Other Australian B-readers registered with Resources Safety & Health Queensland (RSHQ) can undertake the first B-read and provide this to Lungscreen to complete the dual-reading process.

If AMAs or employers choose to use other Australian B-readers registered with RSHQ for the first read, please consult with your B-reader for referral instructions to the relevant X-ray imaging clinic/s registered with RSHQ.

If the chest X-ray examination identifies abnormalities, the AMA is required to follow the Mine dust lung disease clinical pathways guideline (PDF, 789KB) for follow-up investigations and referral to appropriate medical specialists.

The UIC will continue to audit a sample of chest X-rays submitted with health assessment records as part of the ongoing quality assurance program as recommended by the Monash University review.

Workers will be provided a consent form to allow RSHQ to provide their records for auditing.

To support this process:

• From 1 March 2019, Lungscreen will conduct 2 reads (and conduct any adjudications) for any X-ray sent to it unless it receives the first ILO report by another Australian B-reader registered with RSHQ. In these cases, Lungscreen will conduct 1 read and any adjudications before issuing the final report.
• Readers must complete an ILO Classification form.
• All digital chest X-ray images and reports, including the final ILO classification form, are sent to the AMA.

For copies of the ILO classification form phone (07) 3818 5420 or email HSU@rshq.qld.gov.au.

Also consider...

• New process for reading chest X-rays – information for doctors (PDF, 465KB).
• New process for reading chest X-rays – information for imaging clinics (PDF, 474KB).
• B-reading process with Lungscreen Australia: Step by step guide and workflow – periodic health assessment from 1 March 2019 (PDF, 808KB).
• New process for reading chest X-rays – information for workers (PDF, 461KB).