P-152 Investigating Notified Silicosis Cases Enable Evidence-Based Preventive Action

Introduction Silicosis is the oldest known occupational lung disease, and its global burden of disability and death continues today with thousands of workers diagnosed in many parts of the world each year. We report on the investigation of 302 diagnosed silicosis cases notified to the Work Health and Safety (WHS) regulator in the State of New South Wales in Australia, mostly workers from the engineered stone benchtop fabrication industry. Methods An established incident investigation process with documented procedures were followed for each case. Findings on 159 of these cases were reported to a decision-making panel for assessment towards further full investigation of legislative breaches. Fourteen full investigations were undertaken resulting in seven recommended for prosecution of parties in breach. Results Several challenges faced in investigating long-latency work-related disease were identified from this cohort of silicosis cases. These included the difficulties in establishing association between exposure and disease manifestation due to the lack of respirable crystalline silica dust exposure data, absence of worker health surveillance records and communicating with a culturally diverse industry sector with a transient workforce. Discussion and conclusion We demonstrate that by investigating over 300 notified silicosis cases, in addition to enforcing compliance with WHS legislation, valuable insights were gained for evidence-based interventions on illness prevention. Findings on industry demography, worker history, causes of unsafe work practices, ineffective hazard communication and barriers to exposure control were recognised as important determinants of occupational disease that may be globally applicable.