BILLS - National Occupational Respiratory Disease Registry Bill 2023, National Occupational Respiratory Disease Registry (Consequential Amendments) Bill 2023 - Second Reading

03 August 2023

 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.