Workers diagnosed with silicosis and leading industry experts are pushing for the new Labor government to "urgently" introduce tougher national regulations amid fears hundreds of cases are going undetected across a wide range of industries.
Working underground for 33 years, gold miner Tony Kotlin had no idea the job he loved would cost him his health.
After an accident at a mine in 2014, a standard X-ray of his injuries revealed something suspicious in his lungs.
Doctors told him it could be cancer, but the official diagnosis came two years later.
Mr Kotlin was found to have the incurable and often fatal lung disease silicosis — a result of three decades inhaling deadly crystalline silica dust on the job.
"Day-to-day is hard," Mr Kotlin said.
"I'd rather have lung cancer than this — with lung cancer, you've got a good chance of recovery.
"With silicosis, it's there and it's not going away … there's nothing I can do about it."
Lung Foundation Australia says the lung cancer five-year survivorship rate is 20 per cent.
Mr Kotlin, who lives in a rural town south-west of Brisbane, is still coming to terms with the diagnosis, which he says affects all aspects of his life.
"I'm tired all the time, I find it hard to consistently do day-to-day chores, I have a fair bit of difficulty in walking long distances, carrying things if they're heavy," Mr Kotlin said.
"I'm on a breathing machine at night now, which I absolutely hate.
"[I have] depression, anxiety … I'm very uncomfortable around people, I don't go to the supermarket, I don't walk down the street.
"I feel guilty that I'm not full-time supporting my family — it's extremely hard."
Mr Kotlin said he believed not enough was being done to protect workers exposed to dangerous levels of silica dust.
"I think silicosis will be worse than asbestos," Mr Kotlin said.
"I honestly think if attitudes don't change, it's going to get a lot, lot worse than what it is now."
Cases detected 'just the tip of the iceberg'
The number of known silicosis cases in Australia is rapidly climbing.
There has been a strong national focus on the engineered stone workforce, with at least 500 Australian stonemasons diagnosed, but there are fears many more cases remain undetected.
Leading dust diseases clinician Graeme Edwards said the true number was likely higher, with symptoms often taking years to develop.
"A significant proportion of those workers who have already been exposed have not yet developed disease but will do so in the future.
"Those numbers [also] don't count those who will develop the disease from other exposures such as miners, quarry workers, or others in the crafts, building and construction industries," Dr Edwards said.
Australian Council of Trade Unions (ACTU) assistant secretory Liam O'Brien said there were likely hundreds of workers in those industries who have silicosis but do not know it, as health screenings are not available.
"What we've seen over the last decade is an explosion of cases in Australia and what's really worrying is it's much broader than engineered stone – we're seeing cases in quarries, construction, tunnelling," Mr O'Brien said.
"Workers in office spaces around quarries are [even] being diagnosed.
"We've got little understanding as to how widespread it is so we really fear that actually we're seeing just the tip of the iceberg when it comes to this disease."
Dust diseases lawyer Jonathan Walsh, who represents Mr Kotlin in a claim for damages, has acted for dozens of other underground miners with silicosis over the past year.
He said there was a "significant under-reporting" of the disease, particularly in the metalliferous mining sector, covering both surface and underground mining.
"There are probably hundreds of workers underground today who have silica disease — they don't know it but they should know it," Mr Walsh said.
"We are not seeing the rates of diagnosis out of this industry being reported by governments or in the general industry.
"There is a massive problem, particularly when you compare it to stonemasonry silicosis and the attention that that issue rightfully deserves, we're not seeing the same spotlight being shone on the metalliferous mining industry.
"With the [new] Labor government, there is an opportunity to refocus much-needed attention on this issue."
Stronger national regulations needed, experts say
Mr Walsh said tougher national workplace regulations were "absolutely required," with early detection crucial.
"It starts with setting a better federal framework via SafeWork Australia to reduce the maximum allowable dust exposure limit … ensuring they have better PPE and ensuring there is mandated engineering controls in the workplace," Mr Walsh said.
"Employers and governments need to make sure [all affected] industries are screened to ensure workers with this disease know they have it … so they can make informed decisions and choices about what they're going to do with their life going forward — right now, that is not happening."
"Then it's up to the state and territory governments to enact laws in their local jurisdictions to ensure that workers are getting less exposed and better protected in the workplace and that the governments are regulating and ensuring employers are doing the right thing."
Dr Edwards said the Albanese government must "urgently" revisit the findings of the National Dust Disease Taskforce, established in 2019, to develop a national approach to managing occupational dust diseases.
It handed down its final report last year and made seven recommendations, including more widespread health screenings, implementation of a national dust disease registry and better psychological and financial support for workers and their families.
Former federal health minister Greg Hunt said the Coalition government had accepted the recommendations, but Dr Edwards said the Commonwealth and other jurisdictions have been too slow to act.
"Right now, we are still seeing workers being exposed inappropriately to respirable crystalline silica dust, and it will kill them," Dr Edwards said.
"By the time they're diagnosed at the moment, they're lining up for lung transplants … or have already died.
"We need the urgency of a new government to re-look at, accept and fund appropriately the recommendations of the taskforce.
"We need to detect as early as possible so we can intervene," he said.
Mr O'Brien said the disease was "entirely preventable" through safe workplace practices and a stronger national regulatory framework is needed to ensure employers identify hazardous dust levels and take steps to reduce exposure.
'Current standards had clearly failed
Minister for Workplace Relations, Tony Burke, did not respond directly to the ABC's questions about whether the government would revisit the taskforce findings.
In a statement, Mr Burke told the ABC that the government "holds issues of workplace safety very close to its heart".
"In opposition, I met with people who had contracted silicosis at work — the current standards had clearly failed them," Mr Burke said.
"I'll have more to say later, but this is an issue I'll be pursuing with my state counterparts."
