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HEALTH MANAGEMENT EALTH MANAGEMENT IN MINING Putting the “H” back into OHS Putting the “H” back into Occupational Health and Safety means working systematically towards the prevention of foreseeable harm arising from identified health hazards, writes Norman Jennings. The New South Wales Mine Safety Advisory Council (MSAC) is the principal OHS body in the NSW mining and extractives industry that provides advice to the Minister. Part of the world-leading vision of MSAC is to put the “H” back into Occupational Health and Safety. This tripartite vision is shared by the NSW key stakeholders – employers, employee representatives and the regulator. MSAC has a systematic approach to health management, consulting extensively with industry. Firstly, it sought to identify the health and safety priorities of those working in the industry. Secondly, it provided guidance on how those priorities could best be managed or progressed. Thirdly, it provided the means for the industry to obtain targeted assistance. Lastly, MSAC is providing the mechanisms to monitor and evaluate the effectiveness of measures taken to tackle those priorities. MSAC has been actively promoting the systematic management of priority health issues in NSW mining. The Council has also been developing targeted health education and assistance programs for the industry and promoting their delivery throughout NSW. Recently, MSAC established the Health Management Advisory Committee (HMAC). Comprising of representatives with extensive and specialist health knowledge of different industry sectors, HMAC is well placed to provide advice on the coordination of the regulation of health issues in the NSW mining and extractives industry. Its role is to identify and monitor emerging health issues in the industry and propose collaborative approaches to addressing them. The aim is to assist sites in developing and implementing systematic health management plans which integrate into their overall management systems. The MSAC approach to health management Before establishing the HMAC, MSAC undertook extensive consultation with industry and research on priority health issues. MSAC also identified a need to improve the coordination of health management and implement collaborative strategies to raise awareness of issues and promote the use of tools to assist the industry. Moreover, MSAC recognised the need to collect and analyse data on action on-site and evaluate progress in five priority areas: • Health management • Fatigue • Dust and diesel particulate • Noise • Musculoskeletal disorders A breakdown of the high priority exposures and related disorders (apart from health management) is: • Noise causing noise-induced hearing loss • Vibration causing musculoskeletal disorders • Diesel exhaust fumes leading to respiratory disease • Hazardous substance exposure causing dermatitis • Ergonomic stressors causing musculoskeletal conditions • Ergonomic stressors causing back disorders • Ergonomic stressors causing fatigue and related disorders • Psychosocial hazards causing mental disorders • Ultraviolet radiation and skin disease • Dust exposure leading to respiratory disease MSAC recognises that the disease effects of these health hazards are not always apparent until much later after exposure has occurred. Also, while some exposures are readily measurable or have exposure standards (such as noise and dust) they may not be the only cause of the onset of a disease. The lack of a clear work/play divide may then lead to an under-reporting of the issue. Industry too, has acted in concert with the other stakeholders to great effect, with ongoing vigilance, cooperation and a genuine willingness to improve the health outcome of its workers. Industry has systematically tackled the major health issue of pneumoconiosis in the underground coal sector. This collaborative effort by government, industry and unions to develop and use desirable work practices, technology and surveillance to reduce exposure to coal dust has led to the eradication of “Black Lung” in the NSW coal mining industry. This is in contrast to other mining countries where Black Lung is still a major issue. After widespread industry consultation, the next step for MSAC has been the development and rollout of an integrated approach to addressing priority areas through the development of practical guidance to industry. Risk management guides were developed for health, fatigue and musculoskeletal disorders. These resources were promoted and supported through a series of workshops aimed at assisting implementation at sites. MSAC help so far – Industry Health Guides and Education Health Management The MSAC guide Health Management Plan1 covers: • Policy development • Consultation • Risk management • Exposure monitoring • Training and information • Supervision • Health surveillance • Illness management and rehabilitation • Health and wellbeing • Records management and reporting • Evaluation and performance measures The purpose of the guide is to enable mine operators to systematically manage health risks in the workplace so that they comply with the legislative framework. Ultimately, the aim is to ensure that there are no negative impacts to the health of workers. Desirable approaches to the development of a health management plan are suggested but not prescribed. This means that individual operators can develop a plan that is specific to their needs, commensurate with their level of management maturity and reflective of their resources, while addressing the key components of a health management plan. Fatigue The 2005 Wran Mine Safety Review2 highlighted hours of work and fatigue as one of the single most important issues facing the mining and extractives industry in NSW. In 2007, MSAC Digging Deeper project3 showed clearly that hours of work in the NSW mining and extractives industry are long, and that fatigue issues needed to be addressed. AUSTRALASIAN MINE SAFETY JOURNAL 41