CT scans remain an important part of the icare health screening process

icare response to recent claims about silicosis detection efficacy.

Recently there have been claims made that x-ray screening misses 40 per cent of silicosis cases that are subsequently picked up by HRCT and other tests. This figure has been based on an analysis of experience in Queensland.

In NSW, X-rays and CT scans both play an important role in the screening of workers potentially exposed to an occupational dust disease.

Safe Work Australia currently recommends workers with exposure to silica to undergo screening every year using standardised validated methodology. The tests performed by icare as part of the health monitoring program for silica include a medical examination, capture of medical and occupational history, standardised respiratory questionnaire, standardised respiratory function tests and standardised full-size chest X-rays.

All results are then reviewed by an experienced registered Senior Respiratory Physician who upon the detection of any dust-related abnormalities, requests a follow up investigation which may include a high resolution CT scan. Any discrepancy in diagnosis is referred for a third level of review.

The current guidance for screening programs provided by Safe Work Australia - using chest x-rays as a screening tool - is endorsed by peak bodies nationally and internationally including the National Institute for Occupational Safety and Health (NIOSH) US and the Health and Safety Executive (HSE) UK.

In the process adopted by icare, each chest X-ray is reviewed and reported in line with International Labour Organisation (ILO) standards by a qualified radiologist registered by the Royal Australian and New Zealand College of Radiologists (RANZCR).

Safe Work Australia is currently reviewing the national guides for health monitoring. icare will follow this work closely, in addition to any other peak body findings, and adjust practices if there are recommendations from this research.

If you would like to learn more about icare’s health monitoring (screening) please contact us at lungscreen@icare.nsw.gov.au.