How the exit assessment works

From 1 January 2017, retiring coal mine workers may be eligible for an exit assessment (previously called a retirement examination) consisting of a respiratory function examination and a chest X-ray examination.

Retiring coal mine workers can ask their employer for a voluntary exit assessment if each of the following apply:

• the worker is intending to permanently retire from working as a coal mine worker
• the worker has worked as a coal mine worker for a total of least 3 years (for any employer)
• the worker's last routine health assessment which included chest X-ray and respiratory examinations was more than 3 years ago.

Requests can be made within a 6-month period starting 3 months before retirement (i.e. 3 months either side of the retirement date).

Exit assessment process

If an eligible worker asks for an exit assessment, their employer is obliged to arrange and pay for the assessment, including any additional tests or follow-up investigations needed to complete the health assessment.

The exit assessment is conducted by the appointed medical adviser (AMA) within the 6-month period (see above) using the Resources Safety & Health Queensland (RSHQ) exit assessment form in accordance with sections 49A and 49B of the Coal Mining Safety and Health Regulation 2017.

• Read about the role and appointment of AMAs.

For copies of the exit assessment form, phone (07) 3818 5420 or email HSU@rshq.qld.gov.au.

This form has 4 sections:

• Section 1 is completed by the employer. It includes information about the employer, the worker's position, and the requirement for retirement examination.
• Section 2 is completed by the worker. It lists personal and work history information. Photo ID must be brought to the examination.
• Section 3 is completed by an examining medical officer and details clinical findings.
• Section 4 (the retirement examination report) is completed and signed by the AMA. Only this section is forwarded to the employer.

Note: The AMA only completes Section 4 when all examinations and follow up investigations, including the chest X-ray examination, are complete.

Chest X-ray examination

Exit assessments include a chest X-ray to detect coal mine dust lung diseases such as coal workers' pneumoconiosis. Images are dual-read by B-readers who have been accredited by the United States National Institute for Occupational Safety and Health (NIOSH).

These readers examine chest X-rays to the International Labour Organization International Classification of Radiographs of Pneumoconioses (ILO Classification).

Since July 2016, US-based B-readers accredited by NIOSH have provided a dual-reading service to Queensland's coal mine workers.

On 1 March 2019, Lungscreen Australia replaced US-based B-reading for all Queensland coal mine worker chest X-rays. All chest X-rays must now be sent to Lungscreen Australia.

Amendments to the Coal Mining Safety and Health Regulation 2017 that commenced on 1 March 2019 made this a mandatory requirement of the Coal Mine Workers' Health Scheme.

Lungscreen will classify coal mine worker chest X-rays to the ILO Classification and will provide the final ILO report back to the referring doctor.

Other Australian B-readers registered with RSHQ can undertake the first B-read and provide this to Lungscreen to complete the dual-reading process.

If the chest X-ray examination identified abnormalities, the AMA is required to follow the Mine dust lung disease clinical pathways guideline (PDF, 789KB) for follow-up investigations and referral to appropriate medical specialists.

RSHQ will send a sample of chest X-rays and ILO Classification reports to US-based B-readers for audit as part of the ongoing quality assurance program as recommended by the Monash University review.

• Read more about the Two-reader process for chest X-rays (PDF, 265KB).

Record keeping and reporting requirements

When the exit assessment is complete, the AMA sends:

• the completed health assessment form and all medical reports (chest X-ray report, spirometry report, CT scan report if applicable) to RSHQ (Health Surveillance Unit) (Note: AMAs are no longer required to lodge the chest X-ray image with the completed health assessment to RSHQ if the final dual-read ILO report was issued by Lungscreen. This new arrangement also applies if the final ILO report was issued by University of Illinois at Chicago (UIC) and that report was facilitated through RSHQ. However, RSHQ may request the AMA to provide a copy of the image in certain instances.)
• a copy of the exit assessment report (section 4 of the form) to the coal mine worker (does not include sections 1, 2 or 3 of the form)
• the exit assessment report (section 4 of the form) to the coal mine worker's employer.

If the employer requires an explanation of an exit assessment report (section 4 of the form) about a worker from the AMA, the employer must obtain the agreement of the worker and ensure that the worker is present - see section 47(1)(c) of the Coal Mining Safety and Health Regulation 2017.

AMAs are responsible for keeping all records associated with assessments and reviews they complete for coal mine workers. The records that AMAs must keep and give to RSHQ include a legible copy of the completed form for the assessment or review and the data or information on which it was based, including:

• the digital chest x-ray image file (DICOM) and a copy of the standard clinical x-ray report (see note above about lodging the chest X-ray image. The correct X-ray date must be recorded on the completed form.)
• the spirometry report and spirogram and/or lung function test reports
• ILO classification form
• high resolution computed tomography (HRCT) clinical report
• International Classification of HRCT for Occupational and Environmental Respiratory Diseases report
• any relevant medical specialist reports.

AMAs must give a copy of the records for each assessment and review to RSHQ within 28 days of completing the assessment or review by:

• uploading the records to the Coal Mine Workers' Health Assessment portal
• or
• sending hardcopy records, including the chest X-ray image file (DICOM) to Health Surveillance Unit, Resources Safety and Health, GPO Box 1321, BRISBANE CITY 4001.

RSHQ strongly encourages AMAs to upload records to the Coal Mine Workers' Health Assessment portal. If you require further information on the Portal, contact the Health Surveillance Unit on AMAPortal@rshq.qld.gov.au or phone (07) 3818 5420.

AMAs must retain all records relating to assessments and reviews that they complete for a period of:

• If the AMA has provided a copy of all documentation for that assessment/review to RSHQ: at least 10 years after the last medico-legal action arising from that assessment, as per the Health Sector (Clinical Records) Retention and Disposal Schedule. The last medico-legal action may occur after the AMA has completed the section 4, for example any follow-up actions, checks, reviews, or treatment. The AMA must keep a record disposal log for all records disposed of after this period.
• Records must not be disposed of under this policy unless they have been provided to RSHQ.

AMAs may retain electronic (digital) copies of assessment and review records, and dispose of the original hardcopy records, if the following requirements are met:

• The digital versions provide adequate quality substitutes for the hard-copy originals – that is, they are legible, accurate, complete, and unaltered.
• The digital versions are managed in an IT environment that meets the minimum level of computer and information security acceptable for the 12 standards set out in the RACGPs Computer and information security standards (CISS), 2nd Edition (PDF, 1.5MB).
• The hard-copy originals are kept for a reasonable checking period after scanning, that period being determined by the AMA.
• The AMA must keep a record disposal log for all original hardcopy records disposed of.

The above retention requirements continue to apply after a doctor ceases to be an AMA for an employer.