AFOEM eBulletin – 28 June 2019

New Zealand Forum on Accelerated Silicosis: Occupational Dust Diseases Taskforce

On 6 June 2019, alongside Ms Catherine Epps (Worksafe Head of Health and Technical Services), I had the privilege of co-chairing a day-long forum on the New Zealand response to Accelerated Silicosis held at our RACP Wellington office. The day brought together a broad range of key NZ stakeholders to urgently address this very serious emerging disease, to contribute and learn from the current knowledge, and to progress the development of a unified management response including clinical pathways for exposed workers and ongoing protection of workers.

The NZ work has built on existing knowledge from the Australian experience and we will continue to work closely with our Australian colleagues. I would like to acknowledge my gratitude to Dr Graeme Edwards FAFOEM who set the scene providing a comprehensive presentation of the case finding activities in Australia. The Australian experience has highlighted the need for NZ to establish a centralised multidisciplinary occupational health response to ensure appropriate and supportive case finding, exposure assessment and health screening, followed by specialist assessment of affected workers.

The clinical response to silica in engineered stone follows an accelerated pathway compared to exposure to silica in natural stone with exposure histories as short as two to three years causing sufficient lung burden to result in significant disease in some very young workers in Queensland. Distinct and new clinical findings are being identified in these workers that have not been traditionally seen. To ensure accurate diagnosis, health screening activities must be performed and interpreted by experts, therefore we are not advising potentially exposed workers to visit their GP but are asking them to register themselves with Worksafe so they can be contacted directly by the occupational health team for further assessment.

We are currently not aware of any NZ stonemasons with diagnosed silica-related disease. Based on overseas data we expect there will be around 150 to 300 of an estimated 1000 local workers who will have radiologic evidence of disease, and despite the absence of overt symptoms a significant number of these will have progressive massive fibrosis. Establishing a register of exposed workers will inform the international understanding of this emerging disease to allow improvement of future clinical pathways, workplace and worker monitoring, and treatment recommendations.

The forum agreed to establish the Occupational Dust Diseases Taskforce with an initial focus on the effects of silica exposure in engineered stone workers. We identified key priorities with work underway in a joint media statement, clinical pathways, and an application for New Zealand Government funding to establish a centralised taskforce response to co-ordinate case finding activity and occupational health oversight of affected workers.

At the forum, respiratory physicians, thoracic radiologists, The Thoracic Society of Australia and New Zealand (TSANZ), Health Quality & Safety Commission (HSQC), The Australian and New Zealand Society of Occupational Medicine (ANZSOM), public health, occupational health nurses, occupational hygienists, university researchers, the Ministry of Health, the Prime Minister’s Office, Accident Compensation Corporation (ACC), Worksafe and the RACP were all united in our concern for the affected workers who are currently unaware of their risks and potential significant disease and agreed to continue to lead the response collaboratively.

Read an article about accelerated silicosis in New Zealand which appeared on stuff.co.nz on 19 June 2019.

Dr Alexandra Muthu 
AFOEM New Zealand Committee Chair

A message from your President

Queen’s Birthday Honours and #CrazySocks4Docs

Warm congratulations to two of our members who received awards in the Queen’s Birthday 2019 Honours List for their service and dedication to occupational and environmental medicine. Professor Malcolm Sim, our President-Elect, from Monash University, Victoria and Dr Chris Cunneen, from Queensland. The full list is available on the Governor General’s website

It is with great pride that the important work done by our speciality has been recognised in this way.
It was with difficulty that I tumbled out of bed on a dark and very cold winter morning on 5 June 2019 and put on my bright purple socks with yellow ducks to attend the breakfast launch in South Australia of #CrazySocks4Docs, at the Adelaide Convention Centre.  CrazySocks4Docs is a movement founded by Dr Geoffrey Toogood, a cardiologist from Victoria, to raise awareness and stimulate actions to deal with doctors’ mental health.  Attendees included the Hon Stephen Wade, SA Minister for Health. The launch was sponsored by Breakout Mental Health Research Foundation, the South Australian Salaried Medical Officers Association (SASMOA – doctors union) and Doctors Health SA (a private organisation run by doctors, providing 24/7 dedicated medical service for students and doctors). The funds raised will be used by Professor Paul Ward, Head of Public Health, College of Medicine and Public Heath, Flinders University, to run a pilot study looking at the psychosocial safety climate in which doctors work, using that data to implement changes. He will then conduct a review after one year to see what the effect has been. He will be working in collaboration with Professor Maureen Dollard, our recent Ferguson-Glass Orator, and is keen to have ‘buy-in’ from medical colleges.

What were some of the key messages I heard?

  • This is a national issue. Mental health should be an apolitical agenda.
  • The conversation about doctors’ mental health needs to be normalised.
  • Culture, particularly in our hospitals, needs to change. Dispense with the ‘right of passage’ mentality.
  • This is a systems issue and we should not stigmatise or imply that the individual is the problem or to blame.
  • It is OK to be not OK, we must not be afraid to ask for help.
  • We need to ask our colleagues, “Are you OK?”
  • Remove the stigma of ‘not coping’, which can occur at any time along our career path, from medical school to retirement, junior doctor or senior doctor.
  • Some high-risk groups for mental health issues are young doctors and females.
  • Changes we make now may not be perfect but we need to start somewhere, then measure the effect of that intervention, so future changes are evidence-based and so on.

Doctors have the same need and right to work in a safe and effective environment: ‘good work’. Therefore, our Faculty’s headline campaign Health Benefits of Good Work is as important for us as doctors as it is for the rest of the workforce.

When you read this eBulletin I will have attended the Health Benefits of Good Work (HBGW) Signatory Steering Group (SSG) Forum in Darwin.  

Accelerated silicosis update

The Coalition Government has pledged $5 million dollars towards setting up a national Dust Disease Taskforce, as outlined in the RACP/AFOEM/TSANZ proposal during the election campaign. There will be more news to follow on this front as it evolves.

Dr Alexandra Muthu and the NZ Committee hosted a successful forum in Wellington, held on 6 June 2019, involving multiple stakeholders who brainstormed a list of key priorities to address the matter of accelerated silicosis in New Zealand.  

Professor Malcolm Sim is undertaking a review of Occupational Lung Diseases (OLD) in Australia that has been funded by Safe Work Australia and will update a previous review on OLDs, completed by Professor Sim and Professor Michael Abramson in 2006.   

The review aims to provide an overall summary of the latest available evidence relating to the burden of OLDs in Australia, including incidence and prevalence. A section in the review will include available Australian data sources on OLDs. 

In addition to database searching for peer-reviewed literature, Professor Sim is also looking for additional unpublished/published/internal data/prevalence information on OLDs from organisations across Australia. Therefore, if anyone collects or holds any data sources related to OLDs in Australia, could you please complete this form and return to Sheikh.Alif@monash.edu by 5 July 2019. 

With kind regards,

Dr Beata M Byok 
President, AFOEM

Review of occupational lung diseases in Australia

The review has been funded by Safe Work Australia and will update a previous review on occupational lung diseases (OLDs), completed by Professor Malcolm Sim and Professor Michael Abramson in 2006. 

The review aims to provide an overall summary of the latest available evidence relating to the burden of occupational lung diseases in Australia, including incidence and prevalence. A section in the review will include available Australian data sources on OLDs. 

In addition to database searching for peer-reviewed literature, Monash University are also looking for additional unpublished/published/internal data/prevalence of OLDs from organisations across Australia. Therefore, if you hold any data sources related to OLDs in Australia, could you please complete the form and return to Sheikh.Alif@monash.edu by Monday, 8 July 2019. 

Contact: Dr Sheikh Alif, Senior Project Officer and Teaching Associate, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University.

Nominations now open for the RACP Trainee Board Director

A casual vacancy is available for the position of RACP Trainee Board Director.

The successful candidate for the Trainee Director position is appointed by the Board and will fill the position until the conclusion of the College’s Annual General Meeting in May 2020.

Visit the website for eligibility criteria and nomination details.

Nominations close on Monday, 8 July.

All eligible trainees are encouraged to nominate.

AFOEM examinations now open for applications 

Applications are now open for all eligible trainees (who have met the training program requirements) for the September and November 2019 examinations.

Upcoming 2019 AFOEM examination dates are:

  • Stage A Written Examinations – Saturday, 7 September 2019
  • Stage B Written Examinations – Saturday, 7 and Sunday, 8 September 2019
  • Stage B Practical Examinations – Saturday, 16 November 2019 (an additional date of Sunday, 17 November 2019 may be added depending on the number of eligible candidates).

Applications  will close on 5 July 2019 at 5pm (AEST). Any applications received after this closing time may not be accepted.

Remember you will need to have satisfactorily completed all requirements for the January to June 2019 training period by the relevant deadlines in order to be eligible. The Training Handbook provides more information. 

Research awards applications closing soon

If you are seeking support to undertake research, training, or develop educational initiatives, do not miss out on the different awards and grants offered by AFOEM through the RACP Foundation. Applications close soon for the following awards:

Fellows and trainees of AFOEM are also eligible to apply for Research Entry Scholarships, and applications are closing 15 July 2019.

Full details for these and other opportunities are available on the Foundation webpage

Resources to assist Fellows meet changes to the 2019 MyCPD framework

Important changes to the MyCPD framework came into effect in January 2019 that will affect all physicians. These changes are in response to requirements flagged by the Medical Board of Australia.

This update on the changes provides:

Upcoming continuing professional development (MyCPD) sessions

Two separate MyCPD information sessions in Canberra and Sydney are being held to help you understand what the changes mean for you and why we have made them. There will also be opportunities to ask any questions you may have and speak directly to a member of our CPD team. The Canberra session will be held on Wednesday, 31 July from 6pm to 7.30pm and the Sydney session will be held the following week on Thursday, 25 July from 6pm to 7.30pm. 

To find out more, visit our event pages: CanberraSydney.

The CPD team is happy to answer any questions you may have, please don’t hesitate to contact us on the details below.

Australia
Phone: 1300 697 227
Overseas: +61 2 9256 5444 
MyCPD@racp.edu.au 

New Zealand
Phone: 4 460 8122
Overseas: +64 4 460 8122 
MyCPD@racp.org.nz 

Recognising outstanding contributions and achievements

Hominum servire saluti – to serve the health of our people.

The annual awards for outstanding contributions made by members of the RACP in their respective fields are of special importance and highly valued by their recipients. Our College and the broader medical community benefit in many different ways and in recognition of this, the criteria for The John Sands Medal and The College Medal have changed to clearly define these differences.

Nominations are now open for:

  • the John Sands Medal, recognising a Fellow who makes a significant contribution to the welfare of the RACP and its members
  • the College Medal, recognising a Fellow who makes a significant contribution to medical specialist practice and improving the health of people
  • the Howard Williams Medal, recognising a Fellow who has made an outstanding contribution to improving the health of children and young people in Australia or New Zealand.

Applications for this year’s Trainee Research Awards open on 1 July 2019. The Trainee Research Awards provide a wonderful opportunity for trainees to do an oral presentation of their research at a regional event and if selected, also present at the RACP Congress 2020 in Melbourne in May.

For further details on our medals and prizes, please visit the Foundation webpage.

Come and meet your College Board on 11 July at Westmead Hospital

You are invited to join RACP President, Associate Professor Mark Lane and your RACP Board at an informal meeting where you will have the opportunity to engage in conversation and network with other Fellows and trainees.

When: Thursday, 11 July 2019 from 6.15pm to 7.15pm with refreshments being served from 5.30pm.
Where: The Green Room, Level 1 next to the Westmead Education and Conference Centre at Westmead Hospital, Corner Hawkesbury Road and Darcy Road, Westmead NSW 2145.
Spaces are limited, so please RSVP by close of business on Thursday, 4 July 2019 to events@racp.edu.au.

This is an open invitation for RACP trainees and Fellows, so please feel free to share this within your network. A summary of previous Conversations with the Board events can be found through the following links:

Regrettably the College is unable to provide support for travel and accommodation for this event.

RACP Congress 2019 session recordings

Presentation videos of selected sessions from RACP Congress 2019 are now available. You are also able to view all presentation slides. Selected sessions and slides have only been released where approval has been given by the presenters.

We are now planning for RACP Congress 2020, view the RACP Congress 2020 video. We look forward to seeing you in Melbourne on Monday, 4 May to Wednesday, 6 May 2020. 

New Pomegranate podcast episodes now available

Episode 46: The first 1000 days

This episode was recorded at the RACP Congress 2019 in Auckland. The three speakers dealt with the profound influence that the early years of life have on lifelong health, wellbeing, behaviour and socioeconomic outcomes. 

Professor Richie Poulton CNZM FRSNZ outlined the influential Dunedin Multidisciplinary Health and Development Study, which has followed over 1,037 participants since 1972. All sorts of measures have been taken throughout the participants’ lives, but Professor Poulton showed the incredible predictive power of one behavioural trait in particular: self-control. 

Paediatrician Dr Johan Morreau FRACP revealed how such associations between childhood deprivation and behavioural outcomes might be explained by developmental neuroscience, and public health physician Professor Susan Morton FAFPHM showed evidence from the Growing Up in New Zealand Study which reveals the importance of social factors in protecting against poor outcomes. 

Together, these speakers demonstrated that the consequences of childhood disadvantage are borne not just by individuals and families but by all of society. The lectures were framed by the launch of the RACP early childhood position statement titled 'The Importance of the Early Years' and another released last year on 'Inequities in Child Health'. 

Episode 47: Complex adolescent transitions

Everyone knows that adolescence is a turbulent time. Teens are faced not just with changes to their bodies, but to their moods and thought patterns as well. They might also be saying goodbye to familiar carers in the paediatric department, and in episode 11 we heard how important it is to ensure a smooth transition to adult services, which tend to be more anonymous. 

This is especially true for young people with special needs such as diabetes, transplant management or intellectual disability, though they are the least likely to receive dedicated transition support. The three speakers in this podcast explain that improving this transition process doesn’t require going way above and beyond regular practice, it just needs a little more coordination. 

Recorded at the RACP Congress 2019, Dr Fran Mouat outlined Starship’s transition program for young patients with diabetes, and some of the data showing its impact on glycaemic control after they’ve left paediatric care. 

Dr Rachael Harry leads a transition program for adolescents who’ve undergone transplants early in life. With a moving case study, she described how all the medical care in the world needs to fit in with the lifestyle that every young adult aspires to.

Finally, Dr Colette Muir, described what this period is like for adolescents with developmental disabilities. Intellectual disability is associated with a lower quality of care throughout the lifespan, often because of 'diagnostic overshadowing' – the phenomenon by which the complaints of such patients get attributed to the disability itself, rather than being investigated thoroughly in their own right. 

The RACP is a signatory to an international consensus statement called 'Equally Well', and has also published a position paper about transition of young people with chronic disability needs

Clinical documents in My Health Record explained 

The Australian Digital Health Agency will be holding a national webinar for all healthcare providers, 'Clinical documents in My Health Record explained'.

This webinar will provide insights into the types of provider clinical documents that can be found in an individual’s My Health Record, highlighting the origins and accessibility to different document types as well as clarifying common ambiguities. Areas covered include: 

  • shared health summaries vs event summaries
  • prescription and dispense records vs Pharmaceutical Benefits Scheme (PBS) medicines
  • medicines information view – pharmaceutical shared medicines list (PSML)
  • pathology and diagnostic imaging
  • specialist letters
  • eReferrals
  • Medicare documents
  • advanced care plan and advanced care document custodian.

Webinar details:  

  • date and time: 1pm to 2pm (AEST time) on Thursday, 18 July 2019
  • join via your computer – register beforehand on the event webpage, registrations close 24 hours prior to the event
  • a copy of the presentation will be made available following the event to individuals who have registered to attend the webinar.

RACP Policy & Advocacy Council communique and report 

At the College Policy & Advocacy Council meeting held in May, a bi-annual report of the College’s policy and advocacy activity was released. The meeting communique is available on the College website. 

The report contains detailed updates on policy priorities, which includes both CPAC led items and Divisions, Faculties, Chapters and regional activity.

AFOEM Regional Committee casual vacancies

There are various casual vacancies on AFOEM Regional Committees to be filled by way of expressions of interest.

New South Wales

  • one position open for Trainee Representative of AFOEM NSW Regional Committee

Queensland/Northern Territory

  • one position open for the Chair of AFOEM QLD/NT Regional Committee
  • one position open for Deputy Chair of AFOEM QLD/NT Regional Committee.

South Australia

  • one position open for Deputy Chair of AFOEM SA Regional Committee.

Victoria/Tasmania

  • one position open for Trainee Representative of AFOEM VIC/TAS Regional Committee.

Western Australia

  • one position open for Chair of AFOEM WA Regional Committee
  • one position open for AFOEM Trainee Representative of AFOEM WA Regional Committee.

Before nominating for the role, candidates must familiarise themselves with the following documents:

To nominate, submit a completed Expression of Interest Form and your resume by email to AFOEM@racp.edu.au.

Attention Queensland specialists 

The Health and Other Legislation Amendment Act 2019 was recently passed by Queensland Parliament. The Act includes changes to the  Public Health Act 2005 to provide a legislative framework for a notifiable dust lung disease register (NDLD register). These changes will commence on 1 July 2019. 

The NDLD register will ensure Queensland Health has a comprehensive register of all diagnosed cases of notifiable dust lung diseases in Queensland. 

Prescribed medical practitioners, from the following specialties or specialty fields, will be required to notify Queensland Health of diagnoses of notifiable dust lung diseases:

  • occupational and environmental medicine
  • respiratory and sleep medicine.

Notifiable diseases include the following diseases caused by occupational exposure to inorganic dust:

  • cancer
  • chronic obstructive pulmonary disease including chronic bronchitis and emphysema
  • pneumoconiosis including asbestos, coal workers’ pneumoconiosis mixed dust pneumoconiosis and silicosis.

For further information and expected updates please visit the Queensland Health website.

Be on your way sooner with Member Advantage 

Get uncompromising value and peace of mind when you purchase your next car through your benefits program. 

With access to Australia’s largest car buying service you can save up to 20 per cent off dealer prices plus other exclusive benefits including:

  • personalised service to help you choose the right car
  • delivery to your door with a full tank of fuel
  • 12 months roadside assistance.

Get an exclusive quote through your RACP Member Advantage website or call 1300 853 352 for more information.

*Terms and conditions apply.

Benzathine penicillin approved for inclusion in doctors bag

In July 2018 the RACP sent a letter to the Pharmaceutical Benefits Advisory Committee’s (PBAC) review of the ‘Doctors Bag’ recommending the addition of syphilis treatment medication benzathine penicillin to enable general practitioners and other primary care services, including Aboriginal health services, to supply and stock benzathine for syphilis treatment.  

In February 2019 the PBAC Secretariat requested further information, to support the 2018 submission. A submission was developed by the National Aboriginal Community Controlled Health Organisation (NACCHO) and the RACP’s Sexual Health in Aboriginal and Torres Strait Islander Communities Expert Reference Group (ERG) recommending including benzathine penicillin on the pharmaceutical benefits scheme prescriber bag list (‘Doctors bag’).
 
The Pharmaceutical Benefits Advisory Committee accepted the recommendation, and this is an important step in increasing syphilis treatment availability to address the syphilis epidemic in Queensland, Northern Territory, Western Australia and South Australia. 

Benzathine penicillin in the Doctors Bag will be specifically useful for:

  • non-remote Aboriginal medical service, high caseload urban general practitioners to stock benzathine
  • any general practitioners calling a sexual health clinic for advice can be advised that they can order the treatment in for free before the patient arrives to reduce delays to treatment initiation and loss to follow-up.

Expression of Interest  

Check the Expressions of Interest page at any time, to find out if there are any opportunities that are of benefit to you. 

Conferences and events

The Royal Australasian College of Physicians publishes notices of events and courses as a service to members. Such publication does not constitute endorsement or mandating of any such events or courses. 

ANZSOM VIC/TAS branch educational meeting and Annual General Meeting, 17 July, Melbourne
ANZSOM SA/NT branch educational meeting, 17 July, Melbourne
Joint WA ANZSOM and WA AFOEM branch meeting, 6 August, Perth
The Medico-Legal Society of Queensland's 2019 Annual Conference, 16 to 17 August 2019, Surfers Paradise
ANZSOM NSW/ACT branch weekend meeting, 24 August, Orange
ANZCA 2019 Medical Education Special Interest Group meeting, 20 September, Sydney
ANZSOM Annual Scientific Meeting – 'Making it work: Practical solutions in occupational health', 27 to 30 October 3019, Adelaide
ANZCA 2019 Rural Special Interest Group meeting, 2 to 4 November, Ballarat

Go to the events list at any time to see what other events are coming up.

Career opportunities

View all positions vacant

AFOEM contact details

AFOEM Faculty enquiries (including Council and committees):
Lucie Perrissel-Taggart, AFOEM Executive Officer
Phone: +61 2 8076 6351
Email: afoem@racp.edu.au

AFOEM Health Benefits of Good Work (HBGW) enquiries:
Email: HBGW@racp.edu.au

AFOEM Education and Training enquiries:
Email: occenvmed@racp.edu.au

AFOEM Examination enquiries:
Examination Coordinator, Assessment and Selection Unit
Email: examinations@racp.edu.au

AFOEM training site accreditation inquiries:
Site Accreditation Unit
Email: accreditation@racp.edu.au

AFOEM CPD enquiries:
Email: mycpd@racp.edu.au
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