Silica health monitoring usually involves a medical and work history, a respiratory questionnaire, a lung function test (spirometry) and chest imaging. A baseline assessment is done before or soon after a worker starts silica work. The supervising doctor then sets how often each part is repeated, based on the worker’s level and type of exposure. Many programs repeat the medical assessment and spirometry every year, with chest imaging at longer intervals.
This guide explains what silica health monitoring involves, who it is for, how often it is typically carried out, how chest imaging requirements differ between states and how monitoring fits into an employer’s workplace health and safety obligations.
What is silica health monitoring?
Crystalline silica is found in materials such as concrete, bricks, sandstone, granite and some manufactured products. When these materials are cut, drilled, ground, polished or otherwise disturbed, fine respirable crystalline silica dust can be released and breathed deep into the lungs.
Health monitoring (also called health surveillance) is a structured program of medical checks for workers exposed to this dust. Its purpose is to identify early changes in a worker’s lung health, so that exposure can be reviewed and further assessment arranged before longer-term problems develop. Silica-related lung disease can develop slowly and may not cause symptoms in its early stages, which is why regular checks matter. Health monitoring sits alongside, not in place of, dust controls such as wet cutting, local exhaust ventilation, respiratory protection and safe work practices.
Who may need silica health monitoring?
Health monitoring may be appropriate for workers who regularly carry out tasks that generate silica dust, including in:
- Construction, demolition and renovation
- Tunnelling and civil infrastructure
- Mining and quarrying
- Stone processing and monumental masonry
- Manufacturing, including brick, tile, glass and ceramics
- Foundries and abrasive blasting
Whether monitoring is needed for a particular role depends on how often the work is done, the material involved, the controls in place and air monitoring results. A health monitoring doctor can help an employer assess this. You can read more about the risks in our article on the health risks of silica exposure.
What does silica health monitoring involve?
Under the model WHS Regulations, the minimum requirements for silica health monitoring are:
- A demographic, medical and occupational history
- Records of the worker’s personal exposure to silica
- A standardised respiratory questionnaire covering symptoms such as cough and breathlessness
- Standardised lung function tests (spirometry) to measure how well the lungs are working and to compare results over time
- A chest X-ray (full posterior-anterior view), read by a radiologist who meets RANZCR reporting requirements or is a qualified B reader, or a low-dose CT scan where required or recommended
Depending on the worker’s history and exposure, the doctor may also carry out a physical examination or recommend further tests with a specialist. The doctor reviews all of the results together and compares them with any earlier results. Through our silica health surveillance medicals, Employees Health can carry out the medical assessment and spirometry onsite or at our clinics, and coordinate imaging, including through our mobile X-ray service.
Chest X-ray or low-dose CT scan?
Chest X-rays have long been the standard imaging test for silica-exposed workers. A low-dose high-resolution CT (HRCT) scan is more sensitive and can pick up early changes in the lungs that an X-ray may miss.
Requirements differ between states. Western Australia has legislated low-dose HRCT as the screening test for silica health monitoring in place of chest X-rays. Elsewhere, national guidance allows the supervising doctor to consider low-dose HRCT depending on the worker’s exposure history and silica levels. Because these rules continue to change, employers should check the current requirements of their state regulator.
How often is silica health monitoring carried out?
A typical program includes:
- Baseline assessment: before the worker starts silica work, or as soon as possible after, to give a starting point for later comparisons
- Periodic assessments: the medical assessment and spirometry are commonly repeated every year
- Chest imaging: repeated at intervals set by the doctor, generally more often for workers with higher or longer exposure
The supervising doctor should be given air monitoring results and details of the worker’s tasks, as these help determine the right frequency. As an example of how strict requirements can be, WorkSafe WA guidance for engineered stone workers recommends annual monitoring and spirometry, with a low-dose CT scan every 2 years once a worker has 2 or more years of significant exposure.
What about engineered stone?
Since 1 July 2024, the manufacture, supply, processing and installation of engineered stone benchtops, panels and slabs has been banned in Australia. Health monitoring remains important, because silica is present in many natural materials, work such as removing, repairing or disposing of existing engineered stone continues under strict controls, and workers with past engineered stone exposure may still be at risk of developing silica-related disease.
What happens after an assessment?
If results are stable, the worker continues on their monitoring schedule. If the doctor sees a change, such as new respiratory symptoms, a drop in lung function or a change on imaging, they may recommend further tests, a shorter interval before the next check or referral to the worker’s GP or a respiratory specialist. Findings like these are also a prompt for the employer to review dust controls, respiratory protection and work practices.
Health monitoring reports and record keeping
After each round of monitoring, the employer receives a health monitoring report for each worker. The report sets out whether any adverse health effects were identified and whether the doctor recommends any changes to controls, while the worker’s detailed medical information stays confidential between the worker and the clinicians.
Under the model WHS Regulations, employers must give each worker a copy of their report and keep health monitoring reports as confidential records for at least 30 years. In some cases, such as where a report identifies an adverse effect or recommends remedial measures, a copy must also be provided to the state regulator.
Supporting your workplace health and safety obligations
Under workplace health and safety laws, a person conducting a business or undertaking (PCBU) has obligations to manage risks from respirable crystalline silica, including keeping exposure as low as reasonably practicable and providing health monitoring where it is required. Requirements can vary between states and territories, so employers should check the guidance from their state regulator. Our overview of health monitoring requirements explains the general rules for hazardous chemicals, silica and asbestos.
Employees Health supports employers by:
- Helping assess which workers may need monitoring
- Scheduling baseline and periodic assessments around your operations
- Delivering assessments onsite, at our clinics or at regional sites
- Coordinating chest imaging in line with state requirements
- Providing health monitoring reports, with individual medical information kept confidential
- Coordinating follow-up where a doctor recommends further assessment
Get a free quote
If your workers cut, drill, grind or handle silica-containing materials, we can help you set up a monitoring program that suits your team and locations. Call 1300 880 804, email our team or send us an enquiry.
Frequently Asked Questions
What are the health monitoring requirements for silica exposure in NSW?
NSW follows the model WHS Regulations. Where there is a significant risk to a worker’s health from silica, the employer must provide health monitoring that includes a demographic, medical and occupational history, records of personal exposure, a standardised respiratory questionnaire, lung function tests and a chest X-ray. The supervising doctor may also use a low-dose CT scan depending on the worker’s exposure.
How do you get tested for silica?
There is no simple blood test for silica. Silica-related lung disease is detected through health monitoring, which combines a medical and work history, a respiratory questionnaire, lung function testing (spirometry) and chest imaging, either a chest X-ray or a low-dose CT scan, reviewed by a doctor.
How do you know if you’ve been exposed to silica?
Exposure is most likely if you cut, drill, grind, polish or sandblast materials such as concrete, brick, stone or tiles, especially without water suppression, extraction or respiratory protection. Silicosis often has no symptoms in its early stages, which is why regular health monitoring and air monitoring are important for exposed workers.
How long does silica stay in the lungs?
Respirable crystalline silica particles that reach deep into the lungs are not easily cleared and can remain there long-term, continuing to cause inflammation and scarring. This is why silicosis can develop or get worse years after exposure has stopped.
Can you get silicosis from one day of exposure?
Silicosis usually develops after months or years of exposure. However, very high exposure over a relatively short period, from weeks to a few years, can cause accelerated or acute silicosis, so even short periods of uncontrolled dust exposure should be avoided.
What is the mandatory limit for silica exposure in Australia?
The workplace exposure standard for respirable crystalline silica is 0.05 mg/m³ averaged over an eight-hour working day. Employers must make sure workers are not exposed above this level and should keep exposure as low as reasonably practicable.
Is silica just as bad as asbestos?
Both are serious workplace hazards. Respirable crystalline silica and asbestos are both classified as known human carcinogens and can cause permanent, irreversible lung disease. They cause different conditions, silicosis for silica and asbestosis or mesothelioma for asbestos, but both require strict exposure controls and health monitoring.
How often should silica health monitoring be done?
Monitoring starts with a baseline assessment before the worker begins silica work. Safe Work Australia’s guide recommends spirometry every year and a chest X-ray every five years for the first 20 years of work, with more frequent imaging for higher or longer exposure. In Western Australia, a low-dose CT scan is required instead of an X-ray.