The future burden of silicosis and lung cancer among tunnel construction workers in Queensland.

Exposure to respirable crystalline silica (RCS) is known to increase the risk of the development of silicosis, in addition to lung cancer and other diseases. While much evidence of the link between underground tunnel construction and the resultant development of silicosis exists, limited information is available on the levels of occupational exposure to RCS or the prevalence of RCS-related disease in tunnelling in Australia. Publicly available RCS exposure data were sourced from the construction of 3 major Queensland tunnelling projects between 2007 and 2013. Statistical evaluation was performed to estimate RCS exposure, and together with estimates of workforce size and risk estimates, the future excess number of silicosis and lung cancer in that tunnelling workforce were estimated. In a cohort of around 2,000 workers who serviced the Queensland tunnel projects, it was estimated that between 20 and 30 cases of lung cancer and between 200 and 300 cases of silicosis would develop over their lifetime as a result of exposure to RCS. This paper highlights the likely future burden of disease, the need for case-finding and better control measures to reduce RCS exposure in this high-risk cohort.