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A NSW Order 43 Coal Mine Workers Medical is a standard occupational medical examination required for all Coal Mine workers currently working in New South Wales.

The Order 43 Medical forms are part of the NSW Coal Mining Health and Safety Scheme; a scheme managed by Coal Services. The scheme protects the health and safety of New South Wales Coal Mine workers by ensuring they undergo periodic health assessments.




You log your referral online via Carelever.




Carelever will request Section A details.




Applicant instantly contacted via text message, requesting their availability, previous work in the NSW Coal industry and the current brand and model of their respirator (if currently employed)



Appointment Scheduled

Once applicant confirms their location and availability an appointment will be booked within 8 business hours. This appointment is booked with an Coal Services Approved Medical Provider. An ILO Chest X-ray and Respirator Fit Test is also scheduled with a provider.



Appointment Reminder

Applicant receives appointment time reminder via text message 24 hours prior to their appointment.




Order 43, Chest X-ray and Respirator Fit Test assessments takes place.




Chest X-ray results can take up to 72 hours to be received. Once received the Order 43 Medical, Chest X-ray and Respirator Fit test results are reviewed by the CS Health medical provider for Section D sign off. Results are sent and can also be accessed in Carelever.



Upload of Complete Results

The Approved Medical Provider will upload the complete results into the Coal Services Health portal as per legislative requirement.

A NSW Order 43 Medical consists of 3 primary components:

Order 43 Medical

  • Medical History Questionnaire
  • Vision Test
  • Spirometry Test
  • Respiratory Questionnaire
  • Urinalysis
  • Hearing Test
  • Auditory Canal Examination
  • Cardiovascular System Examination
  • Musculoskeletal System Examination
  • Abdomen Examination
  • Skin Examination

Chest x-ray (ILO Standard)

Respirator Fit Test

Once the Order 43 Medical has been completed by an approved Medical Doctor, the assessing doctor completes a summary report called a “Section D”.

The Section D of the Order 43 Medical is the only information from the Order 43 Medical that the employer is privy to, unless an Authority to Release form is signed by the worker releasing sections A to C of the Order 43 Medical.

The medical results and information contained within the Order 43 Medical are submitted to Coal Services. The confidentiality of the information contained within the Order 43 Medical is protected by law and the results of a Order 43 Medical can only be released to the worker or a representative, appointed in writing, by the worker.

Should you require all sections of an order 43 medical be released please inform KINNECT at the time of engagement to ensure that an Authority to Release form can be included.


Order 43 requires that coal mine workers complete their pre-placement medical assessment prior to commencing work in a coal operation.
Every coal worker must undertake the periodic medical assessment:

  • every three (3) years from the coal worker’s pre-placement medical assessment carried out under the Order, or not more than three (3) years from when they commenced work, whichever is earlier; and
  • no more than every three (3) years after that.

Exit Order 43 Medicals

Employers must ensure that an exit medical assessment is offered to each worker who is retiring or otherwise ceasing work. This is to ensure that any conditions that may impact on the worker’s health in retirement are identified and an appropriate course of action is implemented.

What is Coal Mine Workers’ Pneumoconiosis

Pneumoconiosis is a series of diseases caused by the inhalation of organic or inorganic dusts or chemical irritants. Typically the disease occurs from exposure over a prolonged period of time. The type and severity of the disease depends on the composition of the dust; small quantities of some substances, notably silica and asbestos, produce grave reaction, while milder irritants produce symptoms of lung disease only with massive exposure.

Coal Workers’ Pneumoconiosis (CWP) is a chronic occupational lung disease caused by long-term inhalation of coal dust. CWP causes inflammation of the alveoli. Alveoli are tiny sacs within our lungs that allow oxygen and carbon dioxide to move between the lungs and bloodstream. Inflammation of the alveoli will eventually result in irreversible damage to the lungs. CWP ranges in severity from simple to advanced; the most severe form is progressive massive fibrosis (PMF). Advanced CWP is debilitating and often fatal.

A respirator fit test is exactly as the title refers to, that being a test to ensure that a respirator properly fits the face of a worker. Respirator fit testing is a mandatory component of an Order 43 Medical, in addition to being a requirement for many sites and industries across Australia.

Testing is conducted in accordance to Australian Standards AS/NZ 1715:2009 Selection use and maintenance of respiratory protective equipment.

There are two types of respirator fit testing, Qualitative and Quantitative. Quantitative is the required method used for Order 43 Medicals. It involves an instrument called a portacount, measuring the leakage around the face seal of the respirator and providing a numerical value called a fit factor. This fit factor provides an indication as to whether the chosen respirator provides adequate protection for the individual.

Need More Information?

Contact KINNECT to discuss our NSW Order 43 Medical Services further.

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