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A NSW Order 43 medical is an occupational examination required for all NSW coal mine workers.

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The Order 43 forms part of the NSW Coal Mining Health and Safety Scheme; a scheme managed by Coal Services. The workers health scheme protects the health and safety of New South Wales coal miners by providing mandatory periodic health assessments.

Order 43 replaced Order 41 on 1 July 2018, with the new order building upon existing processes to protect employee health.

What is Assessed in an Order 43 Medical?

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

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What is a Section D?

Once the medical has been completed by an approved medical doctor, the assessing doctor completes a summary report, or “Section D”. The Section D is the only information an employer receives, unless an Authority to Release form is signed by the worker. The confidentiality of the information contained within the medical is protected by law. The full medical results are then submitted to Coal Services. Should you require all sections of an order 43 medical please inform KINNECT at the time of engagement.

When should an Order 43 be completed?


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 years from the coal worker’s pre-placement medical assessment
Exit 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 health conditions 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.

Coal Workers’ Pneumoconiosis (CWP) is a chronic occupational coal mine dust 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.

What is a respirator fit test?

A respirator fit test ensures that a respirator properly fits the face of a worker. Respirator fit testing is a mandatory component of an Order 43 Medical. 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 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.

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