March 23, 2026 - A new research project is investigating whether advanced lung function tests could improve early detection of respiratory disease in coal mine workers, helping protect thousands of miners exposed to harmful dusts on the job.

The three-year study, funded by the Coal Services Health and Safety Trust, brings together researchers from the Hunter Medical Research Institute, University of Newcastle, University of New South Wales, University of Sydney, and the Woolcock Institute. Workplace medical provider Happy Health, and Coal Services Health are supporting the project by facilitating the testing.

Co-leading the research are University of Newcastle’s Professor Jay Horvat from HMRI’s Immune Health Research Program, and University of NSW’s Professor W. Alexander Donald.

“We’re investigating whether new and advanced lung function tests can be integrated into the mandatory Order 45 medical assessments for New South Wales coal workers,” Professor Horvat said.

“The current standard relies primarily on spirometry, a test that measures exhaled air volume and speed. While spirometry has been the go-to diagnostic tool since the 1970s, we believe it may lack the sensitivity needed to catch early signs of disease caused by coal dust, silica, or diesel exposure.”

Study researcher Dr Jemma Mayall from the University of Newcastle and HMRI said newer technologies could help detect changes in the lungs long before symptoms appear.

“These workers currently perform spirometry, which is quite an old test. There’s been developments for other respiratory diseases and newer tests that we want to implement in these medicals to detect disease before it develops,” Dr Mayall said.

One of the methods being trialled is the Forced Oscillation Technique (FoT), which uses gentle pressure waves to detect resistance and elasticity in the lungs. It can help identify structural abnormalities or changes in lung function that may not show up in standard tests.

“It’s able to detect structural changes to the lungs or changes to the physical properties of the lungs and where in the lungs those are happening,” she said.

Another test, known as Fractional Exhaled Nitric Oxide testing (FeNO), measures the amount of nitric oxide in exhaled breath. Because nitric oxide is produced during inflammation, elevated levels may indicate early stages of inflammatory conditions such as asthma or chronic bronchitis.

The study is also investigating the use of breath analysis through mass spectrometry. Participants provide a breath sample, which is analysed for volatile organic compounds. These are tiny chemical markers that may indicate the presence of lung disease or environmental exposure. The researchers then use machine learning to mine the data and identify patterns.

“With enough participants, we should be able to identify new biomarkers that we can use to develop a new test to diagnose disease in people in the coal industry,” Dr Mayall said.

Currently testing the FoT and FeNO tests at Happy Health Warners Bay, workers attending either Happy Health or Coal Service Health Speers Point could contribute to the breath analysis. The breath analysis is likened to blowing up a balloon – using that left over air in the lungs after a regular breath to blow into a plastic bag, and can take as little as 15 minutes to add on to the medical appointments.

Happy Health’s Mining and Education Lead, Tom Sonntag, said the study offers an opportunity to find more accurate, less strenuous ways to assess respiratory health.

“Adding in new tests and then finding out if they’re actually clinically valuable is one of the big reasons why we want to partake in this study,” Mr Sonntag said.

As a provider of Order 45 medicals, Happy Health’s role is to help ensure the tests can be realistically implemented in clinical practice.

“They’re the boots on the ground, the people that are actually running the medicals for people in the coal industry,” Dr Mayall said. “It’s important to us that these tests are able to be implemented in a realistic scenario.”

The research team hopes that more sensitive and less invasive testing will allow earlier diagnosis of diseases such as Chronic Obstructive Pulmonary Disease (COPD), silicosis and pneumoconiosis. Dr Mayall said early intervention could prevent permanent damage to lung tissue.

“These diseases can be quite devastating and can result in people requiring lung transplants, people developing cancer or COPD,” she said. “We want to improve our detection of disease early so measures can be implemented to avoid these permanent changes.”

Participating in this research, contributing anonymous and confidential research data, will help researchers explore if these tests are effective. These findings could lead to updates to the Order 45 framework that make testing quicker and easier for workers, and provide long-term improvements to respiratory health monitoring in the coal industry.