The New NSW Order 43 Medical For The Coal Mining Industry

On the first of July 2018, NSW Order 41 has been replaced by the more comprehensive Order 43.

Order 43 is a scheme that protects the safety and health of coal miners of New South Wales by offering mandatory periodic health tests and assessments.

Order 41 VS. Order 43: What’s The Difference?

The NSW Order 43 Medical is more comprehensive than the previous Order 41 and comes with additional tests, assessments, and requirements. These include:

  • Increased chest x-rays test to every 3 years for underground and open-cut coal mine workers as well as those with a dust exposure history
  • Mandatoryrespirator fit testing
  • Reporting standards formalization
  • A completed Employer Role Requirement Form before the assessment
  • An appropriately and approved qualified occupational physician or medical practitioners and registered nurse should perform the assessment

Primary Components of NSW Order 43 Medical

  1. Order 43 Medical

This include:

  • Vision Test
  • Medical History Questionnaires
  • Urinalysis
  • Spirometry Test
  • Respiratory questionnaires
  • Hearing test
  • Skin examination
  • Musculoskeletal system assessment
  • Abdomen assessment
  • Cardiovascular system assessment
  • Auditory canal assessment
  1. ILO Standard Chest X-Ray


Required for all workers entering the NSW mining industry. For the existing coal mining workers who are changing jobs or roles, a chest x-ray is not necessary as long as they can provide an ILO standard chest x-rays not over 3 years old.


  • Open cut workers involved in the processing, production or maintaining coal needs to undergo a chest x-ray every 3 years or at the recommendation in their last medical assessment.
  • Underground coal workers should undergo chest X-ray every 3 years or shorter if recommended in their last medical.
  • Workers with dust exposure history need to undergo a chest x-ray every 3 years.
  • Other coal industry workers should undergo a chest x-ray every 6 years.
  1. Respirator Fit Testing

A respirator fit testing ensures that a respirator fits the face of a worker properly. A mandatory component of the NSW Order 43 medical, the testing is conducted in accordance with the Australian Standards Selection use and maintenance of respiratory protective equipment.

There are 2 types of respirator fit testing Perth medical companies offer— quantitative and qualitative. The quantitative kind is the required method for Order 43 medicals.

This is a process of measuring the leakage around the respirator’s face seal and providing a numerical value known as the fit factor. This factor should provide indications as to whether the respirator offers enough protection for the worker.

What Is An Occupational Physician And Why They Are Required For An Order 43 Medical?

Occupations physicians are specialized medical practitioners in the identification of specific risks for worker’s health and safety. So, it makes sense that they are the ones required to perform the Order 43 medical.

They have proper qualifications including:

  • Spirometry interpretation course completion
  • Registered in the Medical Board of Australia
  • Has Annual Calibration Statements to Coal Services
  • Listed on the Registered of Approved Medical Practitioners on the Coal Services site
  • Completed NSW Coal Industry Medical Induction Program

To find out more about the Order 43 medical, its qualifications and injury classifications, visit