Construction is a priority industry for work health and safety, with controlling exposures to disease-causing hazards identified as an area requiring improvement. In comparison to the general construction industry, however, tunnel construction workers have an increased risk of developing silicosis, chronic obstructive pulmonary disease (COPD), adverse respiratory symptoms, double the rate of lung function decline than heavy smokers, asthma, general airflow limitation, and lung cancer, and thus represent a high-risk work group. 

Australian tunnelling has reached a new chapter, planning to tunnel further in the next seven years than we have in more than the past two decades. Tunnel construction represents a vital part of building Australia's necessary infrastructure and services and is complimented by world-class feats of engineering. However, the delivery of such world class infrastructure should not be at the expense of the health of thousands of workers who will support these great projects. 

This Fellowship highlights international best practice in illness and disease prevention from the UK, USA, Norway,and Switzerland. Drawing from existing best practice frameworks, eight elements were reviewed in depth to understand international approaches, which included Leadership, Engagement and Collaboration, Training and Awareness, Standards, Health in Design, Program Health Risk Management, Targeted Health Risk Management, and Sustainability.