The move from prescriptive to ‘duty of care’ style legislation will move the coal industry towards the world of litigation and soaring insurance premiums. Evidence from Queensland suggests that coal miners’ injuries are a $4million Workers Compensation cost but the personal cost to miners, their families and community is well over $43 million per year. Under ‘duty of care’ there is a high risk that much of this cost plus legal expenses could be transferred back to the employers through litigation and increasing insurance premiums. The sustainability of the industry may come under threat. While ‘fitness for duty’ assessments are a key part of all well managed health surveillance programs, ‘duty of care’ style legislation dictates that employers must implement safety management systems for hazardous exposures. This may include long-term assessment and management of the risks of hazardous exposures in the occupational environment. An analysis is undertaken to identify issues of trigger levels for health interventions. Parameters such as health condition, change in heath status and cumulative occupational exposure may be used as triggers that initiate health interventions prior to unacceptable or compensatable harm being suffered. It is argued this and nothing less will effectively meet the employer’s obligation under legislation.