With the recent resurgence of "black lung" detection in the Australian Coal Mining Industry, the spotlight has fallen onto the management of the health aspects of health and safety. Too often health is seen as being hard to manage because it may relate to chronic and/or extended exposure to harm. However proper application of risk management techniques including focussing on critical controls and the continued effectiveness of these controls works as well on occupational health issues as it does on safety issues. This paper will demonstrate that risk management can be successfully applied to health issues including respirable dust, fatigue and psychological impairment. The resurgence of 'black lung" will be used as a case study to underline the need to identify critical controls and institute processes to measure and maintain their effectiveness and not allow them to be eroded.