Emergency services are responding to a truck and car collision at the bottom of Macquarie Pass, on the Illawarra Highway, just before midday.
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Fire and Rescue NSW, police and paramedics are attending the crash, with early reports indicating the truck went into a tree some distance from the crash site.
A car involved in the crash has flipped on its roof.
Paramedics are treating two patients on the scene, and both will be transported to Wollongong Hospital.
Traffic is affected in both directions, on the Illawarra Highway at Tongarra Lane, and drivers are advised to exercise caution.