Statement of Principles concerning chronic lymphoid leukaemia No. 9 of 2005 (Cth)
Statement of Principles
concerning
CHRONIC LYMPHOID LEUKAEMIA
Instrument No. 9 of 2005 as amended
made under section 196B(2) of the
Veterans’ Entitlements Act 1986
This compilation was prepared on 4 April 2014 taking into account Amendment of Statement of Principles concerning CHRONIC LYMPHOID LEUKAEMIA (Instrument No. 28 of 2014)
Prepared by the Repatriation Medical Authority Secretariat, Brisbane
Statement of Principles
concerning
CHRONIC LYMPHOID LEUKAEMIA
No. 9 of 2005
for the purposes of the
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
The Repatriation Medical Authority under subsection 196B(2) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a) revokes Instrument No. 67 of 2001, as amended by No. 59 of 2003; and
(b) determines in their place the following Statement of Principles.
Kind of injury, disease or death
(a) This Statement of Principles is about chronic lymphoid leukaemia and death from chronic lymphoid leukaemia.
(b)For the purposes of this Statement of Principles, “chronic lymphoid leukaemia” means an indolent malignant neoplasm of B-lymphocytes or T-lymphocytes, characterised by proliferation and accumulation of morphologically mature-appearing but biologically immature lymphocytes in the blood, bone marrow and lymphoid tissue. This definition includes hairy cell leukaemia, adult T-cell leukaemia and chronic lymphocytic leukaemia, but excludes myeloma, Hodgkin’s lymphoma, and all forms of non-Hodgkin’s lymphoma including small lymphocytic lymphoma.
(c)chronic lymphoid leukaemia attracts ICD-10-AM code C91.1, C91.3, C91.4 or C91.5.
(d)In the application of this Statement of Principles, the definition of “chronic lymphoid leukaemia” is that given at paragraph 2(b) above.
Basis for determining the factors
The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that chronic lymphoid leukaemia and death from chronic lymphoid leukaemia can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA).
Factors that must be related to service
Subject to clause 6, at least one of the factors set out in clause 5 must be related to the relevant service rendered by the person.
Factors
The factor that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting chronic lymphoid leukaemia or death from chronic lymphoid leukaemia with the circumstances of a person’s relevant service is:
(a)for adult T-cell chronic lymphoid leukaemia only, being infected by the HTLV-1 virus before the clinical onset of chronic lymphoid leukaemia; or
(aa) being exposed to non-ionising radiation as specified before the clinical onset of chronic lymphoid leukaemia, where this dose was accumulated at least ten years before the clinical onset of chronic lymphoid leukaemia; or
(ab) being exposed to benzene:
(i)for a cumulative total of at least 2 500 hours within a continuous period of ten years before the clinical onset of chronic lymphoid leukaemia; and
(ii)where the first exposure in that period occurred at least five years before the clinical onset of chronic lymphoid leukaemia; and
(iii)where the last exposure in that period occurred within the 25 years before the clinical onset of chronic lymphoid leukaemia; or
(ac) inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD), for a cumulative period of at least 1 000 hours, within a consecutive period of ten years before the clinical onset of chronic lymphoid leukaemia, where the first exposure occurred at least five years before the clinical onset of chronic lymphoid leukaemia; or
(ad) being on board a vessel and consuming potable water supplied on that vessel, for a cumulative period of at least 30 days, when the water supply had been produced by evaporative distillation of water that has been contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD), at least five years before the clinical onset of chronic lymphocytic leukaemia; or
(ae) inhaling, ingesting or having cutaneous contact with a pesticide, for a cumulative period of at least 10 000 hours, within a consecutive period of ten years before the clinical onset of chronic lymphoid leukaemia, where the first exposure occurred at least five years before the clinical onset of chronic lymphoid leukaemia; or
(af) inhaling respirable asbestos fibres in an enclosed space:
(i)for a cumulative period of at least 2 000 hours before the clinical onset of chronic lymphoid leukaemia; and
(ii)at the time material containing respirable asbestos fibres was being applied, removed, dislodged, cut or drilled; and
(iii)the first inhalation of respirable asbestos fibres commenced at least five years before the clinical onset of chronic lymphoid leukaemia; or
(ag) inhaling respirable asbestos fibres in an open environment:
(iv)for a cumulative period of at least 6 000 hours before the clinical onset of chronic lymphoid leukaemia; and
(v)at the time material containing respirable asbestos fibres was being applied, removed, dislodged, cut or drilled; and
(vi)the first inhalation of respirable asbestos fibres commenced at least five years before the clinical onset of chronic lymphoid leukaemia; or
(b)inability to obtain appropriate clinical management for chronic lymphoid leukaemia.
Factors that apply only to material contribution or aggravation
Paragraph 5(b) applies only to material contribution to, or aggravation of, chronic lymphoid leukaemia where the person’s chronic lymphoid leukaemia was suffered or contracted before or during (but not arising out of) the person’s relevant service.
Inclusion of Statements of Principles
In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles.
Other definitions
For the purposes of this Statement of Principles:
"a pesticide" means a chemical or biological agent used to prevent, destroy or mitigate any unwanted plant, insect, animal, fungus, nematode or other pest;
"adult T-cell chronic lymphoid leukaemia" means mature T-cell chronic or smouldering leukaemia, consisting of a monoclonal proliferation of CD4+ post-thymic T-cells with clonal proviral integrations and clonal T-cell receptor gene rearrangements, and which presents with a leukaemic or disseminated clinical picture;
"being exposed to benzene" means:
(a)having cutaneous contact with liquids containing benzene greater than 5% by volume;
(b)ingesting liquids containing benzene greater than 5% by volume; or
(c)inhaling benzene vapour where such exposure occurs at an ambient 8-hour time-weighted average benzene concentration exceeding five parts per million;
"being exposed to non-ionising radiation as specified" means receiving greater than 250 microTesla (μT)-years of exposure to magnetic fields generated at extremely low frequencies;
"being infected by the HTLV-1 virus" means serological evidence of infection with the retro virus human T-cell lymphotrophic virus Type 1;
"death from chronic lymphoid leukaemia" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s chronic lymphoid leukaemia;
"8-hour time-weighted average (TWA)" means the averaging of different exposure levels to benzene during an average exposure period equivalent to eight hours;
"ICD-10-AM code" means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM), Fourth Edition, effective date of 1 July 2004, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 594 1;
"inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD)" means:
(a) decanting or spraying;
(b) cleaning or maintaining equipment used to apply;
(c) being sprayed with;
(d) handling or sawing timber treated with;
(e) being in an environment shrouded in dust from timber treated with; or
(f) using cutting oils contaminated with;
one of the following chemicals:
(i)2,4,5-trichlorophenoxyacetic acid;
(ii)2,4,5-trichlorophenoxypropionic acid;
(iii)2,4,5-trichlorophenol;
(iv)2-(2,4,5-trichlorophenoxy)-ethyl 2,2-dichloropropionate;
(v)o,o-dimethyl-o-(2,4,5-trichlorophenyl)-phosphorothioate;
(vi)pentachlorophenol;
(vii)2,3,4,6-tetrachlorophenol;
(viii)2,4,6-trichlorophenol;
(ix)1,3,4-trichloro-2-(4-nitrophenoxy)benzene;
(x)2,4-dichloro-1-(4-nitrophenoxy)benzene; or
(xi)2,4-dichloro-1-(3-methoxy-4-nitrophenoxy)-benzene;
"magnetic fields generated at extremely low frequencies" means technologically generated magnetic fields at frequencies in the range of 50 to 60 hertz (Hz);
"microTesla (μT)-years" means a calculation of cumulative exposure to extremely low frequency magnetic fields, where one microTesla-year equals the exposure occasioned by being subject to a magnetic field of mean flux density of one microTesla for a continuous period of one calendar year, or 8 760 hours, or an equivalent dose;
"potable water" means water used for drinking water, food preparation or beverage production;
"relevant service" means:
(a) operational service under the VEA; or
(b) peacekeeping service under the VEA; or
(c)hazardous service under the VEA; or
(d)warlike service under the MRCA; or
(e)non-warlike service under the MRCA;
"terminal event" means the proximate or ultimate cause of death and includes:
(a) pneumonia;
(b) respiratory failure;
(c) cardiac arrest;
(d) circulatory failure; or
(e) cessation of brain function.
Application
This Instrument applies to all matters to which section 120A of the VEA or section 338 of the MRCA applies.
Date of effect
This Instrument takes effect from 9 March 2005.
Notes to Statement of Principles concerning chronic lymphoid leukaemia (Instrument No. 9 of 2005)
The Statement of Principles concerning chronic lymphoid leukaemia (Instrument No. 9 of 2005) in force under section 196B(2) of the Veterans’ Entitlements Act 1986, as shown in this compilation is amended as indicated in the Tables below.
Table of Instruments
| Title | Date of FRLI registration | Date of | Application, saving or |
| Statement of Principles concerning chronic lymphoid leukaemia (Instrument No. 9 of 2005) | 3 March 2005 F2005L00410 | 9 March 2005 | |
| Amendment Statement of Principles concerning chronic lymphoid leukaemia (Instrument No. 28 of 2014) | 19 March 2014 F2014L00303 | 26 November 2013 |
Table of Amendments
| ad. = added or inserted am. = amended rep. = repealed rs. = repealed and substituted | |
| Provision affected | How affected |
| Clause 5 (aa) – 'being exposed to non-ionising..' | ad. Instrument No. 28 of 2014 |
| Clause 5 (ab) – 'being exposed to benzene…....' | ad. Instrument No. 28 of 2014 |
| Clause 5 (ac) – 'inhaling, ingesting………………....' | ad. Instrument No. 28 of 2014 |
| Clause 5 (ad) – 'being on board a vessel…………..' | ad. Instrument No. 28 of 2014 |
| Clause 5 (ae) – 'inhaling, ingesting………………....' | ad. Instrument No. 28 of 2014 |
| Clause 5 (af) – 'inhaling respirable asbestos….....' | ad. Instrument No. 28 of 2014 |
| Clause 5 (ag) – 'inhaling repirable asbestos..…....' | ad. Instrument No. 28 of 2014 |
| Clause 8 – '"a pesticide"…' | ad. Instrument No. 28 of 2014 |
| Clause 8 – '"being exposed to benzene"……………...' | ad. Instrument No. 28 of 2014 |
| Clause 8 – '"being exposed to non-ionising…………' | ad. Instrument No. 28 of 2014 |
| Clause 8 – '"8-hour time-weighted…………………' | ad. Instrument No. 28 of 2014 |
| Clause 8 – '"inhaling, ingesting…………………' | ad. Instrument No. 28 of 2014 |
| Clause 8 – '"magnetic fields……...………………' | ad. Instrument No. 28 of 2014 |
| Clause 8 – '"microTelsa..…' | ad. Instrument No. 28 of 2014 |
| Clause 8 – '"potable water"…………………….' | ad. Instrument No. 28 of 2014 |
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