Statement of Principles concerning malignant neoplasm of the lip epithelium No. 41 of 2001 (Cth)
Statement of Principles
concerning
MALIGNANT NEOPLASM OF THE LIP EPITHELIUM
Instrument No. 41 of 2001 as amended
made under section 196B(2) of the
Veterans’ Entitlements Act 1986
This compilation was prepared on 28 November 2005
taking into account Amendment of Statement of Principles concerning MALIGNANT NEOPLASM OF THE LIP EPITHELIUM (Instrument No. 49 of 2001)
Prepared by the Repatriation Medical Authority Secretariat, Brisbane
Revocation and Determination
of
Statement of Principles
concerning
MALIGNANT NEOPLASM OF THE LIP EPITHELIUM
ICD-10-AM CODES: C00.0, C00.1, C00.2, C00.6.
Veterans’ Entitlements Act 1986
The Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act):
(a) revokes Instrument No.105 of 1996; and
(b) determines in its place the following Statement of Principles.
Kind of injury, disease or death
(a) This Statement of Principles is about malignant neoplasm of the lip epithelium and death from malignant neoplasm of the lip epithelium.
(b) For the purposes of this Statement of Principles, “malignant neoplasm of the lip epithelium” means a primary malignant neoplasm of the lipstick region of the lips and includes the vermilion borders and commissures of the lips, attracting ICD code C00.0, C00.1, C00.2 or C00.6, but excluding soft tissue sarcoma, non-Hodgkin’s lymphoma and Hodgkin’s disease. This definition also excludes lesions of the skin of the lips (outside the vermilion border) and mucosa lining the oral (inner) aspects of the lips.
Basis for determining the factors
The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that malignant neoplasm of the lip epithelium and death from malignant neoplasm of the lip epithelium can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces.
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 any relevant service rendered by the person.
Factors
The factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting malignant neoplasm of the lip epithelium or death from malignant neoplasm of the lip epithelium with the circumstances of a person’s relevant service are:
(a) being a prisoner of war of Japan before the clinical onset of malignant neoplasm of the lip epithelium; or
(b) smoking at least 2.5 pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of malignant neoplasm of the lip epithelium; or
(c) having a solar UV damage factor ratio of at least 1.1 for the face at the time at the clinical onset of malignant neoplasm of the lip epithelium; or
(d) being treated with immunosuppressive drugs for organ transplantation before the clinical onset of malignant neoplasm of the lip epithelium; or
(e) inability to obtain appropriate clinical management for malignant neoplasm of the lip epithelium.
Factors that apply only to material contribution or aggravation
Paragraph 5(e) applies only to material contribution to, or aggravation of malignant neoplasm of the lip epithelium, where the person’s malignant neoplasm of the lip epithelium was suffered or contracted before or during (but not arising out of) the person’s relevant service; paragraph 8(1)(e), 9(1)(e), 70(5)(d) or 70(5A)(d) of the Act refers.
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:
“death from malignant neoplasm of the lip epithelium” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s malignant neoplasm of the lip epithelium;
“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), Second Edition, effective date of 1 July 2000, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 271 3;
“pack years of cigarettes or the equivalent thereof in other tobacco products” means a calculation of consumption where one pack year of cigarettes equals twenty tailor made cigarettes (being the “standard” cigarette pack contents) per day for a period of one calendar year, or
7 300 cigarettes. One tailor made cigarette approximates one gram of tobacco or one gram of cigar or pipe tobacco by weight. One pack year of tailor made cigarettes equates to 7 300 cigarettes, or 7.3kg of smoking tobacco by weight. Tobacco products means either cigarettes, pipe tobacco or cigars smoked, alone or in any combination;
“relevant service” means:
(a) operational service; or
(b) peacekeeping service; or
(c) hazardous service;
“solar UV damage factor ratio” means the value obtained by applying the solar UV damage factor ratio formula. This may be calculated by using the computer program, UV Risk Version 3.3 (created by the Australian Radiation Laboratory using Microsoft Visual Basic Programming System for Windows Professional Edition, Version 3.0) to the data concerning the exposure of the person to ultra violet (UV) radiation;
Note:(this note does not form part of the instrument) The computer program UV Risk Version 3.3 can be run on a personal computer with at least 8 megabytes of Random Access Memory, using the Microsoft Windows version 3.1 graphical user interface. Further information may be obtained from the Department of Veterans’ Affairs, PO Box 21, Woden ACT 2606.
“solar UV damage factor ratio formula” means:
total lifetime UV damage factor non-service UV damage factor
where:
“total lifetime UV damage factor” means the numerical value calculated by the formula:
T
[MED cum (a,T)] -1 . PAE (n,M,a) at age (T-t) . t-
t=0
for the person’s lifetime to the time of the clinical onset of malignant neoplasm of the lip epithelium; and
“non-service UV damage factor” means the numerical value calculated by the formula:
T
[MED cum (a,T)] -1 . PAE (n,M,a) at age (T-t) . t-
t=0
for the person’s lifetime to the time of the clinical onset of malignant neoplasm of the lip epithelium, with the PAE for each month of the person’s period or periods of relevant service being the arithmetic mean of the PAE for each and every month of the person’s life, other than the period or periods of relevant service, where:
“” has the value of five and is a numerical constant associated with the age dependence of the cumulative incidence;
“” has the value of two and is a biological amplification factor;
“a” is an anatomical body site;
“M”is a specified month of the year;
“MED”means minimal erythemal dose, where one MED is equal to 200 Joules of radiation per square metre of skin;
“[MED cum (a,T)]” is the cumulative solar UV dose to the skin for any given anatomical body site for the person’s age at the time of the clinical onset of malignant neoplasm of the lip epithelium;
“n” has the value specified in column 2 of Table 1 opposite the item in column 1 of that Table for each of the specified life activities set out in column 1:
Table 1—specified life activities
column 1 column 2 Service workday (n1) 1 Service weekend (n2) 2 Service recreation period one (n3) 3 Service recreation period two (n4) 4 Civilian workday (n5) 5 Civilian weekend (n6) 6 Civilian recreation period one (n7) 7 Civilian recreation period two (n8) 8
“PAE” means personal ambient exposure in MEDs, calculated for each and every month of a person’s life to the time of the clinical onset of malignant neoplasm of the lip epithelium based on an estimate of a typical month during each of the five year periods between the ages of 0 and 20 years and each of the ten year periods thereafter;
“PAE (n,M,a)”means the number calculated by the formula:
n8
MAE (M,Ln) . ABFa . EFn . TRFn . ESFn . CPFn . ERFn . Wn
n1
where:
“ABFa” is the anatomical body factor, and has the value specified in column 2 of Table 2 opposite the item in column 1 of that Table for each of the various body sites set out in column 1:
Table 2—body sites
column 1 column 2 Face 0.15
“CPFn” is the clothing protection factor, and has the value assigned to a particular anatomical site proportionately according to the amount of protection provided by clothing and sun screen, ranging from a value of 1.00 for no protection to a value of 0.05 for full cover with heavy clothing for a given specified life activity in column 1 of Table 1;
“EFn” is the exposure factor, and has the value specified in column 2 of Table 3 opposite the item in column 1 of that Table for different exposure situations set out in column 1:
Table 3—exposure situations
column 1 column 2 Indoor 0.10 Mainly indoor 0.20 Indoor and outdoor 0.35 Mainly outdoor 0.50 Outdoor 0.60
“ERFn” is the environment reflectance factor, and has the value specified in column 2 of Table 4 opposite the item in column 1 of that Table for the different environment types set out in column 1:
Table 4—environment types
column 1 column 2 Urban 0.95 Rural 1.00 Maritime 1.00
where:
“Urban” means a location that is either a city or a town;
“Rural” means a location that is bushland, pastoral, or agricultural setting;
“Maritime” means either on the sea, lake, major river, or directly adjacent to such a body of water;
“ESFn” is the environment shade factor, and has the value specified in column 2 of Table 5 opposite the item in column 1 of that Table for the different environment shade types set out in column 1:
Table 5—environment shade types
column 1 column 2 Dense shade 0.50 Moderate shade 0.70 Light shade 0.90 No shade 1.00
where:
“Dense shade” means a location that is predominantly under dense shade, such as jungle or dense forest;
“Moderate shade” means a location that is predominantly under moderate shade, such as open forest or high density housing;
“Light shade” means a location that is predominantly under light shade, such as lightly timbered country or low density housing;
“No shade” means a location that is predominantly without shade, such as open fields, tundra, beach, or ocean;
“MAE(M,Ln)” is the average daily ambient exposure for month, M, in location, L, assuming a long term average cloud cover, being the value, obtained from the Table set out in Schedule 1, that is contained in the row that corresponds to the particular latitude (rounded to the nearest five degrees) and is contained in the column that corresponds to the month of the year that is the particular month under consideration, for each specified life activity;
“TRFn” is the terrain reflectance factor, and has the value specified in column 2 of Table 6 opposite the item in column 1 of that Table for the different terrain types set out in column 1:
Table 6—terrain types
column 1 column 2 Brown 1.02 Black 1.04 Green 1.05 Open water 1.08 Sand 1.16 Snow 1.40
where:
“Black” means a terrain predominantly of black material such as asphalt;
“Brown” means a terrain predominantly of bare soil, clay, or buildings;
“Green” means a terrain predominantly of green vegetation;
“Open Water” means an environment surrounded by water;
“Sand” means a terrain predominantly of light material such as white or yellow sand;
“Snow”means a terrain that is predominantly covered in snow;
“Wn ”is an estimate of the number of days in a month in which a specified life activity in column 1 of Table 1 is performed, and where, for the purposes of this definition, every month is taken to have 30.4375 days;
“t” is the age in months of the person for the particular specified activity;
“T” is the age in months of the person at the time of clinical onset of malignant neoplasm of the lip epithelium;
“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 Act applies.
Notes to Statement of Principles concerning malignant neoplasm of the lip epithelium (Instrument No. 41 of 2001)
The Statement of Principles concerning malignant neoplasm of the lip epithelium (Instrument No. 41 of 2001) 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 notification | Date of | Application, saving or |
| Statement of Principles concerning malignant neoplasm of the lip epithelium (Instrument No. 41 of 2001) | 6 June 2001 (see Gazette 2001, No. GN22) | 6 June 2001 | |
| Amendment of Statement of Principles concerning malignant neoplasm of the lip epithelium (Instrument No. 49 of 2001) | 25 July 2001 (see Gazette 2001, No. GN29) | 25 July 2001 |
Table of Amendments
| ad. = added or inserted am. = amended rep. = repealed rs. = repealed and substituted | |
| Provision affected | How affected |
| Clause 8 – ‘“total lifetime UV damage factor”’........... | am. Instrument No.49 of 2001 |
| Clause 8 – ‘“non-service UV damage factor”’........... | am. Instrument No.49 of 2001 |
| Clause 8 – ‘“[MED cum (a,T)]”’................................ | am. Instrument No.49 of 2001 |
| Clause 8 – ‘“PAE”’.............. | am. Instrument No.49 of 2001 |
| Clause 8 – ‘“T”’................... | am. Instrument No.49 of 2001 |
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