Statement of Principles concerning methaemoglobinaemia No. 284 of 1995 (Cth)

Instrument No.284 of 1995

Statement of Principles

concerning

METHAEMOGLOBINAEMIA

ICD CODE: 289.7

Veterans’ Entitlements Act 1986
subsection 196B(2)

1.         Being of the view that there is sound medical-scientific evidence that indicates that methaemoglobinaemia and death from methaemoglobinaemia can be related to operational service rendered by veterans, peacekeeping service rendered by members of Peacekeeping Forces and hazardous service rendered by members of the Forces, the Repatriation Medical Authority determines, under subsection 196B(2) of the Veterans’ Entitlements Act1986 (the Act), that the factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting methaemoglobinaemia or death from methaemoglobinaemia with the circumstances of that service, are:

(a)       undergoing treatment with a drug that causes oxidation of haemoglobin immediately before the clinical onset of methaemoglobinaemia; or

(b)       being occupationally exposed to a substance that causes oxidation of haemoglobin immediately before the clinical onset of methaemoglobinaemia; or

(c)       inability to obtain appropriate clinical management for methaemoglobinaemia.

2.         Subject to clause 3 (below) at least one of the factors set out in paragraphs 1(a) to 1(c) must be related to any service rendered by a person.

3.         The factor set out in paragraph 1(c) applies only where:

(a)       the person's methaemoglobinaemia was contracted before a period, or part of a period, of service to which the factor is related; and

(b)       the relationship suggested between the methaemoglobinaemia and the particular service of a person is a relationship set out in paragraph 8(1)(e), 9(1)(e), 70(5)(d) or 70(5A)(d) of the Act.

4.         For the purposes of this Statement of Principles:

“ICD code” means a number assigned to a particular kind of injury or disease in the Australian Version of The International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM), effective date of 1 July 1995, copyrighted by the National Coding Centre, Faculty of Health Sciences, University of Sydney, NSW, and having ISBN 0 642 22235 5;

“methaemoglobinaemia” means a greater than normal amount of methaemoglobin in the blood as a result of the oxidation of haem iron to the ferric state, making it less able to bind with oxygen, causing cyanosis, if the methaemoglobin exceeds 10% of the total haemoglobin, attracting ICD code 289.7;

“substance that causes oxidation of haemoglobin” means any of the following chemical substances:

(a)       trinitrotoluene;

(b)       nitrobenzene;

(c)       dinitrobenzene;

(d)       aniline derivatives;

(e)       hydroquinone;

(f)        beta-naphthylamine;

(g)       nitroparaffin;

(h)       nitrogen oxides;

“undergoing treatment with a drug that causes oxidation of haemoglobin” means being treated for an injury or a disease with any of the following drugs:

(a)       amines;

(b)       phenols;

(c)       nitrates;

(d)       nitrites;

(e)       aniline;

(f)        sulphonamides;

(g)       acetanilide;

(h)       phenacetin;

(j)        topical anaesthetics such as benzocaine, cetacaine, lidocaine, novocaine, prilocaine, or aniline cocaine;

(k)       primaquine;

(m)      dapsone;

(n)       resorcinol.

Dated this       Eighteenth          day of              July                 1995

The Common Seal of the    )

Repatriation Medical Authority                   )

was affixed to this instrument   )

in the presence of:   )

KEN DONALD

CHAIRMAN