Statement of Principles concerning methaemoglobinaemia No. 47 of 2010 (Cth)
Statement of Principles
concerning
METHAEMOGLOBINAEMIA
No. 47 of 2010
for the purposes of the
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
Title
This Instrument may be cited as Statement of Principles concerning methaemoglobinaemia No. 47 of 2010.
Determination
The Repatriation Medical Authority under subsection 196B(2) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a) revokes Instrument No. 284 of 1995 concerning methaemoglobinaemia; and
(b) determines in its place this Statement of Principles.
Kind of injury, disease or death
(a) This Statement of Principles is about methaemoglobinaemia and death from methaemoglobinaemia.
(b)For the purposes of this Statement of Principles, "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 and causing clinical manifestations such as cyanosis, headache or fatigue. This definition excludes congenital methaemoglobinaemia.
(c)Methaemoglobinaemia attracts ICD-10-AM code D74.8.
(d)In the application of this Statement of Principles, the definition of "methaemoglobinaemia" is that given at paragraph 3(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 methaemoglobinaemia and death from methaemoglobinaemia 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 7, at least one of the factors set out in clause 6 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 methaemoglobinaemia or death from methaemoglobinaemia with the circumstances of a person’s relevant service is:
(a)taking or being treated with a drug that causes oxidation of haemoglobin, within the two days before the clinical onset of methaemoglobinaemia; or
(b)inhaling, ingesting or having cutaneous contact with a chemical agent that causes oxidation of haemoglobin, within the two days before the clinical onset of methaemoglobinaemia; or
(c)ingesting food or fluid contaminated by excess levels of nitrates or nitrites, within the two days before the clinical onset of methaemoglobinaemia; or
(d)being exposed to dialysis fluid contaminated with chloramine or hydrogen peroxide, within the two days before the clinical onset of methaemoglobinaemia; or
(e)taking or being treated with a drug that causes oxidation of haemoglobin, within the two days before the clinical worsening of methaemoglobinaemia; or
(f)inhaling, ingesting or having cutaneous contact with a chemical agent that causes oxidation of haemoglobin, within the two days before the clinical worsening of methaemoglobinaemia; or
(g)ingesting food or fluid contaminated by excess levels of nitrates or nitrites, within the two days before the clinical worsening of methaemoglobinaemia; or
(h)being exposed to dialysis fluid contaminated with chloramine or hydrogen peroxide, within the two days before the clinical worsening of methaemoglobinaemia; or
(i)inability to obtain appropriate clinical management for methaemoglobinaemia.
Factors that apply only to material contribution or aggravation
Paragraphs 6(e) to 6(i) apply only to material contribution to, or aggravation of, methaemoglobinaemia where the person’s methaemoglobinaemia 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 as in force from time to time.
Other definitions
For the purposes of this Statement of Principles:
"death from methaemoglobinaemia" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s methaemoglobinaemia;
"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), Sixth Edition, effective date of 1 July 2008, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 978 1 74210 016 6;
"relevant service" means:
(a) operational service under the VEA;
(b) peacekeeping service under the VEA;
(c) hazardous service under the VEA;
(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 30 June 2010.
Dated this eighteenth day of June 2010
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRPERSON
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