DECLARATION UNDER SUBSECTION 196B(9)
OF THE VETERANS’ ENTITLEMENTS ACT 1986
The Repatriation Medical Authority (the Authority), under subsection 196B(9) of the Veterans' Entitlements Act 1986 (the Act), makes the following declaration in respect of an investigation to review the contents of the Statements of Principles in force under the Act concerning non-Hodgkin's lymphoma. The investigation related to "exposure to ionising radiation" and "benzene exposure" and the Notice of Investigation was published in the Government Notices Gazette of 16 October 2013.
The Authority declares that while it proposes to amend Statement of Principles, Instrument No. 28 of 2010, concerning non-Hodgkin's lymphoma, it does not propose to amend Statement of Principles, Instrument No. 29 of 2010, for the reason that the new sound medical-scientific evidence available is not sufficient to justify an amendment to this Statement of Principles already determined in respect of non-Hodgkin's lymphoma.
With regard to benzene, the International Agency for Research on Cancer in 2009 concluded that there is limited evidence for a causal association between benzene and non-Hodgkin's lymphoma. Three of four recent meta-analyses found no association between benzene exposure and non-Hodgkin's lymphoma, and (apart from one cohort study), no evidence for a dose-response effect. The study with possibly the highest and purest exposure to benzene found no association with non-Hodgkin's lymphoma. Assessment of the association of benzene and lymphoma is also complicated by problems with exposure misclassification, outcome misclassification, heterogeneity of lymphoma subtypes and low statistical power. The available sound medical-scientific evidence does not establish that such a relationship is more probable than not and does not enable the Authority to determine a benzene factor for inclusion in the Statement of Principles, Instrument No. 29 of 2010, determined pursuant to subsection 196B(3) of the Act.
In relation to ionising radiation, the sound medical-scientific evidence is too limited to conclude that exposure to ionising radiation is causally related to non-Hodgkin's lymphoma at the reasonable hypothesis or balance of probabilities standards of proof. A previous major review concluded that there is little evidence of an association of non-Hodgkin's lymphoma with exposure to external radiation, and insufficient evidence in relation to other types or sources of radiation. No significant association was identified in a multinational study of nuclear industry workers, though an association with mortality from non-Hodgkin's lymphoma was found in US nuclear weapons workers. Elevations in risk of cancers after radiotherapy for benign or malignant conditions are inconsistent. Overall, the evidence concerning the association between ionising radiation and non-Hodgkin's lymphoma is limited in amount and consistency.
The Common Seal of the )
Repatriation Medical Authority )
was affixed in the presence of: )
PROFESSOR NICHOLAS SAUNDERS AO
CHAIRPERSON 24 / 4 / 2014