Statement of Principles concerning chronic myeloid leukaemia No. 15 of 2003

Statement of Principles

concerning

CHRONIC MYELOID LEUKAEMIA

Instrument No. 15 of 2003 as amended

made under section 196B(2) of the

Veterans’ Entitlements Act 1986

This compilation was prepared on 21 July 2011 taking into account Amendment of Statement of Principles concerning CHRONIC MYELOID LEUKAEMIA  (Instrument No. 47 of 2011)

Prepared by the Repatriation Medical Authority Secretariat, Brisbane

Statement of Principles

concerning

CHRONIC MYELOID LEUKAEMIA

Veterans’ Entitlements Act 1986

1. The Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act):

(a) revokes Instrument No.7 of 1997; and

(b) determines in its place the following Statement of Principles.

Kind of injury, disease or death

2. (a) This Statement of Principles is about chronic myeloid leukaemia and death from chronic myeloid leukaemia.

(b)              For the purposes of this Statement of Principles, "chronic myeloid leukaemia" means a haematological neoplasm characterised by the clonal proliferation and accumulation of mature myeloid cells and their progenitors in the peripheral blood and bone marrow, and which is typically associated with the presence of the Philadelphia chromosome on cytogenetic analysis or the presence of BCR-ABL fusion gene on molecular analysis.  This definition of chronic myeloid leukaemia includes chronic monocytic leukaemia, chronic leukaemia of unspecified cell type, chronic granulocytic leukaemia, chronic myeloblastic leukaemia, chronic myelocytic leukaemia and chronic myelogenous leukaemia.

(c)               Chronic myeloid leukaemia attracts ICD-10-AM code C92.1, C93.1 or C95.1.

(d)              In the application of this Statement of Principles, the definition of "chronic myeloid leukaemia" is that given at para 2(b) above.

Basis for determining the factors

3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that chronic myeloid leukaemia and death from chronic myeloid leukaemia 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

4. 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

5. The factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting chronic myeloid leukaemia or death from chronic myeloid leukaemia with the circumstances of a person’s relevant service are:

(a)               smoking at least 15 pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of chronic myeloid leukaemia and where smoking has ceased the clinical onset occurred within 10 years of cessation; or

(b)               having received a cumulative equivalent dose of at least 0.01 sievert of ionising radiation to the bone marrow at least one year before the clinical onset of chronic myeloid leukaemia; or

(c)               undergoing treatment with radioactive iodine for cancer before the clinical onset of chronic myeloid leukaemia, where the first exposure occurred at least one year before the clinical onset of chronic myeloid leukaemia; or

(d)               inability to obtain appropriate clinical management for chronic myeloid leukaemia.

Factors that apply only to material contribution or aggravation

6. Paragraph 5(d) applies only to material contribution to, or aggravation of, chronic myeloid leukaemia where the person’s chronic myeloid leukaemia 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

7. 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

8.                  For the purposes of this Statement of Principles:

"cumulative equivalent dose" means the total dose of ionising radiation received by the particular organ or tissue. The formula used to calculate the cumulative equivalent dose allows doses from multiple types of ionising radiation to be combined, by accounting for their differing biological effect. The unit of equivalent dose is the sievert. For the purposes of this Statement of Principles, the calculation of cumulative equivalent dose excludes doses received from normal background radiation, but includes therapeutic radiation, diagnostic radiation, cosmic radiation at high altitude, radiation from occupation-related sources and radiation from nuclear explosions or accidents;

"death from chronic myeloid leukaemia" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s chronic myeloid leukaemia;

"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), Third Edition, effective date of 1 July 2002, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 413 9;

"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 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;

"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

9. This Instrument applies to all matters to which section 120A of the Act applied.

Notes to Statement of Principles concerning chronic myeloid leukaemia (Instrument No. 15 of 2003)

The Statement of Principles concerning chronic myeloid leukaemia (Instrument No. 15 of 2003) 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

Table of Amendments