Statement of Principles concerning contact dermatitis No. 65 of 1997

Statement of Principles

concerning

CONTACT DERMATITIS

Instrument No. 65 of 1997 as amended

made under section 196B(2) of the

Veterans’ Entitlements Act 1986

This compilation was prepared on 7 July 2006 taking into account Amendment of Statement of Principles concerning CONTACT DERMATITIS (Instrument No. 23 of 2004)

Prepared by the Repatriation Medical Authority Secretariat, Brisbane.

Revocation and Determination

of

Statement of Principles

concerning

CONTACT DERMATITIS

ICD CODES: 373.32, 692.0 - 692.6, 692.81, 692.83, 692.89692.0 - 692.6, 692.81, 692.83, 692.89

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.75 of 1995; 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 contact dermatitiscontact dermatitis and               death from contact dermatitis.

(b) For the purposes of this Statement of Principles, “contact dermatitis” means inflammation of an area of the skin due to a substance coming in contact with that part of the skin, attracting an ICD code in the range 692.0 to 692.6, or ICD code 373.32, 692.81, 692.83 or 692.89.  This definition excludes photocontact dermatitis, urticaria, dermatitis due to exposure to extremes of weather, or solar radiation (for example, solar skin damage), or other radiation or friction.

Basis for determining the factors

3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that contact dermatitis and death from contact dermatitis 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 contact dermatitis or death from contact dermatitis with the circumstances of a person’s relevant service are:

(a) direct cutaneous exposure of the affected area to an irritant within the 3 days immediately before the clinical onset of contact dermatitis; or

(b) for allergic contact dermatitis only, exposure to the allergen responsible for the contact dermatitis, before the clinical onset of contact dermatitis; or

(c) direct cutaneous exposure of the affected area to an irritant within the 3 days immediately before the clinical worsening of contact dermatitis; or

(d) for allergic contact dermatitis only, direct cutaneous re-exposure to the allergen responsible for the allergic contact dermatitis, within the 5 days immediately before the clinical worsening of contact dermatitis; or

(e) inability to obtain appropriate clinical management for contact  dermatitiscontact  dermatitis.

Factors that apply only to material contribution or aggravation

6. Paragraphs 5(c) to 5(e) apply only to material contribution to, or aggravation of, contact  dermatitis where the person’s contact  dermatitis 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.

Other definitions

7. For the purposes of this Statement of Principles:

“allergen” means an antigenic substance capable of producing an immune response.  Low molecular weight chemical substances which act as haptens are the usual cause of allergic contact dermatitis.  Examples of allergens include dyes and their intermediates, oils, resins, coal tar derivatives, chemicals used for fabrics, rubbers, cosmetics, insecticides, the oils and resins of woods and plants, CS agent and coloured smoke, as well as the products or the substances of bacteria, fungi and parasites;

“allergen responsible for the contact dermatitis” means an allergen which the available clinical or serological evidence implicates as the cause of the contact dermatitis;

“allergic contact dermatitis” means immunologically mediated (mainly delayed type IV) contact dermatitis which occurs on an area of skin following exposure of that part of the skin to a particular allergen;

“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 1996, copyrighted by the National Coding Centre, Faculty of Health Sciences, University of Sydney, NSW, and having ISBN 0 642 24447 2;

“irritant” means an agent or substance, for example a chemical, which damages the epidermis on contact and causes inflammation of the contacted skin.  It does not include physical agents such as heat, cold, solar radiation or other forms of radiation;

“relevant service” means:

(a) operational service; or

(b) peacekeeping service; or

(c) hazardous service.

Application

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

Notes to Statement of Principles concerning contact dermatitis (Instrument No. 65 of 1997)

The Statement of Principles concerning contact dermatitis (Instrument No. 65 of 1997) 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