Statement of Principles concerning malignant neoplasm of the lung No. 35 of 2001

Administered by Department of Veterans' Affairs

Legislation au F2005B03737 Not in force Legislative Instrument

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Instrument No.35 of 2001

 

Revocation and Determination

of

Statement of Principles

concerning

 

MALIGNANT NEOPLASM OF THE LUNG

 

ICD-10-AM CODES: C33, C34

 

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.29 of 1996 and Instrument No.149 of 1996; and

 

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

 

Kind of injury, disease or death

2. (a) This Statement of Principles is about malignant neoplasm of the lung and death from malignant neoplasm of the lung.

 

(b) For the purposes of this Statement of Principles, “malignant neoplasm of the lung” means a primary malignant neoplasm of the trachea, bronchus or lung, attracting ICD-10-AM code C33 or C34, but excluding soft tissue sarcoma, non-Hodgkin’s lymphoma, Hodgkin’s disease and malignant neoplasm of the pleura.

 

Basis for determining the factors

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

 

(a)                   for each of the following types of malignant neoplasm of the lung:

 

(i) squamous cell carcinoma,

(ii) small cell carcinoma,

(iii) malignant neoplasm of undetermined histology,

(iv) large cell carcinoma, or

(v) carcinosarcoma

 

(A) smoking at least one half of a pack year of cigarettes or the equivalent thereof in other tobacco products, and

(B) smoking commenced at least five years

before the clinical onset of malignant neoplasm of the lung; or

 

(b)                   for adenocarcinoma of the lung only:

(i)           smoking at least three pack years of cigarettes or the equivalent thereof in other tobacco products, and

(ii)         smoking commenced at least five years

before the clinical onset of malignant neoplasm of the lung; or

 

(c)              for malignant neoplasm of the lung other than typical carcinoid tumour of the lung:

(i)           being in an atmosphere with a visible tobacco smoke haze in an enclosed space for a period or periods totalling at least 5,200 hours, and

(ii)         the first exposure to a visible tobacco smoke haze commenced at least five years

before the clinical onset of malignant neoplasm of the lung; or

 

(d)              inhaling respirable asbestos fibres in an enclosed space:

(i)           at the time material containing asbestos fibres was being applied, removed, dislodged, cut or drilled, and

(ii)         the first inhalation of asbestos fibres commenced at least 10 years

before the clinical onset of malignant neoplasm of the lung; or

 

(e)               inhaling respirable asbestos fibres for a cumulative period of at least 1000 hours in an open environment:

(i)          at the time material containing asbestos fibres was being applied, removed, dislodged, cut or drilled, and

(ii)        the first inhalation of asbestos fibres commenced at least 10 years

before the clinical onset of malignant neoplasm of the lung; or

 

(f)                suffering from asbestosis at the time of the clinical onset of malignant neoplasm of the lung; or

 

(g) working within 100 metres of an industrial coke oven for at least 180 days, at least five years before the clinical onset of malignant neoplasm of the lung; or

 

(h)              being heavily exposed to diesel engine exhaust for a cumulative period of 10,000 hours at least five years before the clinical onset of malignant neoplasm of the lung; or

 

(j) being on land in Vietnam or at sea in Vietnamese waters, for at least 30 days, at least five years before the clinical onset of malignant neoplasm of the lung; or

 

(k) inhaling chemical agents contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) for a cumulative period of at least 30 days, at least five years before the clinical onset of malignant neoplasm of the lung; or

 

(m)           inhaling mustard gas at least five years before the clinical onset of malignant neoplasm of the lung; or

 

(n) having received a cumulative equivalent dose of 0.05 Sievert (Sv) of atomic radiation to the lung where this dose was accumulated at least five years before the clinical onset of malignant neoplasm of the lung; or

 

(o) undergoing a course of therapeutic radiation to the thorax at least five years before the clinical onset of malignant neoplasm of the lung; or

 

(p) suffering from asthma, chronic bronchitis or emphysema at least five years before the clinical onset of malignant neoplasm of the lung;

 

(q)              being exposed to at least 120 Working Level Month (WLM) of radon in an enclosed space and the first exposure to radon occurred at least five years before the clinical onset of malignant neoplasm of the lung; or

 

(r)               suffering from silicosis at the time of the clinical onset of malignant neoplasm of the lung; or

 

(s)               inhaling respirable crystalline silica dust:

(i)           for at least four hours per day on more days than not for two years or for a cumulative period of 1500 hours,

(ii)         in an environment where material containing crystalline silica was being removed, dislodged, cut or drilled, and

(iii)      the first inhalation of crystalline silica commenced at least 10 years

before the clinical onset of malignant neoplasm of the lung; or

 

(t)                inhaling organic arsenic fumes:

(i)           for at least four hours per day on more days than not for two years or for a cumulative period of 1500 hours, and

(ii)         the first inhalation of organic arsenic fumes commenced at least 10 years

before the clinical onset of malignant neoplasm of the lung; or

 

(u)              inhaling cadmium fumes:

(i) for at least four hours per day on more days than not for two years or for a cumulative period of 1500 hours, and

(ii)         the first inhalation of cadmium fumes commenced at least 10 years

before the clinical onset of malignant neoplasm of the lung; or

 

(v) inhaling nickel fumes:

(i)          for at least four hours per day on more days than not for two years or for a cumulative period of 1500 hours, and

(ii)        the first inhalation of nickel fumes commenced at least 10 years

before the clinical onset of malignant neoplasm of the lung; or

 

(w)            inhaling hexavalent chromate fumes:

(i) for at least four hours per day on more days than not for two years or for a cumulative period of 1500 hours, and

(ii) the first inhalation of hexavalent chromate fumes commenced at least 10 years

before the clinical onset of malignant neoplasm of the lung; or

 

(x)              inhaling beryllium fumes:

(i)                 for at least four hours per day on more days than not for two years or for a cumulative period of 1500 hours, and

(ii)              the first inhalation of beryllium fumes commenced at least 10 years

before the clinical onset of malignant neoplasm of the lung; or

 

(y)              inhaling bis(chloromethyl)ether or chloromethyl methyl ether fumes:

(i)           for at least four hours per day on more days than not for at least two years or for a cumulative period of 1500 hours, and

(ii) the first inhalation of bis(chloromethyl)ether or chloromethyl methyl ether fumes commenced at least 10 years

before the clinical onset of malignant neoplasm of the lung; or

 

(z) inability to obtain appropriate clinical management for malignant neoplasm of the lung.

 

Factors that apply only to material contribution or aggravation

6. Paragraph 5(z) applies only to material contribution to, or aggravation of, malignant neoplasm of the lung where the person’s malignant neoplasm of the lung 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:

 

“a course of therapeutic radiation” means one or more fractions (treatment portions) of ionising radiation administered with the aim of achieving palliation or cure with gamma rays, x-rays, alpha particles or beta particles;

 

“an enclosed space” means a substantially enclosed area, for example, the interior of a building, ship or aircraft, a covered workshop or factory;

 

“atomic radiation” means ionising radiation excluding;

(i)                natural background radiation;

(ii)              therapeutic radiation; and

(iii)           radiation from diagnostic procedures;

 

“being heavily exposed to diesel engine exhaust” means:

(i)                being an occupant in an enclosed diesel powered heavy vehicle cabin contaminated with diesel fumes; or

(ii)              working in an enclosed area where diesel powered engines or motors are being operated; or

(iii) repairing and/or servicing diesel engines;

 

“being on land in Vietnam or at sea in Vietnamese waters” means service in at least one of the areas and at the times described in Items 4 and 8 of Schedule 2 of the Veterans’ Entitlements Act 1986;

 

“chemical agents contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD)” means:

  •                  2,4,5-trichlorophenoxyacetic acid,
  •                  2,4,5-trichlorophenoxypropionic acid,
  •                  2,4,5-trichlorophenol,
  •                  2-(2,4,5-trichlorophenoxy)-ethyl 2,2-dichloropropionate,
  •                  o,o-dimethyl-o-(2,4,5-trichlorophenyl)-phosphorothioate,
  •                  pentachlorophenol,
  •                  2,3,4,6-tetrachlorophenol,
  •                  2,4,6-trichlorophenol,
  •                  1,3,4-trichloro-2-(4-nitrophenoxy)benzene,
  •                  2,4-dichloro-1-(4-nitrophenoxy)benzene,
  •                  2,4-dichloro-1-(3-methoxy-4-nitrophenoxy)-benzene;

 

“cumulative equivalent dose” means the total equivalent dose of atomic radiation from all types of radiation (eg alpha, gamma).  It accounts for the differences in biological effectiveness of various types of radiation and allows doses from different radiations to be combined.  Each component is calculated by multiplying the absorbed dose in a particular tissue or organ for a given type of radiation by the radiation weighting factor for that radiation.  The unit of equivalent dose is the Sievert (Sv);

 

“death from malignant neoplasm of lung” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s malignant neoplasm of the lung;

 

“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), Second Edition, effective date of 1 July 2000, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 271 3;

 

“inhaling chemical agents contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD)” means

(a)              undertaking work involving decanting or spraying of 2,3,7,8-TCDD contaminated chemicals; or

(b)              undertaking work involving cleaning and maintenance of equipment used to apply 2,3,7,8-TCDD contaminated chemicals; or

(c)              having been sprayed with 2,3,7,8-TCDD contaminated chemicals; or

(d)              undertaking work involving the handling or sawing of timber treated with 2,3,7,8-TCDD contaminated chemicals; or

(e)              working in an environment shrouded in dust from timber treated with 2,3,7,8-TCDD contaminated chemicals;

 

“mustard gas” means dichlorodiethylsulphide, and is also known as sulphur mustard and yellow cross liquid;

 

“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 (being the “standard” cigarette pack contents) 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;

 

“respirable asbestos fibre” means asbestos fibres less than 5 micrometres in diameter;

 

“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;

 

“Working Level (WL)” is any combination of radon progeny in 1 litre of air that ultimately releases 1.3 105 million electron volts (MeV) of alpha energy during decay;

 

“Working Level Month (WLM)” is exposure to 1 Working Level (WL) for 170 hours.

 

Application

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

 

 

Dated this Twenty-fourth     day of May 2001

 

 

The Common Seal of the    )

Repatriation Medical Authority   )

was affixed to this instrument  )

in the presence of:    )

KEN DONALD

CHAIRMAN

Overview

The Veterans' Entitlements Act 1986 (VEA) was enacted to provide a range of benefits and services to Australian veterans and their families. The VEA aims to address the needs of veterans, including those who have served in peacetime and in war, by providing financial and medical support, as well as rehabilitation services. The Act was introduced to address the gap in support for veterans and their families who had previously been inadequately provided for. This legislative instrument, Instrument No.35 of 2001, was enacted by the Repatriation Medical Authority under subsection 196B(2) of the VEA, revoking earlier instruments and determining a new Statement of Principles concerning malignant neoplasm of the lung. This Statement of Principles aims to ensure that veterans and their families receive appropriate recognition and support for conditions related to their service, specifically malignant neoplasm of the lung and related death. This legislative instrument is significant in that it acknowledges the link between certain occupational exposures during service and the development of malignant neoplasm of the lung. By setting out specific factors that must be related to service to establish a reasonable hypothesis connecting the disease with the circumstances of the person's relevant service, the instrument provides a framework for determining eligibility for benefits under the VEA. The policy objective is to ensure that veterans who have developed malignant neoplasm of the lung due to their service are not left unsupported and that their condition is recognised as a service-related injury.

Scope and Application

The legislative instrument F2005B03737, which revokes and determines the Statement of Principles concerning malignant neoplasm of the lung under the Veterans' Entitlements Act 1986, applies to matters involving veterans, members of Peacekeeping Forces, and members of the Australian Defence Force. The Act addresses the medical-scientific evidence supporting the connection between malignant neoplasm of the lung, including death from this condition, and relevant military service. It sets out specific factors that must be related to service, such as exposure to tobacco smoke, asbestos, industrial chemicals, or radiation, among others, to establish a reasonable hypothesis connecting the disease with the circumstances of the individual’s service. Notably, the instrument excludes certain conditions like soft tissue sarcoma and non-Hodgkin’s lymphoma from its scope. This legislative instrument provides a framework for determining entitlement to benefits for veterans suffering from malignant neoplasm of the lung, establishing criteria that must be met to link the disease with their service.

Key Provisions

The primary provisions of this legislative instrument, Instrument No.35 of 2001, concern the revocation of two previous instruments (Instrument No.29 of 1996 and Instrument No.149 of 1996) and the establishment of a new Statement of Principles concerning malignant neoplasm of the lung and death from such a neoplasm (section 1). The Statement of Principles outlines specific criteria that must be met to establish a connection between malignant neoplasm of the lung and a veteran's or service member's relevant service, including various types of exposure to hazardous substances or environments (section 2 and 5). The obligations imposed by the Act include the requirement for at least one of the specified factors to be related to the person's relevant service, such as smoking, exposure to asbestos, or other hazardous conditions (section 4). Additionally, the Act mandates that if a relevant factor includes an injury or disease for which there is an existing Statement of Principles, the factors in that Statement must be applied accordingly (section 7). Failure to comply with the provisions of this instrument may result in civil or criminal consequences, though the specific penalties are not detailed within the text of this instrument. The Veterans’ Entitlements Act 1986, under which this instrument is made, may contain provisions for penalties and enforcement mechanisms, but these are not elaborated upon in the provided excerpt. It is important for parties affected by this instrument to consult the full Act for comprehensive information on potential penalties and legal recourse.

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