Statement of Principles concerning photocontact dermatitis No. 109 of 2011

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Statement of Principles
concerning
 
PHOTOCONTACT DERMATITIS
No. 109 of 2011
 
for the purposes of the
 
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
 
Title
1.         This Instrument may be cited as Statement of Principles concerning photocontact dermatitis No. 109 of 2011.
 
Determination
2.         The Repatriation Medical Authority under subsection 196B(3) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a)        revokes Instrument No. 64 of 1997 concerning photocontact dermatitis; and
(b)        determines in its place this Statement of Principles.
 
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about photocontact dermatitis and death from photocontact dermatitis.
(b)              For the purposes of this Statement of Principles, "photocontact dermatitis" means inflammation of an area of the skin resulting from a particular substance coming in contact with that part of the skin whilst that same part of the skin is exposed to light.  This definition includes phototoxic contact dermatitis and photoallergic contact dermatitis.  This definition excludes photocontact-type dermatitis due to ingesting a substance and exposing the affected skin to light.
(c)              Photocontact dermatitis attracts ICD-10-AM code L56.2.
(d)              In the application of this Statement of Principles, the definition of "photocontact dermatitis" is that given at paragraph 3(b) above.
 
Basis for determining the factors
4.         On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that photocontact dermatitis and death from photocontact dermatitis can be related to relevant service rendered by veterans 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
5.         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
6.         The factor that must exist before it can be said that, on the balance of probabilities, photocontact dermatitis or death from photocontact dermatitis is connected with the circumstances of a person’s relevant service is:
 
(a)                having exposure of the affected area of skin to a phototoxic agent and light simultaneously within the six hours before the clinical onset of photocontact dermatitis; or
 
(b)               having exposure of the affected area of skin to a photoallergen and light simultaneously within the five days before the clinical onset of photocontact dermatitis; or
 
(c)                for allergic photocontact dermatitis only, having cutaneous exposure to the photoallergen responsible for the photocontact dermatitis and to light before the clinical onset of photocontact dermatitis; or
 
(d)               having exposure of the affected area of skin to a phototoxic agent and light simultaneously within the six hours before the clinical worsening of photocontact dermatitis; or
 
(e)                having exposure of the affected area of skin to a photoallergen and light simultaneously within the five days before the clinical worsening of photocontact dermatitis; or
 
(f)                inability to obtain appropriate clinical management for photocontact dermatitis.
 
Factors that apply only to material contribution or aggravation
7.         Paragraphs 6(d) to 6(f) apply only to material contribution to, or aggravation of, photocontact dermatitis where the person’s photocontact dermatitis was suffered or contracted before or during (but not arising out of) the person’s relevant service.
 
Inclusion of Statements of Principles
8.                  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
9.                  For the purposes of this Statement of Principles:
 
"death from photocontact dermatitis" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s photocontact dermatitis;
 
"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), Seventh Edition, effective date of 1 July 2010, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 978 1 74210 154 5;
 
"photoallergen" means a topical substance which, when applied to an area of skin which is simultaneously exposed to light, is capable of producing an immune response resulting in photoallergic contact dermatitis;
 
"phototoxic agent" means a topical agent or substance, for example a chemical, which, when applied to an area of skin which is simultaneously exposed to light, causes dermatitis which is referred to as phototoxic contact dermatitis. It does not include physical agents such as heat, cold, solar radiation or other forms of radiation;
 
"relevant service" means:
(a)        eligible war service (other than operational service) under the VEA; or
(b)       defence service (other than hazardous service) under the VEA; or
(c)        peacetime 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
10.       This Instrument applies to all matters to which section 120B of the VEA or section 339 of the MRCA applies.
 
Date of effect
11.       This Instrument takes effect from 31 August 2011.
 
Dated this   nineteenth   day of   August   2011
 
 
The Common Seal of the                    )
Repatriation Medical Authority          )
was affixed to this instrument                        )
in the presence of:                               )
 
KEN DONALD
CHAIRPERSON

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