Statement of Principles
concerning
 
SINUS BAROTRAUMA
No. 50 of 2010
 
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 sinus barotrauma No. 50 of 2010.
 
Determination
2.         The Repatriation Medical Authority under subsection 196B(3) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a)       revokes Instrument No. 317 of 1995 concerning sinus barotrauma; and
(b)       determines in its place this Statement of Principles.
 
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about sinus barotrauma and death from sinus barotrauma.
(b)              For the purposes of this Statement of Principles, "sinus barotrauma" means inflammation, oedema, or haemorrhage of the mucosa of a paranasal sinus arising from inequalities in the barometric pressure between the surrounding atmosphere and the air within the sinus cavity. Sinus barotrauma is also known as aerosinusitis, barosinusitis and sinus squeeze.
(c)              Sinus barotrauma attracts ICD-10-AM code T70.1.
(d)              In the application of this Statement of Principles, the definition of "sinus barotrauma" 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 sinus barotrauma and death from sinus barotrauma 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, sinus barotrauma or death from sinus barotrauma is connected with the circumstances of a person’s relevant service is:
 
(a)               experiencing a change in ambient barometric pressure as specified, within the 24 hours before the clinical onset of sinus barotrauma; or
 
(b)              receiving mechanical ventilation involving a face mask at the time of the clinical onset of sinus barotrauma; or
 
(c)              experiencing a change in ambient barometric pressure as specified, within the 24 hours before the clinical worsening of sinus barotrauma; or
 
(d)              receiving mechanical ventilation involving a face mask at the time of the clinical worsening of sinus barotrauma; or
 
(e)              inability to obtain appropriate clinical management for sinus barotrauma.
 
Factors that apply only to material contribution or aggravation
7.         Paragraphs 6(c) to 6(e) apply only to material contribution to, or aggravation of, sinus barotrauma where the person’s sinus barotrauma 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:
 
"a change in the ambient barometric pressure as specified" means a significant reduction or increase in the pressure surrounding the person and occurring with any of the following:
(a)        flying;
(b)       diving;
(c)       ascending from a submerged caisson; or
(d)       decompression or compression in a hypobaric or a hyperbaric chamber;
 
"death from sinus barotrauma" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s sinus barotrauma;
 
"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), Sixth Edition, effective date of 1 July 2008, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 978 1 74210 016 6;
 
"mechanical ventilation" means an artificial method of ventilation in which air is forced into the lungs of a person via mechanical means, and includes anaesthetic and continuous positive airway pressure (CPAP) use;
 
"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 30 June 2010.
 
Dated this       eighteenth     day of              June  2010
 
 
The Common Seal of the                  )
Repatriation Medical Authority       )
was affixed to this instrument          )
in the presence of:                            )
 
KEN DONALD
CHAIRPERSON