Statement of Principles concerning sinusitis (Reasonable Hypothesis) (No. 73 of 2018) (Cth)

Statement of Principles concerning SINUSITIS (Reasonable Hypothesis) (No. 73 of 2018) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.

Dated 24 August 2018

The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:

Professor Nicholas Saunders AO Chairperson

Contents 1 Name 2 Commencement 3 Authority 4 Repeal 5 Application 6 Definitions 7 Kind of injury, disease or death to which this Statement of Principles relates 8 Basis for determining the factors 9 Factors that must exist 10 Relationship to service 11 Factors referring to an injury or disease covered by another Statement of Principles Schedule 1 - Dictionary 1 Definitions

1 Name This is the Statement of Principles concerning sinusitis (Reasonable Hypothesis) (No. 73 of 2018). 2 Commencement This instrument commences on 24 September 2018. 3 Authority This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986. 4 Repeal The Statement of Principles concerning sinusitis No. 9 of 2010 (Federal Register of Legislation No. F2010L00553) made under subsection 196B(2) of the VEA is repealed. 5 Application This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies. 6 Definitions The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument. 7 Kind of injury, disease or death to which this Statement of Principles relates (1) This Statement of Principles is about sinusitis and death from sinusitis. Meaning of sinusitis (2) For the purposes of this Statement of Principles, sinusitis (also known as rhinosinusitis): (a) means inflammation of the nasal cavity and the paranasal sinuses; and (b) includes acute sinusitis and chronic sinusitis. Note: Sinusitis is characterised by the following signs and symptoms: nasal blockage or congestion, nasal discharge (anterior or postnasal drip), facial pain or pressure, or reduction or loss of smell, and fluid within the sinuses. (3) While sinusitis attracts ICD‑10‑AM code J01 or J32, in applying this Statement of Principles the meaning of sinusitis is that given in subsection (2). (4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4. Death from sinusitis (5) For the purposes of this Statement of Principles, sinusitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's sinusitis. Note: terminal event is defined in the Schedule 1 – Dictionary. 8 Basis for determining the factors The Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that sinusitis and death from sinusitis can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the MRCA. Note: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary. 9 Factors that must exist At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting sinusitis or death from sinusitis with the circumstances of a person's relevant service: (1) having impaired drainage of the sinus at the time of the clinical onset of sinusitis; Note: impaired drainage of the sinus is defined in the Schedule 1 - Dictionary. (2) having a viral, bacterial or fungal respiratory tract infection at the time of the clinical onset of sinusitis; (3) being in an immunocompromised state as specified at the time of the clinical onset of sinusitis; Note: immunocompromised state as specified is defined in the Schedule 1 - Dictionary. (4) having a specified medical condition at the time of the clinical onset of sinusitis; Note: specified medical condition is defined in the Schedule 1 - Dictionary. (5) undergoing a course of therapeutic radiation for cancer, where the nasal cavity and paranasal sinuses were in the field of radiation, before the clinical onset of sinusitis; (6) smoking at least one pack-year of cigarettes, or the equivalent thereof in other tobacco products, before the clinical onset of sinusitis, and: (a) smoking commenced at least one year before the clinical onset of sinusitis; and (b) where smoking has ceased, the clinical onset of sinusitis has occurred within three months of smoking cessation; Note: pack-year of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary. (7) being exposed to second-hand smoke: (a) for at least 1 000 hours before the clinical onset of sinusitis; and (b) where the first exposure to second-hand smoke commenced at least one year before the clinical onset of sinusitis; and (c) where the last exposure to second-hand smoke occurred within the three months before the clinical onset of sinusitis; Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary. (8) inhaling a drug or irritant substance which results in: (a) acute nasal symptoms or signs within 48 hours of the inhalation; and (b) scarring or erosion of the nasal or sinus mucosa; before the clinical onset of sinusitis; Note 1: Examples of drugs include cocaine, lidocaine, methylphenidate and narcotics.