Statement of Principles concerning irritant contact dermatitis (Reasonable Hypothesis) (No. 3 of 2021) (Cth)

Statement of Principles concerning IRRITANT CONTACT DERMATITIS (Reasonable Hypothesis) (No. 3 of 2021) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.

Dated 24 December 2020

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 irritant contact dermatitis (Reasonable Hypothesis) (No. 3 of 2021). 2 Commencement This instrument commences on 25 January 2021. 3 Authority This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986. 4 Repeal The Statement of Principles concerning irritant contact dermatitis No. 110 of 2011 (Federal Register of Legislation No. F2011L01746) made under subsection 196B(2) of the VEA is repealed. 5 Application This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004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 irritant contact dermatitis and death from irritant contact dermatitis. Meaning of irritant contact dermatitis (2) For the purposes of this Statement of Principles, irritant contact dermatitis: (a) means inflammation of an area of the skin from exposure to an irritant that has been applied to the same area of skin; and (b) involves direct tissue injury; and (c) includes irritant contact dermatitis that is due to cutaneous exposure from airborne irritants; and (d) excludes: (i) allergic contact dermatitis; (ii) atopic dermatitis (eczema); (iii) dermatitis due to extremes of weather, friction, solar radiation or other forms of radiation; (iv) photocontact dermatitis; (v) systemic allergic dermatitis; and (vi) urticaria. Note: Irritant contact dermatitis typically presents as a well-demarcated red rash in an area of skin that has come into contact with an irritant. It may be acute, with swelling and blistering of affected skin or chronic, with dryness, scaling, thickening or fissuring of affected skin. Irritant contact dermatitis can affect the skin of the eyelids and surrounding the mouth. (3) While irritant contact dermatitis attracts ICD‑10‑AM code L22 or L24, in applying this Statement of Principles the meaning of irritant contact dermatitis 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 irritant contact dermatitis (5) For the purposes of this Statement of Principles, irritant contact dermatitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's irritant contact dermatitis. 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 irritant contact dermatitis and death from irritant contact dermatitis 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 irritant contact dermatitis or death from irritant contact dermatitis with the circumstances of a person's relevant service: (1) having the affected area of skin exposed to an irritant within the three days before the clinical onset of irritant contact dermatitis; Note 1: irritant is defined in the Schedule 1 - Dictionary. Note 2: Activities involving prolonged or frequent contact with water or other liquids (wet work) are a common cause of irritant contact dermatitis. Such activities include frequent hand washing, handling wet things and prolonged wearing of occlusive gloves. (2) having the affected area of skin exposed to an irritant within the three days before the clinical worsening of irritant contact dermatitis; Note 1: irritant is defined in the Schedule 1 - Dictionary. Note 2: Activities involving prolonged or frequent contact with water or other liquids (wet work) are a common cause of irritant contact dermatitis. Such activities include frequent hand washing, handling wet things and prolonged wearing of occlusive gloves. (3) inability to obtain appropriate clinical management for irritant contact dermatitis. 10 Relationship to service (1) The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person. (2) The factors set out in subsections 9(2) to 9(3) apply only to material contribution to, or aggravation of, irritant contact dermatitis where the person's irritant contact dermatitis was suffered or contracted before or during (but did not arise out of) the person's relevant service. 11 Factors referring to an injury or disease covered by another Statement of Principles In this Statement of Principles: (1) if a factor referred to in section 9 applies in relation to a person; and (2) that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(2) of the VEA; then the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.