Statement of Principles concerning mesothelioma (Balance of Probabilities) (No. 42 of 2024) (Cth)

Statement of Principles concerning MESOTHELIOMA (Balance of Probabilities) (No. 42 of 2024) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.

Dated 21 June 2024.

Professor Terence Campbell AM Chairperson by and on behalf of The Repatriation Medical Authority

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 mesothelioma (Balance of Probabilities) (No. 42 of 2024). 2 Commencement This instrument commences on 23 July 2024. 3 Authority This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986. 4 Repeal The Statement of Principles concerning mesothelioma No. 105 of 2015 (Federal Register of Legislation No. F2015L01320) made under subsections 196B(3) and (8) of the VEA is repealed. 5 Application This instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004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 mesothelioma and death from mesothelioma. Meaning of mesothelioma (2) For the purposes of this Statement of Principles, mesothelioma: (a) means a primary malignant neoplasm of the mesothelial cells that are located in the visceral and parietal mesothelium of the pleura, pericardium, peritoneum and tunica vaginalis testis; and (b) excludes soft tissue sarcoma, carcinoid tumour, non-Hodgkin lymphoma and Hodgkin lymphoma. (3) While mesothelioma attracts ICD‑10‑AM code C45, in applying this Statement of Principles the meaning of mesothelioma 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 mesothelioma (5) For the purposes of this Statement of Principles, mesothelioma, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's mesothelioma. Note: terminal event is defined in the Schedule 1 – Dictionary. 8 Basis for determining the factors On the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that mesothelioma and death from mesothelioma can be related to relevant service rendered by veterans 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 exist before it can be said that, on the balance of probabilities, mesothelioma or death from mesothelioma is connected with the circumstances of a person's relevant service: (1) inhaling asbestos fibres in an enclosed space: (a) at the time material containing asbestos fibres was being applied, removed, dislodged, cut or drilled; and (b) the first inhalation of asbestos fibres occurred at least 20 years before clinical onset; (2) inhaling asbestos fibres in an open environment for a cumulative period of at least 1,000 hours before the clinical onset of mesothelioma: (a) at the time material containing asbestos fibres was being applied, removed, dislodged, cut or drilled; and (b) the first inhalation of asbestos fibres occurred at least 20 years before clinical onset; (3) having asbestosis at the time of clinical onset; (4) inhaling fluoro-edenite fibres at a concentration of at least 1.76 fibres per litre on more days than not for at least 10 years, at least 25 years before clinical onset of pleural or peritoneal mesothelioma; Note: fluoro-edenite is defined in the Schedule 1 - Dictionary. (5) inhaling erionite fibres at a concentration of at least 0.3 fibres/cm3, every day for at least 10 years, at least 25 years before clinical onset; Note: erionite is defined in the Schedule 1 - Dictionary. (6) having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the affected region at least 10 years before clinical onset; Note: cumulative equivalent dose is defined in the Schedule 1 – Dictionary. (7) having received ablative radiotherapy for the treatment of cancer at least 10 years before clinical onset, with the mesothelioma occurring within the original field of radiation; (8) firefighting for a cumulative period of at least 1,000 hours before the clinical onset of mesothelioma, where the firefighting commenced at least 20 years before clinical onset; Note: firefighting is defined in the Schedule 1 – Dictionary. (9) inability to obtain appropriate clinical management for mesothelioma before clinical worsening. 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 factor set out in subsection 9(9) applies only to material contribution to, or aggravation of, mesothelioma where the person's mesothelioma 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(3) 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.