Consuming phenacetin

Phenacetin

RMA definition

In the SOP for malignant neoplasm of the renal pelvis and ureter the RMA has defined phenacetin to mean "an aniline derivative that has analgesic and ant-pyretic properties, and is also known as acetophenetidin, aceto-p-phenetidide, acetylphenetidin, phenacetinum, N-(4-ethoxyphenyl) acetamide, p-ethoxyacetanilide, or CAS 62-44-2.  It was previously found as a constituent of many over-the-counter headache remedies such as APC, Bromo seltzer and Empirin Compound (usually 90-150 mg per tablet)."

Malignant neoplasm of the bladder - Consuming phenacetin Factor

General information about phenacetin

·  At least prior to 1975 phenacetin was used in compound forms of many analgesics and headache remedies including APC (aspirin, phenacetin and caffeine), Vincent's powders, Bex, Bromo seltzer, Empirin Compound and many other over-the-counter and prescription drugs which were commonly used to treat pain and/or fever.  In the 1950s it was common practice for housewives to purchase a gross (144) of powders of aspirin, phenacetin and caffeine with the weekly groceries.

·  By 1980 phenacetin had been removed from all Australian products and had been replaced with paracetamol.

·  Phenacetin was available on prescription until the early 1970s, in formulas such as Nembudeine, Pentalgin, and Fiorinal which contained 150mg of phenacetin.  (NB the current product Fiorinal does not contain phenacetin).  Another similarly available formula, Sonalgin, contained 225mg of phenacetin.  These drugs would have been widely prescribed within the veteran community.

·  In the SOP for malignant neoplasm of the renal pelvis and ureter the RMA refers to single dosages as containing between 90-150mg of phenacetin, however it seems most preparations contained 150mg phenacetin.

Calculating phenacetin consumption

INVESTIGATIVE DOCUMENTS

PRELIMINARY QUESTIONS [39111]

39121 there is some evidence that consuming phenacetin may be a factor in the development of the condition under consideration.

39129 the veteran has consumed phenacetin in phenacetin-containing analgesics at some time.

39130 the veteran consumed a total of at least 100 grams of phenacetin in phenacetin-containing analgesics at least 5 years before the clinical onset of the condition under consideration.

39131 the veteran's consumption of a total of at least 100 grams of phenacetin in phenacetin-containing analgesics at least 5 years before the clinical onset of the condition under consideration was materially contributed to by an illness or injury which is identifiable.

39134  the veteran has established the causal connection between the consumption of phenacetin in phenacetin-containing analgesics and VEA service for the clinical onset of malignant neoplasm of the bladder.

39135   the veteran has established the causal connection between the consumption of phenacetin in phenacetin-containing analgesics and operational service for the clinical onset of malignant neoplasm of the bladder.

or

39136   the veteran has established the causal connection between the consumption of phenacetin in phenacetin-containing analgesics and eligible service for the clinical onset of malignant neoplasm of the bladder.

CLINICAL ONSET AND OPERATIONAL SERVICE [39135]

39132  the identified illness or injury, which made a material contribution to the veteran's consumption of phenacetin in phenacetin-containing analgesics, is causally related to operational service.

CLINICAL ONSET AND ELIGIBLE SERVICE [39136]

39133  the identified illness or injury, which made a material contribution to the veteran's consumption of phenacetin in phenacetin-containing analgesics, is causally related to eligible service.