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(Brisbane & Adelaide) (previously the SMACC Unit) |
4th floor AMP Place, 10 Eagle St Brisbane Qld 4000.
Facsimile: 07 3223 8722.
Bob Connolly |
07 3223 8325 |
(Manager, Brisbane) |
Dr Bev Grehan |
07 3223 8376 |
Maureen Anderson |
08 8290 0365 |
(Manager, Adelaide) |
Dr Jon Kelley |
07 3223 8412 |
Duncan Cape |
07 3223 8757 |
Sue Lee |
08 8290 0227 |
|
Gaynor Cavanagh |
07 3223 8331 |
Bernadette McCabe |
07 3223 8393 |
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SOP BULLETIN # 23 |
28 June, 1999
THE FOLLOWING RMA SOPS ARE TO BE GAZETTED ON 30 JUNE 1999
New SOPs |
Hiatus Hernia |
Revocations & Determinations |
Non-Hodgkin's Lymphoma Diabetes Mellitus Subarachnoid Haemorrhage Seborrhoeic Dermatitis Cerebrovascular Accident |
Amendments |
Post Traumatic Stress Disorder Acute Stress Disorder Panic Disorder |
IMPORTANT OPERATIONAL FEATURES
HIATUS HERNIA |
New - 42 & 43 of 1999 |
There is only one factor – inability to obtain appropriate clinical management, and this only applies to aggravation of (the rare) paraoesophageal hiatal hernia. There are no factors which apply to the more commonly-occurring sliding hiatal hernia which means that that condition cannot be accepted as service-related.
NON-HODGKIN'S LYMPHOMA |
Revocation - 44 & 45 of 1999 (replaces 69 & 70 of '97) |
Minor changes to the definition.
The RH SOP factor dealing with exposure to herbicides in Vietnam has been removed. In both the RH and BOP SOP, there is now the new causal factor: “ spraying or decanting (not necessarily in Vietnam) of (specified) herbicides at least 5 years before the clinical onset of NHL ”. This factor in the BOP SOP specifies at least 100 days of spraying or decanting.
For RH cases, there is also the new causal factor: “ being on land or at sea in Vietnam for a total of at least 30 days (defined in terms of Schedule 2 of the VEA) at least 5 years before the clinical onset of NHL ”.
Immunosuppressive drug therapy must now be systemic (no longer chronic) and be for the treatment of specific diseases i.e. rheumatoid arthritis, Sjogren's syndrome, dermatitis herpetiformis or chronic glomerulonephritis.
For both RH and BOP cases, there is the new causal factor: “ receiving a solid organ or bone marrow transplant before the clinical onset of Non-Hodgkin's lymphoma ”.
DIABETES MELLITUS |
Revocation - 46 & 47 of 1999 (replaces 47 & 48 of '96 as amended by 187 & 188 of '96) |
For both RH and BOP, there are two new causal factors dealing with dioxin exposure. The first requires certain activities involving exposure to 2,3,7,8 TCDD-contaminated herbicides for specified periods before the clinical onset of diabetes mellitus
The second requires a specified minimum serum level of 2,3,7,8 TCDD at the time of the clinical onset of diabetes mellitus. Arrangements for these tests to be performed are being coordinated by Dr Keith Horsley, MSA, Disability Compensation.
The smoking factors have been reworded to express the consumption levels in pack years.
The drug factors have been re-organised. The factors dealing with lists of specified drugs have been removed. For both the RH and BOP SOPs, there are new causal and aggravating factors for drugs reported in the published peer-reviewed medical literature to have caused hyperglycaemia. It is likely that you will have to seek medical advice on individual cases. For both RH and BOP, there are also new causal and aggravating factors for having been treated with the drug pentamidine.
Treatment with immunosuppressive drugs for organ transplantation, as either a causal or aggravating element, must now be at the time of the clinical onset or worsening of diabetes mellitus in order to succeed.
SUBARACHNOID HAEMORRHAGE |
Revocation - 48 & 49 of 1999 (replaces 384 & 385 of '95) |
The definition has been changed to specifically exclude sub-arachnoid haemorrhage due to cerebral tumours or due to the presence of a bleeding disorder.
There have been changes to the dose levels in the alcohol factors. Note that the dose for both males and females is now the same in the BOP SOP.
The requirement to have used the oral contraceptive pill prior to 1980 has been removed.
The stress factor has been reworded, and the definition of “experiencing a severe stressor” has been amended by adding the word 'severe' before the word 'stressors' in the second paragraph.
There are three new factors dealing with intracranial mycotic aneurysm or intracranial mycotic arteritis, intracranial dissecting aneurysm and inflammatory vascular disease affecting the cerebral vessels.
SEBORRHOEIC DERMATITIS |
Revocation - 50 & 51 of 1999 (replaces 49 & 50 of '96) |
For both RH and BOP SOPs, two new ca — u — sal and aggravating factors have been added. One is “suffering from Parkinson's disease or syndrome” which can both cause and aggravate this condition.
The other new causal factor is suffering from an injury, or a physical or psychiatric disorder which limits the ability to maintain personal hygiene of the affected area for a period of at least two (RH) or four (BOP) weeks.
The other new aggravating factor consists of a specified list of conditions which if present for at least two (RH) or four (BOP) weeks, can aggravate seborrhoeic dermatitis.
CEREBOVASCULAR ACCIDENT |
Revocation - 52 & 53 of 1999 (replaces 7 & 8 of '99) |
The physical inactivity factor has been reworded in the same way as for the Ischaemic Heart Disease SOPs i.e. “a mildly strenuous level of”. The actual level of activity is unchanged.
The definition of “experiencing a severe stressor” has been changed by the addition of the word 'severe' before the word 'stressors' in the second paragraph.
For cerebral ischaemia, the “cerebral embolus” factor (k)(v) has been re-worded. The associated list has been re-organised and a number of conditions added.
There are five new causal factors for cerebral ischaemia - an acute hypotensive episode, a course of therapeutic radiation to the head or neck, hyperhomocystinaemia and nephrotic syndrome.
Vertebrobasilar ischaemia now appears as a sub-set of cerebral ischaemia (k)(xiv) to clarify that all factors for cerebral ischaemia also apply to vertebrobasilar ischaemia. The factors and their application are unchanged.
There are two new causal factors for intracerebral haemorrhage – “ undergoing intracranial surgery within the seven days before the clinical onset .. ” and “ bleeding from a cerebral aneurysm or cerebral arteriovenous malformation at the time of the clinical onset .. ”
For intracerebral haemorrhage, factor (m)(iv) has been reworded. This factor now refers to a specified list of haematological disorders that are associated with an excessive bleeding tendency due to a coagulation defect (rather than haemostatic failure). There have also been some changes to the contents of the specified list.
POST TRAUMATIC STRESS DISORDER |
Amendment - 54 & 55 of 1999 (amends 3 & 4 of '99) |
ACUTE STRESS DISORDER |
Amendment - 56 & 57 of 1999 (amends 5 & 6 of '99) |
PANIC DISORDER |
Amendment - 58 & 59 of 1999 (amends 9 & 10 of '99) |
These three SOPs have all had the definition of “experiencing a severe stressor” amended to add the word 'severe' before the word 'stressors' in the second paragraph.
This is the same change that has been made in the Cerebrovascular Accident SOPs and the Subarachnoid Haemorrhage SOPs. This change has also been previously made to the Ischaemic Heart Disease SOPs, the Drug Dependence or Drug Abuse SOPs, and the Alcohol Dependence or Alcohol Abuse SOPs.
Remember ! if you are having any problems with SOPs, including if you think a SOP needs to be changed, talk to us !