SOP Bulletin No. 44

8 January 2001

IMPORTANT OPERATIONAL FEATURES

• This is a particular and rare form of anaemia and it is life threatening.
• There are only causal factors.

• This SOP covers blood clots that have lodged in the lungs, having broken off from: the deep veins draining the limbs (DVT); the right side of the heart; or the veins draining other organs (e.g. liver, kidney).
• There are only causal factors.

• There are new factors for undergoing non-surgical hospitalisation, being obese, hormone replacement therapy, antiphospholipid antibody syndrome, myocardial infarction, aneurysm of the affected vein and (for DVT in the lower limbs only) varicose veins and superficial vein thrombosis.
• The RH SOP includes a factor for treatment with an anti-psychotic drug that is not in the BOP SOP.  This represents a new approach by the RMA.

• The acoustic trauma factor has been reworded:

Being exposed to an impulsive noise of at least 130 dBA (RH)/140 dBA (BOP) without adequate ear protection within the 48 hours immediately before the clinical onset/worsening of tinnitus.

"Impulsive noise means noise which is characterised by a sharp rise and a rapid decay in sound level and is less than one second in duration."  An example of such a noise would be a rifle shot when fired at eye level (163 dBA)

• There is a new factor for being exposed to noise of at least 85 dBA as an 8-hour time-weighted average.  There is a table in the SOP that sets out the required duration for noise exposure levels between 80 dBA and 140 dBA for the purposes of satisfying this factor.
• The above factors will be mirrored in new sensorineural hearing loss SOPs which are expected to be gazetted in the near future.

• Factor (r) exposure to 2,3,7,8-TCDD contaminated herbicides is amended by splitting it into 2 factors.  As 2 factors this makes it absolutely clear that hand decanting or spraying of 2,3,7,8-TCDD contaminated herbicides is subject to a stipulated minimum exposure time before the clinical onset of diabetes mellitus.  Similarly cleaning and maintenance of spray equipment used to apply 2,3,7,8-TCDD contaminated herbicides is subject to a stipulated minimum exposure time.  This amendment was necessary to overcome an unintended interpretation of this factor.

• The only factor for this condition remains inability to obtain appropriate clinical management (ACM).  However the amendment makes it clear that this is the only factor that may be related to a veteran's service that causes, or materially contributes to, or aggravates polycythaemia vera.
• This is meant to overcome an interpretation that this SOP only applied to worsening of polycythaemia vera because as there were no "causation factors" in this SOP then the "causes" of polycythaemia vera were not covered by this SOP.
• All other SOPs with an ACM factor only will be amended in the same way in the near future.

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