SOP Bulletin No. 48

4 May 2001

THE FOLLOWING RMA SOPS ARE TO BE GAZETTED ON 9 May, 2001

IMPORTANT OPERATIONAL FEATURES

• There are changes to the soft tissue sarcoma definition and malignant neoplasm of the articular cartilage is now specifically excluded.  This clarifies that malignant neoplasm of the non-articular or non-skeletal cartilage (eg nasal cartilage) can be considered under this SOP.
• The herbicide factor now applies to both SOPs.  It requires exposure of at least 30 (RH) / 60 (BOP) days at least 2 (RH) / 5 (BOP) years before onset.  The definition of “a herbicide” provides an exclusive list of chemical agents found in chlorophenoxy herbicides.
• There are three factors that apply only to RH:

• 30 days on land or sea in Vietnam at least 2 years before onset
• exposure to 0.05 Sievert of atomic radia — tion - refer SOP Bulletin No 106
• infection with HIV

• There is a new chlorophenol factor with RH and BOP expressing different exposure and latency periods.  The RMA has specified the chemical agents affected and also defined the circumstances where “inhaling or absorbing a chlorophenol” may occur.  Chlorophenols have been widely produced since the 1950s and used as wood preservatives, fungicides, weedkillers and as precursors for chlorophenoxy herbicides.
• The gaseous vinyl chloride factor has been revised to provide latency periods (2 years RH / 5 years BOP) and now covers all types of soft tissue sarcoma.
• Radium-224 – a radionuclide that has been used in the treatment of tuberculosis, ankylosing spondylitis and some other diseases in the early period after World War II – is a new factor.
• There are minor changes to the therapeutic radiation factors - angiosarcoma requires a reduced latency period.
• There are new factors, with various RH/BOP requirements, relating to diagnostic scanning with a colloidal solution of thorium dioxide (thorotrast).  This form of radiological investigation was stopped around 1955.
• Two new factors apply only to hepatic angiosarcoma:

• Ingestion of arsenic
• Exposure to arsenic-containing pesticides

• Immunosuppressive drugs as treatment for specific medical conditions is a new factor.  In BOP this is limited to cyclophosphamide where it applies only to leiomyosarcoma of the bladder.

• A new factor - sensorineural hearing loss - has been added to both SOPs.  This overcomes the difficulties created by the January 2001 revocation by addressing those cases where the clinical onset of tinnitus has occurred many years after service.

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