SOP Bulletin No. 55

4 — th Floor AMP Place, 10 Eagle St Brisbane  3 — rd Floor Blackburn House, 199 Grenfell St Adelaide

Intranet site:  http://intranet/nat/comp/dp/Nop/dsu/dsudefault.htm

26 November 2001

THE FOLLOWING RMA SOPS ARE TO BE GAZETTED ON 28 NOVEMBER, 2001

IMPORTANT OPERATIONAL FEATURES

• The definition has changed, but this should not have any operational effect.  Asthmatic bronchitis (covered by the CB & E SOP) is now specifically excluded. 
• There are two new causal factors, covering antigen and irritant exposures.  The irritant factor applies only to reactive airways dysfunction syndrome, a specific rare form of asthma.  Note the particular definitional requirements for these factors.  The DSU will be happy to assist with information on whether an agent has been reported in the literature to be a cause of asthma, as required by the relevant definitions.
• The “occupational antigen” causal factor remains but with a new definition that provides a list of specific inhaled substances instead of examples.
• All three causal factors apply only where the first ever episode of asthma has occurred within 24 hours of the relevant exposure.
• There is a new worsening factor for reflux (GORD).
• This SOP remains the only one with a specific definition of clinical worsening.  That definition has been changed and now allows for an increase in maintenance asthma medication as evidence of permanent worsening in some circumstances.

• There is a reworked definition, without any operational effect.
• Smoking factor: There are different smoking doses for the RH and BOP SOPs, as before.  But in addition, the RH factor covers all forms of tobacco, whereas the BOP SOP covers cigarettes only.  
• Asbestos exposure:  The RH SOP includes two asbestos factors.  One for exposure in an enclosed space and a higher dose one for exposure in any circumstances.  The BOP SOP has only the latter factor, with a higher dose requirement than the RH SOP.

• There is a reworked definition, without any operational effect.
• The two hours per day (for X days) requirement in both the repetitive movements factor and the vibration factor has been removed and replaced with a total number of hours requirement.
• The repetitive activities factor has been broadened and now also covers “forceful activities”.  Note the accompanying definition – CCPS commentary will attempt to explain this.  Until that commentary is available, contact the DSU for advice if required.
• The daily use of a manual wheelchair factor has been reworded and now has time requirements.
• The fracture to the wrist factor now also includes dislocation to various relevant bones.
• The separate rheumatoid arthritis factor has been removed;  RA is now included in a new factor – inflammatory arthritis - which covers various specified diseases.
• There are new factors for oedema, haemorrhage, and infection, all involving the affected carpal tunnel at the time of onset/worsening.

• The disease definition has been changed, with a reduction in the required fasting blood glucose concentration to 7.0 millimoles per litre (previously 7.8).
• SOPs with a diabetes factor still have the old definition.  This discrepancy has been raised with the RMA and will be considered at the next RMA meeting.

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