Reasonable Hypothesis [1] | 83 of 2019 |
Balance of Probabilities [2] | 84 of 2019 |
SOP Bulletin 210 [3]
This is a primary cancer of the lining of the bladder.
The diagnosis requires confirmation by histology.
The relevant medical specialist is a urologist.
* another SOP applies
#Non-SOP condition
The most common presentation is painless haematuria (blood in the urine), either visible or detected on testing. However, haematuria in most cases is due to a benign cause. Other symptoms of bladder cancer are also similar to those of benign urinary disorders. Delays in diagnosis are common. Clinical onset may coincide with the time of diagnosis, or it may be possible to backdate clinical onset based on preceding symptoms or findings.
The only SOP worsening factor is for inability to obtain appropriate clinical management. Bladder cancer has a very variable course and prognosis. It is amenable to treatment if found early. A delay in appropriate treatment could result in worsening of the condition. Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.
Place holder node for Rulebase for malignant neoplasm of the bladder
Renal transplantation means surgical replacement of a kidney with a kidney from another person.
If a veteran or member had undergone renal transplantation, this would be recorded in doctors' notes and/or hospital records. However, if these records have been destroyed or can no longer be obtained and there is a reliable history of renal transplantation at a particular time, this generally will be accepted, unless there is contradictory evidence.
39127 there is some evidence that having a renal transplant may be a factor in the development of the condition under consideration.
12229 the veteran has had a renal transplantation at some time.
20052 the renal transplant was for an illness or injury which is identifiable. [Default true]
39166 for the identified illness or injury, the veteran had a renal transplant at least one year before the clinical onset of the condition under consideration.
39167 the veteran has established the causal connection between the renal transplant and VEA service for the clinical onset of malignant neoplasm of the bladder.
39168 the veteran has established the causal connection between the renal transplant and operational service for the clinical onset of malignant neoplasm of the bladder.
or
39169 the veteran has established the causal connection between the renal transplant and eligible service for the clinical onset of malignant neoplasm of the bladder.
25040 the identified illness or injury which required the renal transplant is causally related to operational service.
20067 the identified illness or injury which required the renal transplant is causally related to eligible service.
A catheter is used to drain urine from the bladder where bladder control does not enable this to be done normally. The catheter can be inserted via the urethra or directly into the bladder via an incision in the abdominal wall (suprapubic catheter). An indwelling catheter can be left in place for weeks at a time; it is usually held securely by an inflated balloon at the end of the catheter. Conditions requiring long term catherisation include spinal cord injuries, advanced multiple sclerosis, dementia, and bladder neck obstruction.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Medical Report | Having an Indwelling Bladder Catheter - Malignant Neoplasm of the Bladder | MR9402.pdf [5] | MR9402.docx [6] |
39125 there is some evidence that having an indwelling bladder catheter may be a factor in the development of the condition under consideration.
39150 the veteran has had an indwelling bladder catheter for a continuous period of at least ten years, excepting routine catheter changes, at some time.
39151 the veteran had an indwelling bladder catheter for a continuous period of at least ten years, excepting routine catheter changes, before the clinical onset of the condition under consideration.
39152 the veteran had an indwelling bladder catheter for a continuous period of at least ten years, excepting routine catheter changes, before the clinical onset of the condition under consideration as a consequence of an illness or injury which is identifiable.
39155 the veteran has established the causal connection between having an indwelling bladder catheter and VEA service for the clinical onset of malignant neoplasm of the bladder.
39156 the veteran has established the causal connection between having an indwelling bladder catheter and operational service for the clinical onset of malignant neoplasm of the bladder.
or
39157 the veteran has established the causal connection between having an indwelling bladder catheter and eligible service for the clinical onset of malignant neoplasm of the bladder.
39153 the identified illness or injury, for which the veteran had an indwelling bladder catheter for a continuous period of at least ten years, excepting routine catheter changes, is causally related to operational service.
39154 the identified illness or injury, for which the veteran had an indwelling bladder catheter for a continuous period of at least ten years, excepting routine catheter changes, is causally related to eligible service.
The RMA defines atomic radiation as "ionising radiation excluding:
Australian service personnel with known atomic radiation exposure are:
(i) POW(J)s who were in the Nagasaki area on 9 August 1945.
(ii) Personnel who served in or visited Hiroshima in connection with the occupation of Japan by the British Commonwealth Occupation Force from February 1946.
(iii) Members of the defence forces who were involved in the British Nuclear Tests (BNT) Program in Australia between 1952 and 1963.
There are no other groups of Australian service personnel with eligible VEA service who have known service-related atomic radiation exposure.
There may also be other individual service personnel who contend exposure to atomic radiation during service covered by the VEA. Such claims should be investigated on their merits.
Further information about atomic radiation is contained in SOP bulletin No. 106 - ATOMIC RADIATION and SOP bulletin No. 145 – ATOMIC RADIATION – UPDATE BRITISH NUCLEAR TEST PARTICIPANTS
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Exposure to Atomic Radiation | CR9171.pdf [7] | CR9171.docx [8] |
30275 there is some evidence that atomic radiation may be a factor in the development of the condition under consideration.
11718 the veteran has established the causal connection between the atomic radiation and VEA service for the clinical onset of malignant neoplasm of the bladder.
30276 the veteran has established the causal connection between the atomic radiation and operational service for the clinical onset of malignant neoplasm of the bladder.
or
30277 the veteran has established the causal connection between the atomic radiation and eligible service for the clinical onset of malignant neoplasm of the bladder.
11719 the veteran received a cumulative equivalent dose of at least 0.05 Sievert of atomic radiation to the bladder.
11720 the veteran received a cumulative equivalent dose of at least 0.05 Sievert of atomic radiation to the bladder where this dose was accumulated at least five years before the clinical onset of the condition under consideration.
34941 the veteran's operational service made a material contribution to the cumulative equivalent dose of at least 0.05 Sievert of atomic radiation to the bladder where this dose was accumulated at least five years before the clinical onset of the condition under consideration.
11721 the cumulative equivalent dose of at least 0.05 Sievert of atomic radiation to the bladder, to which operational service made a material contribution, and this dose was accumulated at least five years before the clinical onset of the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline.
11723 the veteran received a cumulative equivalent dose of at least 0.5 Sievert of atomic radiation to the bladder.
11724 the veteran received a cumulative equivalent dose of at least 0.5 Sievert of atomic radiation to the bladder where this dose was accumulated at least five years before the clinical onset of the condition under consideration.
34942 the veteran's eligible service made a material contribution to the cumulative equivalent dose of at least 0.5 Sievert of atomic radiation to the bladder where this dose was accumulated at least five years before the clinical onset of the condition under consideration.
30278 the cumulative equivalent dose of at least 0.5 Sievert of atomic radiation to the bladder, to which eligible service made a material contribution, and this dose was accumulated at least five years before the clinical onset of the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline.
If there is a history of cigar smoking it will be necessary to obtain information about:
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Smoking | CRD905.pdf [9] | CRD905.docx [10] |
Claimant Report | Smoking | CRV905.pdf [11] | CRV905.docx [12] |
22889 there is some evidence that cigar smoking may be a factor in the development of the condition under consideration.
11770 the veteran has established the causal connection between the cigar smoking and VEA service for the clinical onset of malignant neoplasm of the bladder.
11771 the veteran has established the causal connection between the cigar smoking and operational service for the clinical onset of malignant neoplasm of the bladder.
or
11772 the veteran has established the causal connection between the cigar smoking and eligible service for the clinical onset of malignant neoplasm of the bladder.
11773 the veteran smoked at least 2.5 pack years of cigars before the clinical onset of the condition under consideration.
4921 the veteran has some period or periods of cigar smoking that are causally related to operational service.
11774 the veteran smoked at least 5 pack years of cigars before the clinical onset of the condition under consideration.
4922 the veteran has some period or periods of cigar smoking that are causally related to eligible service.
This factor deals with the personal use of cigarettes ie it does not include passive smoking.
If there is a history of cigarette smoking it will be necessary to obtain information about:
· the quantity smoked (either tailor-made cigarettes per day or hand-rolled cigarettes in ounces per week or a combination of both);
· when this took place; and
· the reasons for smoking.
The evidence gathered should be as complete and accurate as possible. Information already held in departmental files, eg in previous statements and clinical notes, should not be overlooked. Conflicting evidence should be resolved.
Before a causal link between a smoking habit and service may be established, consideration must be given to Repatriation Commission Guideline CM5030 - Guideline for claims assessors on smoking and alcohol related conditions and military service.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Smoking | CRD905.pdf [9] | CRD905.docx [10] |
Claimant Report | Smoking | CRV905.pdf [13] | CRV905.docx [12] |
5803 the veteran has ever smoked cigarettes.
11766 the veteran has established the causal connection between the cigarette smoking and VEA service for the clinical onset of malignant neoplasm of the bladder.
4031 the veteran has established the causal connection between the cigarette smoking and operational service for the clinical onset of malignant neoplasm of the bladder.
or
11767 the veteran has established the causal connection between the cigarette smoking and eligible service for the clinical onset of malignant neoplasm of the bladder.
11768 the veteran smoked at least 2.5 pack years of cigarettes before the clinical onset of the condition under consideration.
3116 the veteran has some period or periods of cigarette smoking that are causally related to operational service.
11769 the veteran smoked at least 5 pack years of cigarettes before the clinical onset of the condition under consideration.
3521 the veteran has some period or periods of cigarette smoking that are causally related to eligible service.
Aristolochia fangchi
This herb, which has no therapeutic benefit, has been mistakenly used in traditional Chinese medicine in place of other herbs very similar in appearance or of similar name. Aristolochia has been banned in Australia by the Therapeutic Goods Administration (http://www.tga.gov.au/docs/html/aristol.htm [14]).
Type | Title | PDF Formar | Word Format |
---|---|---|---|
Claimant Report | Consuming Aristolochia Fangchi as a Contaminant of Herbal Weight Loss Medication | CR9294.pdf [15] | CR9294.docx [16] |
Medical Report | Consuming Aristolochia Fangchi as a Contaminant of Herbal Weight Loss Medication | MR9401.pdf [17] | MR9401.docx [18] |
39122 there is some evidence that consuming Aristolochia fangchi as a contaminant of herbal weight loss medication may be a factor in the development of the condition under consideration.
39189 the veteran has consumed a total of at least 100 grams of Aristolochia fangchi as a contaminant of herbal weight loss medication at some time.
39190 the veteran consumed a total of at least 100 grams of Aristolochia fangchi as a contaminant of herbal weight loss medication at least 5 years before the clinical onset of the condition under consideration.
39191 the veteran has established the causal connection between consuming Aristolochia fangchi as a contaminant of herbal weight loss medication and VEA service for the clinical onset of malignant neoplasm of the bladder.
39192 the veteran has established the causal connection between consuming Aristolochia fangchi as a contaminant of herbal weight loss medication and operational service for the clinical onset of malignant neoplasm of the bladder.
or
39193 the veteran has established the causal connection between consuming Aristolochia fangchi as a contaminant of herbal weight loss medication and eligible service for the clinical onset of malignant neoplasm of the bladder.
39195 operational service made a material contribution to the veteran's consumption of a total of at least 100 grams of Aristolochia fangchi as a contaminant of herbal weight loss medication at least 5 years before the clinical onset of the condition under consideration.
or
39199 the veteran's consumption of a total of at least 100 grams of Aristolochia fangchi as a contaminant of herbal weight loss medication 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.
39197 the identified illness or injury, which materially contributed to the veteran's consumption of a total of at least 100 grams of Aristolochia fangchi as a contaminant of herbal weight loss medication at least 5 years before the clinical onset of the condition under consideration, is causally related to operational service.
39196 eligible service made a material contribution to the veteran's consumption of a total of at least 100 grams of Aristolochia fangchi as a contaminant of herbal weight loss medication at least 5 years before the clinical onset of the condition under consideration.
or
39199 the veteran's consumption of a total of at least 100 grams of Aristolochia fangchi as a contaminant of herbal weight loss medication 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.
39198 the identified illness or injury, which materially contributed to the veteran's consumption of a total of at least 100 grams of Aristolochia fangchi as a contaminant of herbal weight loss medication at least 5 years before the clinical onset of the condition under consideration, is causally related to eligible service.
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)."
· 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.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Phenacetin - Malignant Neoplasm of the Bladder | CR9293.pdf [19] | CR9293.docx [20] |
Medical Report | Phenacetin - Malignant Neoplasm of the Bladder | MR9400.pdf [21] | MR9400.docx [22] |
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.
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.
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.
Diabetes mellitus is an endocrine disease where there is diminished insulin action. It can also be referred to as "sugar diabetes", juvenile onset diabetes, Type I diabetes, IDDM (insulin dependent diabetes mellitus), NIDDM (non insulin dependent diabetes mellitus), Type II diabetes and maturity onset diabetes.
· Insulin dependent diabetes usually begins before the age of 40 with the abrupt onset of symptoms such as thirst, excessive urination, increased appetite and weight loss.
· Non insulin dependent diabetes usually begins in middle life or beyond, and the typical patient is overweight. The onset of symptoms is more gradual, or there may be no symptoms and diabetes is diagnosed on routine testing.
If a veteran had diabetes mellitus there would be specific evidence with regard to blood sugar levels and the need for diet, weight loss, insulin or drugs to lower blood sugar levels (eg Daonil, Euglocon, Glimel, Diabinese, Rastinon, Diamicron, Minidiab, Melizide), drugs to help insulin work better (eg Diabex, Diaformin, Glucophage) and drugs to slow the digestion of carbohydrates (eg Glucobay).
31954 there is some evidence that diabetes mellitus may be a factor in the development of the condition under consideration.
489 the veteran has diabetes mellitus.
10547 the veteran has insulin dependent diabetes mellitus (type 1).
or
10548 the veteran has non-insulin dependent diabetes mellitus (type 2).
39137 the veteran had the identified illness or injury, a type of diabetes mellitus, for at least 5 years before the clinical onset of the condition under consideration.
39138 the veteran has established the causal connection between the diabetes mellitus and operational service for the clinical onset of malignant neoplasm of the bladder.
17527 the identified illness or injury, a type of diabetes mellitus, is causally related to operational service.
Renal dialysis is an artificial method of maintaining the chemical balance of the blood when the kidneys have failed. The term dialysis refers to the process in which the components of the blood are separated using a semipermeable membrane. The blood is cleansed of impurities and returned to the patient. There are two main types of dialysis:
· Haemodialysis where the blood is pumped out of the patient, cycled through a machine (dialyser) containing a membrane, and back into the patient via catheters; and
· Peritoneal dialysis where the individual's peritoneum is used to perform dialysis inside the patient's body. Sterile, warmed dialysis fluid is infused via a catheter into the patient's peritoneal cavity, allowed to remain there the prescribed length of time, then drained out along with the dissolved waste products, discarded, and replaced with fresh fluid.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Medical Report | Dialysis for a Chronic Renal Condition - Malignant Neoplasm of the Bladder | MR9403.pdf [23] | MR9403.docx [24] |
39128 there is some evidence that dialysis for a chronic renal condition may be a factor in the development of the condition under consideration.
39158 the veteran has undergone dialysis for a chronic renal condition for at least a year at some time.
39159 the veteran underwent dialysis for a chronic renal condition for at least the one year before the clinical onset of the condition under consideration.
39160 the chronic renal condition, for which the veteran underwent dialysis for at least the one year before the clinical onset of the condition under consideration, is an illness or injury which is identifiable.
39163 the veteran has established the causal connection between undergoing dialysis for a chronic renal condition and VEA service for the clinical onset of malignant neoplasm of the bladder.
39164 the veteran has established the causal connection between undergoing dialysis for a chronic renal condition and operational service for the clinical onset of malignant neoplasm of the bladder.
or
39165 the veteran has established the causal connection between undergoing dialysis for a chronic renal condition and eligible service for the clinical onset of malignant neoplasm of the bladder.
CLINICAL ONSET AND OPERATIONAL SERVICE [39164]
39161 the identified illness or injury, a chronic renal condition for which the veteran underwent dialysis for at least a year, is causally related to operational service.
CLINICAL ONSET AND ELIGIBLE SERVICE [39165]
39162 the identified illness or injury, a chronic renal condition for which the veteran underwent dialysis for at least a year, is causally related to eligible service.
In the SOP for malignant neoplasm of the bladder, the RMA has defined being exposed to aromatic amines as "inhaling, ingesting or having cutaneous contact" with an aromatic amine which is "an organic compound that contains one or more amino groups joined to an aromatic structure".
In reasonable hypothesis cases the exposure can be to any aromatic amine; whereas in balance of probability cases there is a specified list of aromatic amines. However the SOPs for both standards of proof require exposure for a cumulative period of at least 250 days.
Aromatic amines have a wide range of uses including the manufacture of textile and fur dyes, polyurethane products, and pesticides, and as a chemical agent in laboratory analysis. However, chlornaphazine was used a treatment for haematological malignancies.
There are several trades or musterings in the Defence Forces which may have involved some exposure to aromatic amines. Examples advised by the Department of Defence are:
RAAF |
Surface finishers Structural fitters |
Army |
RAEME (RA Electrical and Mechanical Engineers) Ordnance Corps |
RAN |
Bosun's mate Engine room crew |
Additional information about the nature and scope of specific military occupations may be found in Physical requirements, duties, and workplace hazards of specific military occupations which also contains an embedded hotword military occupations with fumes and irritants component.
· the 11th Report on Carcinogens(http://ntp.niehs.nih.gov/go/16183 [25])
· the Agency for Toxic Substances and Disease Registry(http://www.atsdr.cdc.gov/toxfaq.html [26])
· EPA Chemical Fact Sheets(http://www.ndcrt.org/data/EPA_Chemical_Fact_Sheets/ [27])
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Exposure to a Aromatic Amines - Malignant Neoplasm of the Bladder | CR9169.pdf [28] | CR9169.docx [29] |
11716 there is some evidence that exposure to aromatic amines may be a factor in the development of the condition under consideration.
11781 the veteran has established the causal connection between the exposure to aromatic amines and VEA service for the clinical onset of malignant neoplasm of the bladder.
11782 the veteran has established the causal connection between the exposure to aromatic amines and operational service for the clinical onset of malignant neoplasm of the bladder.
or
11783 the veteran has established the causal connection between the exposure to aromatic amines and eligible service for the clinical onset of malignant neoplasm of the bladder.
11785 the veteran experienced inhalation, ingestion or cutaneous contact with an aromatic amine for a cumulative period of at least 250 days at some time.
11786 the veteran experienced inhalation, ingestion or cutaneous contact with an aromatic amine for a cumulative period of at least 250 days before the clinical onset of the condition under consideration.
11784 operational service made a material contribution to the veteran experiencing inhalation, ingestion or cutaneous contact with an aromatic amine for a cumulative period of at least 250 days before the clinical onset of the condition under consideration.
11788 the veteran experienced inhalation, ingestion or cutaneous contact with one of the aromatic amines from the specified list for a cumulative period of at least 250 days at some time.
11790 the veteran experienced inhalation, ingestion or cutaneous contact with one of the aromatic amines from the specified list for a cumulative period of at least 250 days before the clinical onset of the condition under consideration.
11787 eligible service made a material contribution to the veteran experiencing inhalation, ingestion or cutaneous contact with one of the aromatic amines from the specified list for a cumulative period of at least 250 days before the clinical onset of the condition under consideration.
The SOP requirements for arsenic exposure have different amounts for reasonable hypothesis cases and balance of probability cases.
The RMA has defined this exposure as meaning:
(a) consuming drinking water with arsenic content higher than [0.05 ppm (50 µg/l) for RH cases] or [0.10 ppm (100 µg/l) for BOP cases] for a cumulative period of at least ten years; or
(b) having clinical evidence of excessive chronic arsenic exposure.
A veteran or member would not have consumed drinking water with an arsenic content higher than 50 µg/l during service in Australia. This is because in major Australian reticulated water supplies, concentrations of arsenic should not exceed 7 µg/l.
Arsenic is a naturally occurring element which can be introduced into water through the dissolution of minerals and ores, or from industrial effluent, atmospheric deposition, drainage from old gold mines, or the use of some types of sheep dip. Arsenic is also used in many pesticides.
If excessive arsenic exposure is suspected, blood and urine tests would be conducted as well as an ECG, and sensory conduction tests particularly in the lower limbs. Some investigation would be done to determine the source of arsenic poisoning in order to prevent on-going exposure.
Type | Title | PFD Format | Word Format |
---|---|---|---|
Claimant Report | Exposure to Arsenic | CR9295.pdf [30] | CR9295.docx [31] |
12957 there is some evidence that exposure to arsenic as specified may be a factor in the development of the condition under consideration.
39523 the veteran has been exposed to arsenic as specified in the Statements of Principles for malignant neoplasm of the bladder at some time.
39170 the veteran has established the causal connection between the exposure to arsenic as specified and VEA service for the clinical onset of malignant neoplasm of the bladder.
39171 the veteran has established the causal connection between the exposure to arsenic as specified and operational service for the clinical onset of malignant neoplasm of the bladder.
or
39172 the veteran has established the causal connection between the exposure to arsenic as specified and eligible service for the clinical onset of malignant neoplasm of the bladder.
31444 the veteran was exposed to arsenic as specified in the reasonable hypothesis Statement of Principles for the condition under consideration at some time.
39173 the veteran was exposed to arsenic as specified in the reasonable hypothesis Statement of Principles for the condition under consideration before the clinical onset of the condition under consideration.
39174 operational service made a material contribution to the veteran's exposure to arsenic as specified in the reasonable hypothesis Statement of Principles for the condition under consideration before the clinical onset of the condition under consideration.
39175 the veteran's exposure to arsenic as specified in the reasonable hypothesis Statement of Principles for the condition under consideration, to which operational service made a material contribution before the clinical onset, was due to the veteran's serious default, wilful act or serious breach of discipline.
31445 the veteran was exposed to arsenic as specified in the balance of probabilities Statement of Principles for the condition under consideration at some time.
39176 the veteran was exposed to arsenic as specified in the balance of probabilities Statement of Principles for the condition under consideration before the clinical onset of the condition under consideration.
39177 eligible service made a material contribution to the veteran's exposure to arsenic as specified in the balance of probabilities Statement of Principles for the condition under consideration before the clinical onset of the condition under consideration.
39178 the veteran's exposure to arsenic as specified in the balance of probabilities Statement of Principles for the condition under consideration, to which eligible service made a material contribution before the clinical onset, was due to the veteran's serious default, wilful act or serious breach of discipline.
Being exposed to fumes containing high concentrations of polycyclic aromatic hydrocarbons means:
(i) working with creosote;
(ii) working with coal-tar pitch, coal-tar or asphalt;
(iii) working in the coal gasification, coke production, carbon electrode manufacture or the coal-tar distillation industry;
(iv) being exposed to coke oven emissions; or
(v) inhaling diesel engine exhaust or combustion products in an enclosed space – this 'inhalation' exposure applies to reasonable hypothesis cases only.
Information about the scope and nature of service duties may be found in Physical requirements, duties, and workplace hazards of specific military occupations which also contains an embedded table: Military occupations with fumes and irritants component.
Malignant neoplasm of the bladder - Exposure to fumes containing high concentrations of PAHs Factor
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Polycyclic Aromatic Hydrocarbons - Malignant Neoplasm of the Bla | CR9170.pdf [32] | CR9170.docx [33] |
39123 there is some evidence that exposure to fumes containing high concentrations of polycyclic aromatic hydrocarbons may be a factor in the development of the condition under consideration.
39182 the veteran has been exposed to fumes containing high concentrations of polycyclic aromatic hydrocarbons at some time.
39179 the veteran has established the causal connection between the exposure to fumes containing high concentrations of polycyclic aromatic hydrocarbons and VEA service for the clinical onset of malignant neoplasm of the bladder.
39180 the veteran has established the causal connection between the exposure to fumes containing high concentrations of polycyclic aromatic hydrocarbons and operational service for the clinical onset of malignant neoplasm of the bladder.
or
39181 the veteran has established the causal connection between the exposure to fumes containing high concentrations of polycyclic aromatic hydrocarbons and eligible service for the clinical onset of malignant neoplasm of the bladder.
39183 the veteran has been exposed to fumes containing high concentrations of polycyclic aromatic hydrocarbons as specified in the reasonable hypothesis Statement of Principles for malignant neoplasm of the bladder for a cumulative period of at least 5000 hours at some time.
39185 the veteran was exposed to fumes containing high concentrations of polycyclic aromatic hydrocarbons as specified in the reasonable hypothesis Statement of Principles for malignant neoplasm of the bladder for a cumulative period of at least 5000 hours before the clinical onset of the condition under consideration.
39187 operational service made a material contribution to the veteran's exposure to fumes containing high concentrations of polycyclic aromatic hydrocarbons as specified in the reasonable hypothesis Statement of Principles for malignant neoplasm of the bladder for a cumulative period of at least 5000 hours before the clinical onset of the condition under consideration.
39184 the veteran has been exposed to fumes containing high concentrations of polycyclic aromatic hydrocarbons as specified in the balance of probabilities Statement of Principles for malignant neoplasm of the bladder for a cumulative period of at least 10000 hours at some time.
39186 the veteran was exposed to fumes containing high concentrations of polycyclic aromatic hydrocarbons as specified in the balance of probabilities Statement of Principles for malignant neoplasm of the bladder for a cumulative period of at least 10000 hours before the clinical onset of the condition under consideration.
39188 eligible service made a material contribution to the veteran's exposure to fumes containing high concentrations of polycyclic aromatic hydrocarbons as specified in the balance of probabilities Statement of Principles for malignant neoplasm of the bladder for a cumulative period of at least 10000 hours before the clinical onset of the condition under consideration.
Tetrachloroethylene is used mainly in the dry cleaning industry but is also used in car care products, and in the textile, printing and film industries. It is commonly know as perchloroethylene or 'perc'.
Other dry cleaning solvents
Dry cleaning solvents dissolve oils and fats that are not water soluble. Apart from 'perc', petroleum hydrocarbons, such as white spirits, are commonly used in dry cleaning. Solvents have many uses besides dry cleaning, these include degreasing, fire retardation and pesticides, for example carbon tetrachloride.
Carbon tetrachloride has been known to be highly toxic since the 1920's. Its use in Australia was phased out by 1995. The Department of Defence have advised that carbon tetrachloride was used extensively in vehicle workshops. It was used as a degreaser and therefore mechanics and drivers of all three services were the most likely trades to be using this solvent on a regular basis. In the 1960's the use of carbon tetrachloride was restricted and has been replaced by less toxic alternatives but has not been eliminated altogether.
Additional information may be found in Physical requirements, duties, and workplace hazards of specific military occupations which also contains an embedded hotword, military occupations with fumes and irritants component.
Malignant neoplasm of the bladder - Exposure to tetrachloroethylene or dry cleaning solvents Factor
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Exposure to Tetrachloroethylene or Dry Cleaning Solvents - Malignant Neoplasm of the Bladder | CR9296.pdf [34] | CR9296.docx [35] |
39126 there is some evidence that exposure to tetrachloroethylene or dry cleaning solvents may be a factor in the development of the condition under consideration.
39146 the veteran has established the causal connection between inhaling or having cutaneous contact with tetrachloroethylene or dry cleaning solvents and operational service for the clinical onset of malignant neoplasm of the bladder.
39147 the veteran has experienced inhalation or cutaneous contact with tetrachloroethylene or dry cleaning solvents for a cumulative period of at least 5000 hours at some time.
39148 the veteran experienced inhalation or cutaneous contact with tetrachloroethylene or dry cleaning solvents for a cumulative period of at least 5000 hours before the clinical onset of the condition under consideration.
39149 operational service made a material contribution to the veteran experiencing inhalation or cutaneous contact with tetrachloroethylene or dry cleaning solvents for a cumulative period of at least 5000 hours before the clinical onset of the condition under consideration.
Schistosoma haematobium is a type of parasitic worm that may infest the genito-urinary system in humans. Eggs are deposited and are passed in the urine. Symptoms of infestation include painful urination, frequency of urination and blood in the urine. Diagnosis is usually by identification of eggs in the urine although eggs may also be detected in bladder or rectal biopsy materials.
There are 6 species of Schistosoma, each of which is endemic to specific areas of the world. Therefore, a person could only have suffered Schistosoma haematobium infestation if he or she had been to one of the countries where Schistosoma haematobium is found. Schistosoma haematobium is distributed in:
· parts of Africa
· the Eastern Mediterranean Region
· Turkey
· Portugal
· India.
Further information about the world wide distribution of the different species of Schistosoma can be obtained from the RMA SOP dealing with Schistosomiasis which is contained in the CCPS Research Library.
Many patients with Schistosomiasis never have symptoms or signs of disease, or only have mild ones. A person can only be said to have suffered Schistosoma haematobium infestation of the bladder if such eggs were identified. The detection of living Schistosoma haematobium eggs in a patient warrants initiation of treatment. Such medical treatment would normally be recorded in doctors' notes and/or hospital records. However, these records may have been destroyed or can no longer be obtained. Therefore, if there is a reliable history of a diagnosis of Schistosoma haematobium at a particular time, this generally will be accepted, unless there is contradictory evidence.
Schistosoma was previously known as Bilharzia and service medical documents prior to discharge from WW2 service (eg AAF D2(a)) included a question about Bilharzia.
· A negative answer to a history of Bilharzia indicates that a person has not suffered Schistosoma haematobium infestation (note however that the presence of Schistosoma species may not be suspected until disease manifests some years after initial infestation).
· A positive answer to that question does not necessarily mean that the person has suffered Schistosoma haematobium infestation. The species of Schistosoma would need to be identified.
11734 there is some evidence that an infection of the bladder with Schistosoma haematobium may be a factor in the development of the condition under consideration.
4173 the veteran has had an infection of the bladder with Schistosoma haematobium at some time.
11736 the veteran had an infection of the bladder with Schistosoma haematobium before the clinical onset of the condition under consideration.
3497 the veteran has established the causal connection between the infection of the bladder with Schistosoma haematobium and VEA service for the clinical onset of malignant neoplasm of the bladder.
3498 the veteran has established the causal connection between the infection of the bladder with Schistosoma haematobium and operational service for the clinical onset of malignant neoplasm of the bladder.
or
3499 the veteran has established the causal connection between the infection of the bladder with Schistosoma haematobium and eligible service for the clinical onset of malignant neoplasm of the bladder.
4441 the infection of the bladder with Schistosoma haematobium is causally related to operational service.
4442 the infection of the bladder with Schistosoma haematobium is causally related to eligible service.
Polycyclic aromatic hydrocarbons (PAHs) are hydrocarbons with three or more condensed aromatic rings in which certain carbon atoms are common to two or three rings. A common example is benzo[a]pyrene. Polycyclic aromatic hydrocarbons occur in crude oil, shale oil, and coal tars, and can be formed during the combustion of organic material or during high temperature processing of crude oil, coal, coke, or other industrial carbon compounds.
For the purposes of the SOP the minimum concentration of PAHs in the air must be 0.2mg/m3. This is a very high concentration level well beyond that which would be permissible under normal workplace health and safety provisions. Such concentrations would result in visible pollution and might occasionally occur, for example, within an enclosed vehicle workshop, when diesel exhaust fumes leak into a closed APC, or as a result of the oil fires during the first Gulf War.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Polycyclic Aromatic Hydrocarbons - Malignant Neoplasm of the Bladder | CR9170.pdf [32] | CR9170.docx [33] |
11745 there is some evidence that inhaling air containing polycyclic aromatic hydrocarbons may be a factor in the development of the condition under consideration.
11746 the veteran has inhaled air containing polycyclic aromatic hydrocarbons at a concentration of at least 0.2 mg/m3 at some time.
11749 the veteran has established the causal connection between inhaling air containing polycyclic aromatic hydrocarbons and VEA service for the clinical onset of malignant neoplasm of the bladder.
11750 the veteran has established the causal connection between inhaling air containing polycyclic aromatic hydrocarbons and operational service for the clinical onset of malignant neoplasm of the bladder.
or
11751 the veteran has established the causal connection between inhaling air containing polycyclic aromatic hydrocarbons and eligible service for the clinical onset of malignant neoplasm of the bladder.
11880 the veteran has inhaled air containing polycyclic aromatic hydrocarbons at a concentration of at least 0.2 mg/m3 for a cumulative period of at least 5000 hours at some time.
11752 the veteran inhaled air containing polycyclic aromatic hydrocarbons at a concentration of at least 0.2 mg/m3 for a cumulative period of at least 5000 hours before the clinical onset of the condition under consideration.
11747 operational service made a material contribution to the veteran inhaling air containing polycyclic aromatic hydrocarbons at a concentration of at least 0.2 mg/m3 for a cumulative period of at least 5000 hours before the clinical onset of the condition under consideration.
11881 the veteran has inhaled air containing polycyclic aromatic hydrocarbons at a concentration of at least 0.2 mg/m3 for a cumulative period of at least 10000 hours at some time.
11754 the veteran inhaled air containing polycyclic aromatic hydrocarbons at a concentration of at least 0.2 mg/m3 for a cumulative period of at least 10000 hours before the clinical onset of the condition under consideration.
11748 eligible service made a material contribution to the veteran inhaling air containing polycyclic aromatic hydrocarbons at a concentration of at least 0.2 mg/m3 for a cumulative period of at least 10000 hours before the clinical onset of the condition under consideration.
A stone can develop in the kidney (i.e. nephrolithiasis or renal calculus); the stone can then pass into the ureter (i.e. ureteric calculus) or into the bladder. Stones can also develop in the bladder itself.
Stones may cause pain, nausea, vomiting, haematuria and fever from secondary infection. Treatment consists of medication for symptoms, and possibly lithotripsy, nephrolithotomy, or an endoscopic procedure to remove the stone.
39124 there is some evidence that having a kidney or bladder stone may be a factor in the development of the condition under consideration.
39139 the veteran has had a kidney or bladder stone.
39140 the veteran has had a kidney stone at some time.
or
39141 the veteran has had a bladder stone at some time.
or
39142 the veteran has had ureteric calculus at some time.
39143 the veteran had the identified illness or injury, a kidney or bladder stone, before the clinical onset of the condition under consideration.
39145 the veteran has established the causal connection between the kidney or bladder stone and operational service for the clinical onset of malignant neoplasm of the bladder.
39144 the identified illness or injury, a kidney or bladder stone, is causally related to operational service.
Early stage cancer can be treated using a cystoscope which allows the tumour to be snipped off at the stem. The bladder wall is then cauterised to prevent bleeding. Chemotherapy drugs and an immunotherapy drug (BCG vaccine) may also be placed in the bladder via a catheter. Regular cystoscopy would be required to check for any recurrence.
Invasive cancer can be treated with surgery, chemotherapy and/or radiotherapy as appropriate. Surgery (cystectomy) may remove part of the bladder or all of the bladder with different options for passing urine out of the body.
Inability to obtain appropriate clinical management
Type | Title | PDF Format | Word Format |
---|---|---|---|
Medical Report | Inability to Obtain Appropriate Clinical Management | GQACM.pdf [36] | GQACM.docx [37] |
11109 the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7066 there is some evidence that an inability to obtain appropriate clinical management for the condition under consideration may be a factor in the worsening of the condition under consideration.
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
7378 the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.
7379 the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration.
11234 the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration.
11235 the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration.
or
11236 the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration.
7384 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service.
21084 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service, as a causal result of operational service.
7387 the veteran's inability to obtain appropriate clinical management for the condition under consideration during operational service was due to the veteran's serious default, wilful act or serious breach of discipline.
or
7389 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.
7390 the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service.
7392 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related.
7385 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service.
7386 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service, as a causal result of eligible service.
7388 the veteran's inability to obtain appropriate clinical management for the condition under consideration during eligible service was due to the veteran's serious default, wilful act or serious breach of discipline.
or
7389 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.
7391 the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service.
7393 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related.
If there is a history of pipe smoking it will be necessary to obtain information about:
· the quantity smoked (ascertain tobacco smoked per week in grams or ounces; 1 ounce = 28 grams);
· when this took place; and
· the reasons for smoking.
The evidence gathered should be as complete and accurate as possible. Information already held in departmental files, eg in previous statements and clinical notes, should not be overlooked. Conflicting evidence should be resolved.
Before a causal link between a smoking habit and service may be established, consideration must be given to Repatriation Commission Guideline CM5030 - Guideline for claims assessors on smoking and alcohol related conditions and military service.
NB The SOP factor dealing with pipe smoking covers only the smoking of tobacco. It does not include non-tobacco products such as marijuana or hashish. This is because the RMA SOP factors refer to "cigarettes or the equivalent thereof in other tobacco products".
Type | Title | PDF Format | Word Formqt |
---|---|---|---|
Claimant Report | Smoking | CRD905.pdf [9] | CRD905.docx [10] |
Claimant Report | Smoking | CRV905.pdf [13] | CRV905.docx [12] |
22895 there is some evidence that pipe smoking may be a factor in the development of the condition under consideration.
11775 the veteran has established the causal connection between the pipe smoking and VEA service for the clinical onset of malignant neoplasm of the bladder.
11776 the veteran has established the causal connection between the pipe smoking and operational service for the clinical onset of malignant neoplasm of the bladder.
or
11777 the veteran has established the causal connection between the pipe smoking and eligible service for the clinical onset of malignant neoplasm of the bladder.
11778 the veteran smoked at least 2.5 pack years of pipe tobacco before the clinical onset of the condition under consideration.
4911 the veteran has some period or periods of pipe smoking that are causally related to operational service.
11779 the veteran smoked at least 5 pack years of pipe tobacco before the clinical onset of the condition under consideration.
4913 the veteran has some period or periods of pipe smoking that are causally related to eligible service.
Smoking cigarettes, cigars or pipe tobacco due to VEA service need only have made a material contribution to the minimum smoking requirements specified in the SOP (refer Kattenberg v Repatriation Commission [2002] FCA 412). It has not been possible to make changes to the smoking module in CCPS to take account of this, but for many cases this is of no consequence because service-related smoking alone is sufficient to meet the SOP requirements. However, for smoking cases that do not succeed under the CCPS smoking module, there is a contention:
· Smoking tobacco products - material contribution
This contention covers all types of smoking – cigarettes, pipe and cigars - with rulebase questions to ascertain whether or not VEA service made a material contribution to the SOP requirements. This may entail addressing issues that have already been covered in the smoking module because it has not been possible to isolate specific facts established within that module.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Smoking | CRD905.pdf [9] | CRD905.docx [10] |
Claimant Report | Smoking | CRV905.pdf [13] | CRV905.docx [12] |
30303 the veteran has smoked cigarettes, cigars or pipe tobacco at some time.ý
34944 the veteran has established the causal connection between smoking tobacco products and VEA service for the clinical onset of malignant neoplasm of the bladder.
34945 the veteran has established the causal connection between smoking tobacco products and operational service for the clinical onset of malignant neoplasm of the bladder.
or
34946 the veteran has established the causal connection between smoking tobacco products and eligible service for the clinical onset of malignant neoplasm of the bladder.
34949 the veteran smoked at least 2.5 pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of the condition under consideration.
34947 smoking as a causal result of operational service made a material contribution to the SOP requirements for malignant neoplasm of the bladder and smoking tobacco products.
34950 the veteran smoked at least 5 pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of the condition under consideration.
34948 smoking as a causal result of eligible service made a material contribution to the SOP requirements for malignant neoplasm of the bladder and smoking tobacco products.
The therapeutic radiation would only be relevant if it was given for a condition other than the one now being considered.
The pelvis is the basin formed by the hip bones and the lower portion of the vertebral column constituting the lowest part of the trunk.
Therapeutic radiation
11738 there is some evidence that a course of therapeutic radiation to the region of the pelvis may be a factor in the development of the condition under consideration.
11737 the veteran has undergone a course of therapeutic radiation to the region of the pelvis at some time.
11739 the veteran underwent a course of therapeutic radiation to the region of the pelvis where the first exposure occurred at least five years before the clinical onset of the condition under consideration.
30280 the veteran underwent a course of therapeutic radiation to the region of the pelvis where the first exposure occurred at least five years before the clinical onset of the condition under consideration for treatment of an illness or injury which is identifiable.
11740 the veteran has established the causal connection between the course of therapeutic radiation to the region of the pelvis and VEA service for the clinical onset of malignant neoplasm of the bladder.
11741 the veteran has established the causal connection between the course of therapeutic radiation to the region of the pelvis and operational service for the clinical onset of malignant neoplasm of the bladder.
or
11742 the veteran has established the causal connection between the course of therapeutic radiation to the region of the pelvis and eligible service for the clinical onset of malignant neoplasm of the bladder.
1608 the identified illness or injury for which the course of therapeutic radiation to the region of the pelvis was undergone is causally related to operational service.
11744 the identified illness or injury for which the course of therapeutic radiation to the region of the pelvis was undergone is causally related to eligible service.
Ifosfamide is a chemotherapeutic agent used alone or in combination with other agents to treat tumours such as germ cell tumours, sarcomas and lymphomas, ovarian and cervical cancers, and lung and breast cancers. The drug is given as an infusion under the brand name Holoxan.
Systemic means "affecting the entire body," rather than a single organ or body part.
fosfamide
Ifosfamide is a chemotherapeutic agent used alone or in combination with other agents to treat tumours such as germ cell tumours, sarcomas and lymphomas, ovarian and cervical cancers, and lung and breast cancers. The drug is given as an infusion under the brand name Holoxan.
Systemic means "affecting the entire body," rather than a single organ or body part.
11757 there is some evidence that treatment with systemic cyclophosphamide or systemic ifosfamide may be a factor in the development of the condition under consideration.
11758 the veteran has been treated with systemic cyclophosphamide or systemic ifosfamide at some time.
11760 the veteran was treated with systemic cyclophosphamide or systemic ifosfamide at least 5 years before the clinical onset of the condition under consideration.
11759 the veteran was treated with systemic cyclophosphamide or systemic ifosfamide at least 5 years before the clinical onset of the condition under consideration for treatment of an illness or injury which is identifiable. [Default true]
11761 the veteran has established the causal connection between the treatment with systemic cyclophosphamide or systemic ifosfamide and VEA service for the clinical onset of malignant neoplasm of the bladder.
11762 the veteran has established the causal connection between the treatment with systemic cyclophosphamide or systemic ifosfamide and operational service for the clinical onset of malignant neoplasm of the bladder.
or
11763 the veteran has established the causal connection between the treatment with systemic cyclophosphamide or systemic ifosfamide and eligible service for the clinical onset of malignant neoplasm of the bladder.
11764 the identified illness or injury, for which treatment with systemic cyclophosphamide or systemic ifosfamide was given, is causally related to operational service.
11765 the identified illness or injury, for which treatment with systemic cyclophosphamide or systemic ifosfamide was given, is causally related to eligible service.
Links
[1] http://www.rma.gov.au/assets/SOP/2019/dd1356c9a9/083.pdf
[2] http://www.rma.gov.au/assets/SOP/2019/1080f2ea4e/084.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20210_0.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/63742%23comment-form
[5] https://clik.dva.gov.au/system/files/media/MR9402.pdf
[6] https://clik.dva.gov.au/system/files/media/MR9402.docx
[7] https://clik.dva.gov.au/system/files/media/CR9171_2.pdf
[8] https://clik.dva.gov.au/system/files/media/CR9171_2.docx
[9] https://clik.dva.gov.au/system/files/media/CRD905_7.pdf
[10] https://clik.dva.gov.au/system/files/media/CRD905_6.docx
[11] https://clik.dva.gov.au/system/files/media/CRV905_6.pdf
[12] https://clik.dva.gov.au/system/files/media/CRV905.docx
[13] https://clik.dva.gov.au/system/files/media/CRV905_7.pdf
[14] http://www.tga.gov.au/docs/html/aristol.htm
[15] https://clik.dva.gov.au/system/files/media/CR9294.pdf
[16] https://clik.dva.gov.au/system/files/media/CR9294.docx
[17] https://clik.dva.gov.au/system/files/media/MR9401.pdf
[18] https://clik.dva.gov.au/system/files/media/MR9401.docx
[19] https://clik.dva.gov.au/system/files/media/CR9293.pdf
[20] https://clik.dva.gov.au/system/files/media/CR9293.docx
[21] https://clik.dva.gov.au/system/files/media/MR9400.pdf
[22] https://clik.dva.gov.au/system/files/media/MR9400.docx
[23] https://clik.dva.gov.au/system/files/media/MR9403.pdf
[24] https://clik.dva.gov.au/system/files/media/MR9403.docx
[25] http://ntp.niehs.nih.gov/go/16183
[26] http://www.atsdr.cdc.gov/toxfaq.html
[27] http://www.ndcrt.org/data/EPA_Chemical_Fact_Sheets/
[28] https://clik.dva.gov.au/system/files/media/CR9169.pdf
[29] https://clik.dva.gov.au/system/files/media/CR9169.docx
[30] https://clik.dva.gov.au/system/files/media/CR9295.pdf
[31] https://clik.dva.gov.au/system/files/media/CR9295.docx
[32] https://clik.dva.gov.au/system/files/media/CR9170.pdf
[33] https://clik.dva.gov.au/system/files/media/CR9170.docx
[34] https://clik.dva.gov.au/system/files/media/CR9296.pdf
[35] https://clik.dva.gov.au/system/files/media/CR9296.docx
[36] https://clik.dva.gov.au/system/files/media/GQACM_16.pdf
[37] https://clik.dva.gov.au/system/files/media/GQACM_16.docx