Statement of Principles

concerning

IRRITANT CONTACT DERMATITIS
 (Balance of Probabilities)

(No. 4 of 2021)

Dated    24 December 2020

Contents

1          Name........................................................................................................................................... 3

2          Commencement........................................................................................................................ 3

3          Authority..................................................................................................................................... 3

4          Repeal......................................................................................................................................... 3

5          Application................................................................................................................................. 3

6          Definitions.................................................................................................................................. 3

7          Kind of injury, disease or death to which this Statement of Principles relates............... 3

8          Basis for determining the factors........................................................................................... 4

9          Factors that must exist............................................................................................................. 4

10        Relationship to service............................................................................................................. 5

11        Factors referring to an injury or disease covered by another Statement of Principles. 5

Schedule 1 - Dictionary............................................................................................. 6

1          Definitions.................................................................................................................................. 6

1             Name

This is the Statement of Principles concerning irritant contact dermatitis (Balance of Probabilities) (No. 4 of 2021).

2             Commencement

This instrument commences on 25 January 2021.

3             Authority

This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.

4             Repeal

The Statement of Principles concerning irritant contact dermatitis No. 111 of 2011 (Federal Register of Legislation No. F2011L01747) made under subsection 196B(3) of the VEA is repealed.

5             Application

This instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.

6             Definitions

The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.

7             Kind of injury, disease or death to which this Statement of Principles relates

(1)          This Statement of Principles is about irritant contact dermatitis and death from irritant contact dermatitis.

Meaning of irritant contact dermatitis

(2)          For the purposes of this Statement of Principles, irritant contact dermatitis:

(a)          means inflammation of an area of the skin from exposure to an irritant that has been applied to the same area of skin; and

(b)          involves direct tissue injury; and

(c)          includes irritant contact dermatitis that is due to cutaneous exposure from airborne irritants; and

(d)         excludes:

(i)            allergic contact dermatitis;

(ii)          atopic dermatitis (eczema);

(iii)        dermatitis due to extremes of weather, friction, solar radiation or other forms of radiation;

(iv)        photocontact dermatitis;

(v)          systemic allergic dermatitis; and 

(vi)        urticaria.

Note: Irritant contact dermatitis typically presents as a well-demarcated red rash in an area of skin that has come into contact with an irritant. It may be acute, with swelling and blistering of affected skin or chronic, with dryness, scaling, thickening or fissuring of affected skin. Irritant contact dermatitis can affect the skin of the eyelids and surrounding the mouth.

(3)          While irritant contact dermatitis attracts ICD‑10‑AM code L22 or L24, in applying this Statement of Principles the meaning of irritant contact dermatitis is that given in subsection (2).

(4)          For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.

Death from irritant contact dermatitis

(5)          For the purposes of this Statement of Principles, irritant contact dermatitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's irritant contact dermatitis.

Note: terminal event is defined in the Schedule 1 - Dictionary.

8             Basis for determining the factors

On the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that irritant contact dermatitis and death from irritant contact dermatitis can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.

Note: MRCA, relevant service and VEA are defined in the Schedule 1 - Dictionary.

9             Factors that must exist

At least one of the following factors must exist before it can be said that, on the balance of probabilities, irritant contact dermatitis or death from irritant contact dermatitis is connected with the circumstances of a person's relevant service:

(1)          having the affected area of skin exposed to an irritant within the three days before the clinical onset of irritant contact dermatitis;

Note 1: irritant is defined in the Schedule 1 - Dictionary.

Note 2: Activities involving prolonged or frequent contact with water or other liquids (wet work) are a common cause of irritant contact dermatitis. Such activities include frequent hand washing, handling wet things and prolonged wearing of occlusive gloves.

(2)          having the affected area of skin exposed to an irritant within the three days before the clinical worsening of irritant contact dermatitis;

Note 1: irritant is defined in the Schedule 1 - Dictionary.

Note 2: Activities involving prolonged or frequent contact with water or other liquids (wet work) are a common cause of irritant contact dermatitis. Such activities include frequent hand washing, handling wet things and prolonged wearing of occlusive gloves.

(3)          inability to obtain appropriate clinical management for irritant contact dermatitis.

10         Relationship to service

(1)          The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.

(2)          The factors set out in subsections 9(2) to 9(3) apply only to material contribution to, or aggravation of, irritant contact dermatitis where the person's irritant contact dermatitis was suffered or contracted before or during (but did not arise out of) the person's relevant service.

11         Factors referring to an injury or disease covered by another Statement of Principles

In this Statement of Principles:

(1)          if a factor referred to in section 9 applies in relation to a person; and

(2)          that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(3) of the VEA;

then the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.

Schedule 1 - Dictionary  

Note: See Section 6

1               Definitions

 In this instrument:

                             irritant means a chemical substance or physical agent which, when it comes into contact with an area of skin, is capable of producing direct tissue injury and inflammation. It does not include heat, cold, friction, solar radiation or other forms of radiation. Examples of irritants include:

(a)           cleansers (including soap and alcohol based hand rubs);

(b)          detergents (including sodium lauryl sulphate);

(c)           oils and coolants;

(d)          fuels;

(e)           solvents;

(f)           food (including citrus fruits);

(g)          alkalis (including wet cement or lime);

(h)          pesticides (including insect repellent);

(i)            adhesives (including epoxy resins);

(j)            tear gas or smokescreens;

(k)          fibreglass;

(l)            plant sap (including spurge);

(m)        bodily fluids of the rove beetle; and

(n)          urine or faecal incontinence.

                               irritant contact dermatitis—see subsection 7(2).

                             MRCA means the Military Rehabilitation and Compensation Act 2004.

                             relevant service means:

(a)           eligible war service (other than operational service) under the VEA;

(b)          defence service (other than hazardous service and British nuclear test defence service) under the VEA; or

(c)           peacetime service under the MRCA.

Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.

                             terminal event means the proximate or ultimate cause of death and includes the following:

(a)           pneumonia;

(b)          respiratory failure;

(c)           cardiac arrest;

(d)          circulatory failure; or

(e)           cessation of brain function.

                             VEA means the Veterans' Entitlements Act 1986.