Goitre — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 9 of 2022

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting goitre or death from goitre with the circumstances of a person's relevant service:

1. (1)
   having iodine deficiency within the 6 months before the clinical onset of goitre;

   Note: iodine deficiency is defined in the Schedule 1 - Dictionary.

2. (2)
   having iodine excess within the 6 months before the clinical onset of goitre;

   Note: Iodine excess may be due to consuming foods, dietary supplements or medications with a high content of iodine.

   Note: iodine excess is defined in the Schedule 1 - Dictionary.

3. (3)
   taking a drug from the specified list of drugs within the 6 months before the clinical onset of goitre;

   Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

4. (4)
   taking a drug containing at least 10 milligrams of iodine daily for a continuous period of at least 4 weeks, within the 6 months before the clinical onset of goitre;
5. (5)
   taking amiodarone for a continuous period of at least 2 weeks, within the 1 year before the clinical onset of goitre;
6. (6)
   being administered an iodine-containing radiographic contrast agent within the 6 months before the clinical onset of goitre;
7. (7)
   having smoked tobacco products: (a) in an amount of at least 3 pack-years before the clinical onset of goitre; and (b) if smoking has ceased before the clinical onset of goitre, then that onset occurred within 5 years of cessation;

   Note: one pack-year is defined in the Schedule 1 - Dictionary.

8. (8)
   having a form of thyroiditis from the specified list of forms of thyroiditis at the time of the clinical onset of goitre;

   Note: specified list of forms of thyroiditis is defined in the Schedule 1 - Dictionary.

9. (9)
   having a disease involving the thyroid gland from the specified list of diseases at the time of the clinical onset of goitre;

   Note: specified list of diseases is defined in the Schedule 1 - Dictionary.

10. (10)
    having chronic renal failure at the time of the clinical onset of goitre;

    Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

11. (11)
    having a thyroid-stimulating, hormone-secreting pituitary adenoma at the time of the clinical onset of goitre;
12. (12)
    for nodular goitre only: (a) having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the thyroid gland at least 1 year before the clinical onset of nodular goitre; or (b) undergoing a course of therapeutic radiation for cancer, where the thyroid gland was in the field of radiation, at least 1 year before the clinical onset of nodular goitre;

    Note: Exposure to ionising radiation does not include radioiodine therapy for goitre or thyroid nodules.

    Note: cumulative equivalent dose is defined in the Schedule 1 - Dictionary.

13. (13)
    for toxic goitre first presenting as thyrotoxic crisis only, having an acute precipitating event within the 48 hours before the clinical onset of toxic goitre;

    Note: acute precipitating event and thyrotoxic crisis are defined in the Schedule 1 - Dictionary.

14. (14)
    having iodine deficiency within the 6 months before the clinical worsening of goitre;

    Note: iodine deficiency is defined in the Schedule 1 - Dictionary.

15. (15)
    having iodine excess within the 6 months before the clinical worsening of goitre;

    Note: Iodine excess may be due to consuming foods, dietary supplements or medications with a high content of iodine.

    Note: iodine excess is defined in the Schedule 1 - Dictionary.

16. (16)
    taking a drug from the specified list of drugs within the 6 months before the clinical worsening of goitre;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

17. (17)
    taking a drug containing at least 10 milligrams of iodine daily for a continuous period of at least 4 weeks, within the 6 months before the clinical worsening of goitre;
18. (18)
    taking amiodarone for a continuous period of at least 2 weeks, within the 1 year before the clinical worsening of goitre;
19. (19)
    being administered an iodine-containing radiographic contrast agent within the 6 months before the clinical worsening of goitre;
20. (20)
    having smoked tobacco products: (a) in an amount of at least 3 pack-years before the clinical worsening of goitre; and (b) if smoking has ceased before the clinical worsening of goitre, then that worsening occurred within 5 years of cessation;

    Note: one pack-year is defined in the Schedule 1 - Dictionary.

21. (21)
    having a form of thyroiditis from the specified list of forms of thyroiditis at the time of the clinical worsening of goitre;

    Note: specified list of forms of thyroiditis is defined in the Schedule 1 - Dictionary.

22. (22)
    having a disease involving the thyroid gland from the specified list of diseases at the time of the clinical worsening of goitre;

    Note: specified list of diseases is defined in the Schedule 1 - Dictionary.

23. (23)
    having chronic renal failure at the time of the clinical worsening of goitre;

    Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

24. (24)
    having a thyroid-stimulating, hormone-secreting pituitary adenoma at the time of the clinical worsening of goitre;
25. (25)
    for nodular goitre only: (a) having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the thyroid gland at least 1 year before the clinical worsening of nodular goitre; or (b) undergoing a course of therapeutic radiation for cancer, where the thyroid gland was in the field of radiation, at least 1 year before the clinical worsening of nodular goitre;

    Note: Exposure to ionising radiation does not include radioiodine therapy for goitre or thyroid nodules.

    Note: cumulative equivalent dose is defined in the Schedule 1 - Dictionary.

26. (26)
    for thyrotoxic crisis only, having an acute precipitating event within the 48 hours before that clinical worsening of toxic goitre;

    Note: acute precipitating event and thyrotoxic crisis are defined in the Schedule 1 - Dictionary.

27. (27)
    inability to obtain appropriate clinical management for goitre;

Aggravation-only factors: the factors in subsections 9(14) to 9(27) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.