Malignant neoplasm of the larynx — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 41 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 malignant neoplasm of the larynx or death from malignant neoplasm of the larynx with the circumstances of a person's relevant service:

1. (1)
   having smoked tobacco products: (a) in an amount of at least 1.5 pack-years before the clinical onset of malignant neoplasm of the larynx; and (b) commencing at least 5 years before the clinical onset of malignant neoplasm of the larynx; and if smoking has ceased before the clinical onset of malignant neoplasm of the larynx, then that onset occurred within 20 years of cessation; Malignant Neoplasm Of The Larynx (Reasonable Hypothesis) (No. 41 of 2022.);

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

2. (2)
   having been exposed to second-hand smoke: (a) for at least 5,000 hours before the clinical onset of malignant neoplasm of the larynx; and (b) commencing at least 5 years before the clinical onset of malignant neoplasm of the larynx; and if exposure to second-hand smoke has ceased before the clinical onset of malignant neoplasm of the larynx, then that onset occurred within 20 years of cessation;

   Note: having been exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

3. (3)
   being exposed to mustard gas at least 5 years before the clinical onset of malignant neoplasm of the larynx;
4. (4)
   inhaling respirable asbestos fibres in an enclosed space, at the time material containing asbestos was being applied, removed, cut, drilled, dislodged or disturbed: (a) for a cumulative period of at least 1,000 hours before the clinical onset of malignant neoplasm of the larynx; and (b) where the first inhalation of asbestos fibres commenced at least 5 years before the clinical onset of malignant neoplasm of the larynx;

   Note: Disturbance of debris or dust contaminated with asbestos fibres already present in an enclosed space may result in exposure to respirable asbestos fibres.

5. (5)
   inhaling respirable asbestos fibres in an open environment, at the time material containing asbestos was being applied, removed, cut, drilled, dislodged or disturbed: (a) for a cumulative period of at least 3,000 hours before the clinical onset of malignant neoplasm of the larynx; and (b) where the first inhalation of asbestos fibres commenced at least 5 years before the clinical onset of malignant neoplasm of the larynx;

   Note: Disturbance of debris or dust contaminated with asbestos fibres already present in an open environment may result in exposure to respirable asbestos fibres.

6. (6)
   inhaling smoke from the combustion of wood, charcoal, coal or other biomass or fossil fuel, in an enclosed space: (a) for a cumulative period of at least 7,500 hours before the clinical onset of malignant neoplasm of the larynx; and (b) commencing at least 5 years before the clinical onset of malignant neoplasm of the larynx; Malignant Neoplasm Of The Larynx (Reasonable Hypothesis) (No. 41 of 2022.);
7. (7)
   consuming alcohol: (a) in an amount of at least 100 kilograms within any 10 year period; and (b) at least 5 years before the clinical onset of malignant neoplasm of the larynx; and if consumption of alcohol has ceased before the clinical onset of malignant neoplasm of the larynx, then that onset occurred within 40 years of cessation;

   Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

8. (8)
   inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD): (a) for a cumulative period of at least 1,000 hours, within a consecutive period of 10 years before the clinical onset of malignant neoplasm of the larynx; and (b) where the first exposure occurred at least 5 years before the clinical onset of malignant neoplasm of the larynx;

   Note: inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) is defined in the Schedule 1 - Dictionary.

9. (9)
   being: (a) on land in Vietnam; or (b) at sea in Vietnamese waters; or (c) on board a vessel and consuming potable water supplied on that vessel, when the water supply had been produced by evaporative distillation of estuarine Vietnamese waters; for a cumulative period of at least 30 days, at least 5 years before the clinical onset of malignant neoplasm of the larynx; (a) on land in Vietnam; or (b) at sea in Vietnamese waters; and estuarine Vietnamese waters and potable water are defined in the Schedule 1 - Dictionary;

   Note: being:.

10. (10)
    inhaling mist from sulphuric, nitric or hydrochloric acid: (a) for a cumulative period of at least 5,000 hours before the clinical onset of malignant neoplasm of the larynx; and (b) where inhalation of the mist commenced at least 5 years before the clinical onset of malignant neoplasm of the larynx; Malignant Neoplasm Of The Larynx (Reasonable Hypothesis) (No. 41 of 2022.);

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

11. (11)
    undergoing solid organ transplantation, excluding corneal transplant, before the clinical onset of malignant neoplasm of the larynx;
12. (12)
    having infection with human immunodeficiency virus before the clinical onset of malignant neoplasm of the larynx;
13. (13)
    acquiring persistent infection of the laryngeal epithelium with human papillomavirus type 16 or 18 before the clinical onset of malignant neoplasm of the larynx;
14. (14)
    consuming maté: (a) on more days than not; and (b) for at least 5 years before the clinical onset of malignant neoplasm of the larynx; and if consumption of maté has ceased before the clinical onset of malignant neoplasm of the larynx, then that onset occurred within 15 years of cessation;
15. (15)
    inability to consume an average of at least 200 grams per day of any combination of fruits and vegetables, for a period of at least 5 consecutive years within the 20 years before the clinical onset of malignant neoplasm of the larynx;
16. (16)
    having gastro-oesophageal reflux disease for at least the 5 years before the clinical onset of malignant neoplasm of the larynx;
17. (17)
    inhaling or ingesting opium on average at least weekly for at least 10 years before the clinical onset of malignant neoplasm of the larynx;

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

18. (18)
    inhaling high concentrations of polycyclic aromatic hydrocarbons, through work involving a specified industry, manufacturing process or agent: (a) for a cumulative period of at least 1,500 hours before the clinical onset of malignant neoplasm of the larynx; and (b) where the first inhalation of polycyclic aromatic hydrocarbons occurred at least 5 years before the clinical onset of malignant neoplasm of the larynx;

    Note: polycyclic aromatic hydrocarbons and specified industry, manufacturing process or agent are defined in the Schedule 1 - Dictionary.

19. (19)
    using manual welding equipment for welding metal for a cumulative period of at least 10 years before the clinical onset of malignant neoplasm of the larynx;
20. (20)
    inability to obtain appropriate clinical management for malignant neoplasm of the larynx. Malignant Neoplasm Of The Larynx (Reasonable Hypothesis) (No. 41 of 2022.);

Aggravation-only factors: the factors in subsection 9(20) 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.