Solar keratosis
Meaning of solar keratosis: For the purposes of this Statement of Principles, solar keratosis: (a) means a cutaneous lesion characterised by the local proliferation of atypical (dysplastic) epidermal keratinocytes; and (b) includes sun-damaged skin adjacent to a localised skin lesion (field cancerisation); and (c) excludes Bowen disease, arsenical keratoses and other keratoses that are not related to ultraviolet light exposure.
Reasonable Hypothesis (RH) — Statement of Principles No. 79 of 2021
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 solar keratosis or death from solar keratosis with the circumstances of a person's relevant service:
- (1)having sunlight exposure to unprotected skin at the affected site for a cumulative period of at least 2,250 hours while in a tropical area, or having equivalent sunlight exposure in other latitude zones, before the clinical onset of solar keratosis;
Note: equivalent sunlight exposure in other latitude zones, tropical area and unprotected skin are defined in the Schedule 1 - Dictionary.
- (2)having sunburn as specified: (a) on at least 5 occasions: (i) before the age of 20 years; and (ii) at least 5 years before the clinical onset of solar keratosis; and (b) where the clinical onset of solar keratosis has occurred before the age of 50 years;
Note: sunburn as specified is defined in the Schedule 1 - Dictionary.
- (3)being a prisoner of war of Japan before the clinical onset of solar keratosis;
- (4)having exposure of the affected region to welding light, while arc- welding metal without skin protection, for a cumulative period of at least 12,000 hours before the clinical onset of solar keratosis;
Note: Examples of skin protection include leather gloves, long sleeve jackets, and a welding helmet with a face plate.
- (5)undergoing organ or tissue transplantation, excluding corneal transplant, before the clinical onset of solar keratosis;
Note: organ or tissue transplantation is defined in the Schedule 1 - Dictionary.
- (6)having PUVA therapy involving the affected site where: (a) the first PUVA treatment commenced at least 5 years before the clinical onset of solar keratosis; and (b) at least 25 PUVA treatments were administered before the clinical onset of solar keratosis;
Note: PUVA is defined in the Schedule 1 - Dictionary.
- (7)taking hydroxyurea or voriconazole for at least the 3 months before the clinical onset of solar keratosis;
- (8)inability to obtain appropriate clinical management for solar keratosis;
Aggravation-only factors: the factors in subsection 9(8) 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.
Balance of Probabilities (BoP) — Statement of Principles No. 80 of 2021
5 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, solar keratosis or death from solar keratosis is connected with the circumstances of a person's relevant service:
- (1)having sunlight exposure to unprotected skin at the affected site for a cumulative period of at least 4,500 hours while in a tropical area, or having equivalent sunlight exposure in other latitude zones, before the clinical onset of solar keratosis;
Note: equivalent sunlight exposure in other latitude zones, tropical area and unprotected skin are defined in the Schedule 1 - Dictionary.
- (2)undergoing organ or tissue transplantation, excluding corneal transplant, before the clinical onset of solar keratosis;
Note: organ or tissue transplantation is defined in the Schedule 1 - Dictionary.
- (3)having PUVA therapy involving the affected site where: (a) the first PUVA treatment commenced at least 5 years before the clinical onset of solar keratosis; and (b) at least 50 PUVA treatments were administered before the clinical onset of solar keratosis;
Note: PUVA is defined in the Schedule 1 - Dictionary.
- (4)taking hydroxyurea or voriconazole for at least the 3 months before the clinical onset of solar keratosis;
- (5)inability to obtain appropriate clinical management for solar keratosis;
Aggravation-only factors: the factors in subsection 9(5) 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.
