Systemic lupus erythematosus — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 47 of 2025

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 systemic lupus erythematosus or death from systemic lupus erythematosus with the circumstances of a person's relevant service:

1. (1)
   being exposed to sunlight or ultraviolet light at a level sufficient to induce erythema (sunburn) at least 24 hours, but not more than 30 days, before clinical worsening of systemic lupus erythematosus skin rash;
2. (2)
   inhaling respirable crystalline silica dust for a cumulative period of at least 1,000 hours before clinical onset or clinical worsening;

   Note: Examples of when exposure to respirable crystalline silica dust can occur include when material containing crystalline silica is being produced, excavated, drilled, cut or ground, or used in construction, manufacturing, cleaning or blasting.

3. (3)
   inhaling respirable crystalline silica dust in an amount greater than 50 micrograms/m3-years of cumulative exposure before clinical onset or clinical worsening;

   Note: Examples of when exposure to respirable crystalline silica dust can occur include when material containing crystalline silica is being produced, excavated, drilled, cut or ground, or used in construction, manufacturing, cleaning or blasting.

   Note: micrograms/m3-years is defined in the Schedule 1 - Dictionary.

4. (4)
   where smoking has not ceased before clinical onset, smoking at least 20 pack-years before clinical onset or clinical worsening;

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

5. (5)
   taking one of the following medications (which cannot be ceased or substituted) at the time of clinical onset or clinical worsening; (a) chlorpromazine; (b) hydralazine; (c) isoniazid; (d) methyldopa; (e) minocycline; (f) procainamide; (g) quinidine; (h) tumour necrosis factor-alpha inhibitors; (i) terbinafine; (j) flutamide; (k) interferon gamma; (l) ethosuximide; (m) oxcarbazepine; (n) carbamazepine; (o) phenytoin;
6. (6)
   taking sulfadiazine or trimethoprim-sulfamethoxazole (which cannot be ceased or substituted) at the time of clinical worsening;
7. (7)
   taking a medication which is associated with: (a) the development of systemic lupus erythematosus including laboratory markers during medication therapy; and (b) the cessation of systemic lupus erythematosus including laboratory markers within 3 months of discontinuing medication therapy; and where treatment with the drug continued for at least the 3 days before clinical onset or clinical worsening;
8. (8)
   having hormone replacement therapy with an oestrogen for at least the 2 years before clinical onset;
9. (9)
   having a clinically symptomatic bacterial, viral or fungal infection at the time of clinical worsening;
10. (10)
    being pregnant within the 6 weeks before clinical worsening;
11. (11)
    undergoing a thymectomy within the 5 years before clinical onset;
12. (12)
    having posttraumatic stress disorder for at least the 3 months before clinical onset or clinical worsening;
13. (13)
    inability to obtain appropriate clinical management for systemic lupus erythematosus before clinical worsening;