Systemic sclerosis — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 25 of 2018

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

1. (1)
   inhaling respirable crystalline silica dust, at the time material containing crystalline silica was being: (a) produced; (b) excavated; (c) drilled, cut or ground; or (d) used in construction, manufacturing, cleaning or blasting, for a cumulative period of at least 2 500 hours before the clinical onset of systemic sclerosis;
2. (2)
   being treated with bleomycin at the time of the clinical onset of systemic sclerosis;
3. (3)
   inhaling, ingesting or having cutaneous contact with an organic solvent from the specified list of organic solvents for a cumulative period of at least 2 000 hours within a period of ten consecutive years, before the clinical onset of systemic sclerosis;

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

4. (4)
   being treated with an ergot alkaloid for migraine, for at least the ten years before the clinical onset of systemic sclerosis;

   Note: ergot alkaloid is defined in the Schedule 1 - Dictionary.

5. (5)
   inhaling respirable crystalline silica dust, at the time material containing crystalline silica was being: (a) produced; (b) excavated; (c) drilled, cut or ground; or (d) used in construction, manufacturing, cleaning or blasting, for a cumulative period of at least 2 500 hours before the clinical worsening of systemic sclerosis;
6. (6)
   being treated with bleomycin at the time of the clinical worsening of systemic sclerosis;
7. (7)
   inhaling, ingesting or having cutaneous contact with an organic solvent from the specified list of organic solvents for a cumulative period of at least 2 000 hours within a period of ten consecutive years, before the clinical worsening of systemic sclerosis;

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

8. (8)
   being treated with an ergot alkaloid for migraine, for at least the ten years before the clinical worsening of systemic sclerosis;

   Note: ergot alkaloid is defined in the Schedule 1 - Dictionary.

9. (9)
   for clinical worsening of systemic sclerosis manifesting as scleroderma renal crisis only, being treated with 15 milligrams or more per day of prednisone, or equivalent oral glucocorticoid therapy, for a period of at least four weeks within the six months before the clinical worsening of systemic sclerosis;

   Note: equivalent oral glucocorticoid therapy and scleroderma renal crisis are defined in the Schedule 1 - Dictionary.

10. (10)
    smoking at least 20 pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical worsening of systemic sclerosis, and where smoking has ceased, the clinical worsening of systemic sclerosis has occurred within ten years of cessation;

    Note: pack-years of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.

11. (11)
    inability to obtain appropriate clinical management for systemic sclerosis;

Aggravation-only factors: the factors in subsections 9(5) to 9(11) 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.