Tuberculosis — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 47 of 2024

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

1. (1)
   being exposed to bacteria belonging to the Mycobacterium tuberculosis complex at least 14 days before the clinical onset of tuberculosis;

   Note: being exposed to bacteria belonging to the Mycobacterium tuberculosis complex is defined in the Schedule 1 - Dictionary.

2. (2)
   living or working in an area which has an incidence of tuberculosis of at least 50 cases per 100,000 of population per year, before the clinical onset of tuberculosis, provided that the individual had no negative test results for tuberculosis in any intervening period between living or working in the affected area and the onset of tuberculosis;
3. (3)
   consuming unpasteurised milk, unpasteurised dairy products or uncooked meat from an animal infected with Mycobacterium bovis or Mycobacterium caprae at least 14 days before the clinical onset of tuberculosis;
4. (4)
   for active tuberculosis disease due to infection with Mycobacterium bovis BCG only: (a) having intravesical BCG therapy for malignant neoplasm of the bladder; or (b) being vaccinated with BCG vaccine; before the clinical onset of tuberculosis;

   Note: active tuberculosis disease and BCG are defined in the Schedule 1 - Dictionary.

5. (5)
   inability to access appropriate tuberculosis vaccination in accordance with contemporary medical standards before the clinical onset of tuberculosis;
6. (6)
   having a substantially compromised immune system due to: (a) chronic renal failure; (b) haematological malignancy; (c) infection with human immunodeficiency virus; (d) severe malnutrition; (e) solid organ, stem cell or bone marrow transplantation; or (f) taking an immunosuppressive drug; at the time of the clinical worsening of tuberculosis;

   Note: chronic renal failure and immunosuppressive drug and severe malnutrition are defined in the Schedule -1 Dictionary.

7. (7)
   inhaling at least 1,000 micrograms of beclomethasone, or equivalent inhaled glucocorticoid daily for the 3 months, before the clinical worsening of tuberculosis, and where the treatment has ceased, the last inhaled glucocorticoid dose was taken within the 30 days before the clinical worsening of tuberculosis;

   Note: equivalent inhaled glucocorticoid is defined in the Schedule 1 - Dictionary.

8. (8)
   having cirrhosis of the liver at the time of the clinical worsening of tuberculosis;
9. (9)
   having diabetes mellitus at the time of the clinical worsening of tuberculosis;
10. (10)
    inhaling respirable crystalline silica dust in an enclosed space: (a) for a cumulative period of at least 1,500 hours before the clinical worsening of tuberculosis; and (b) at the time material containing crystalline silica was being produced, excavated, drilled, cut or ground, or used in construction, manufacturing, cleaning or blasting; before the clinical worsening of tuberculosis;
11. (11)
    inhaling respirable crystalline silica dust in an open environment: (a) for a cumulative period of at least 3,000 hours before the clinical worsening of tuberculosis; and (b) at the time material containing crystalline silica was being produced, excavated, drilled, cut or ground, or used in construction, manufacturing, cleaning or blasting; before the clinical worsening of tuberculosis;
12. (12)
    for pulmonary tuberculosis only, smoking at least 1 cigarette per day, or the equivalent thereof in other tobacco products, for at least the 12 months before the clinical worsening of tuberculosis;

    Note: pulmonary tuberculosis is defined in the Schedule 1- Dictionary.

13. (13)
    for pulmonary tuberculosis only, being in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 5,000 hours before the clinical worsening of tuberculosis;

    Note: pulmonary tuberculosis is defined in the Schedule 1- Dictionary.

14. (14)
    having a gastrectomy or jejunoileal bypass before the clinical worsening of tuberculosis;
15. (15)
    consuming at least 40 grams of alcohol per day for at least the 12 months before the clinical worsening of tuberculosis;
16. (16)
    having alcohol use disorder at the time of the clinical worsening of tuberculosis;
17. (17)
    having systemic lupus erythematosus before the clinical worsening of tuberculosis;
18. (18)
    having hepatitis C infection at the time of the clinical worsening of tuberculosis;
19. (19)
    inability to obtain appropriate clinical management for tuberculosis before the clinical worsening of tuberculosis;

Aggravation-only factors: the factors in subsections 9(6) to 9(19) 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.