Document ID: chunk:federal_register_of_legislation:F2019L00223:reg:9
Version: federal_register_of_legislation:F2019L00223
Segment Type: reg
Provision Reference: reg 9
Character Range: 3780–6931

9               Factors that must exist
At least one of the following factors must exist before it can be said that, on the balance of probabilities, methaemoglobinaemia or death from methaemoglobinaemia is connected with the circumstances of a person's relevant service:
(1)          taking or being treated with a drug that causes oxidation of haemoglobin, within the two days before the clinical onset of methaemoglobinaemia;
Note:  Drugs that cause methaemoglobinaemia include, but are not limited to, dapsone; 8‑aminoquinolines such as primaquine or tafenoquine; chloroquine; nitrates such as nitroglycerine; nitrites such as amyl nitrite; local anaesthetics such as benzocaine; and sulphonamide antibiotics.
(2)          inhaling, ingesting or having cutaneous contact with a chemical agent that causes oxidation of haemoglobin, within the two days before the clinical onset of methaemoglobinaemia;
Note:  Chemicals that cause methaemoglobinaemia include, but are not limited to, aniline and its derivatives (for example, found in dyes); naphthalene (for example, found in mothballs); nitrobenzenes (for example, found in solvents and paints); nitrogen oxide (for example, found in smoke from fires); paraquat (for example, found in herbicides); and chlorates, nitrates and nitrotoluenes (for example, found in explosives).
(3)          ingesting food or fluid contaminated by excess levels of nitrates or nitrites, within the two days before the clinical onset of methaemoglobinaemia;
(4)          being exposed to dialysis fluid contaminated with chloramine or hydrogen peroxide, within the two days before the clinical onset  of methaemoglobinaemia;
(5)          taking or being treated with a drug that causes oxidation of haemoglobin, within the two days before the clinical worsening of methaemoglobinaemia;
Note:  Drugs that cause methaemoglobinaemia include, but are not limited to, dapsone; 8‑aminoquinolines such as primaquine or tafenoquine; chloroquine; nitrates such as nitroglycerine; nitrites such as amyl nitrite; local anaesthetics such as benzocaine; and sulphonamide antibiotics.
(6)          inhaling, ingesting or having cutaneous contact with a chemical agent that causes oxidation of haemoglobin, within the two days before the clinical worsening of methaemoglobinaemia;
Note:  Chemicals that cause methaemoglobinaemia include, but are not limited to, aniline and its derivatives (for example, found in dyes); naphthalene (for example, found in mothballs); nitrobenzenes (for example, found in solvents and paints); nitrogen oxide (for example, found in smoke from fires); paraquat (for example, found in herbicides); and chlorates, nitrates and nitrotoluenes (for example, found in explosives).
(7)          ingesting food or fluid contaminated by excess levels of nitrates or nitrites, within the two days before the clinical worsening of methaemoglobinaemia;
(8)          being exposed to dialysis fluid contaminated with chloramine or hydrogen peroxide, within the two days before the clinical worsening of methaemoglobinaemia;
(9)          inability to obtain appropriate clinical management for methaemoglobinaemia.