Document ID: chunk:federal_register_of_legislation:F2024L00487:reg:9
Version: federal_register_of_legislation:F2024L00487
Segment Type: reg
Provision Reference: reg 9
Character Range: 4320–6908

9               Factors that must exist
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 malignant neoplasm of the gallbladder or death from malignant neoplasm of the gallbladder with the circumstances of a person's relevant service:
(1)          having cholelithiasis before clinical onset;
(2)          having a chronic biliary infection of Salmonella typhi or Salmonella paratyphi detected on at least 2 separate occasions, at least a month apart, and within 2 years before clinical onset;
Note: A biliary infection by Salmonella can be ascertained by detection of specific antibodies in serum or detection of Salmonella sp. in stool samples.
(3)          having primary sclerosing cholangitis before clinical onset;
Note: primary sclerosing cholangitis is defined in the Schedule 1 - Dictionary.
(4)          having had an intravascular injection of Thorotrast (thorium dioxide) before clinical onset;
(5)          having porcelain gallbladder before clinical onset;
Note: porcelain gallbladder is defined in the Schedule 1 – Dictionary.
(6)          being obese for at least 5 years within the 20 years before clinical onset;
Note: being obese is defined in the Schedule 1 – Dictionary.
(7)          being overweight for at least 5 years within the 20 years before clinical onset;
Note: being overweight is defined in the Schedule 1 – Dictionary.
(8)          having diabetes mellitus for at least 5 years before clinical onset;
(9)          smoking at least 20 pack-years of cigarettes, or the equivalent thereof in other tobacco products, before clinical onset, and:
(a)          smoking commenced at least 5 years before clinical onset; and
(b)          where smoking has ceased,  clinical onset has occurred within 20 years of cessation;
Note: one pack-year is defined in the Schedule 1 - Dictionary.
(10)      having non-alcoholic fatty liver disease for at least 5 years within the 20 years before clinical onset;
(11)      having chronic infection with hepatitis B or C virus before clinical onset;
Note: chronic infection with hepatitis B or C virus is defined in the Schedule 1 - Dictionary.
(12)      being exposed to high levels of dietary aflatoxins, on more days than not, for a period of at least 5 years within the 30 years before clinical onset;
Note: being exposed to high levels of dietary aflatoxins is defined in the Schedule 1 – Dictionary.
(13)      inability to obtain appropriate clinical management of malignant neoplasm of the gallbladder before clinical worsening.