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Government Response to Expert Panel Report on SAS Health Concerns

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Recommendation 1

In relation to past exposure to lead, testing is unnecessary for SAS veterans, except where indicated in the context of clinical investigations.

Where serving Australian Defence Force (ADF) members are identified with lead exposure symptoms, an occupational medicine specialist will determine when exposure testing is appropriate on a case by case basis.

Where indicated, the Department of Veterans’ Affairs (DVA) will also be conducting testing as part of the investigation processes applying to claims for compensation.

Recommendation 2

Occupational health authorities within the Australian Defence Force (ADF) should determine whether current practice for measuring airborne lead concentration in training facilities and blood lead levels in SAS members in training is satisfactory in terms of occupational standards (National Standard for the Control of Inorganic Lead at Work, National Occupational Health and Safety Commission, 1994 - see Appendix B).

The management of inorganic lead in ADF workplaces has been, and will continue to be, improved through a number of initiatives including:

  • The removal of lead from range activities with the introduction of simulated ranges and use of non-lead ballistics;
  • The introduction of new range facilities with improved ventilation;
  • Rationalisation and simplification of blood lead testing; and
  • Revision of health surveillance of lead exposure policy to bring the ADF into line with national standards for the control of inorganic lead in workplaces.

Consistent with the OHS Strategic Plan and development of the Defence OHS management system, Defence will be updating the ADF’s occupational health surveillance program including for environmental monitoring in the workplace. This will include ensuring that appropriate environmental measuring procedures are in place.

Recommendation 3

For the purposes of the relevant Statement of Principles, the RMA should consider whether “irritant” definitions and other listed definitions should include CS exposure.

This recommendation will be referred to the Repatriation Medical Authority by the Repatriation Commission.

Recommendation 4

Respiratory function monitoring is not considered necessary for all those exposed to coloured smokes and masking agents, except where clinically indicated.

Where serving ADF members are identified with respiratory symptoms, a respiratory specialist will determine when respiratory function monitoring is appropriate on a case by case basis.

Where indicated, DVA will also be conducting testing as part of the investigation processes applying to claims for compensation.

Recommendation 5

The RMA and occupational health authorities within the ADF should monitor literature on the potential human carcinogenicity of hexachloroethane smoke and its combustion products and also 2-aminoanthroquinone, solvent yellow 33 and disperse blue 180 (chemical constituents of certain coloured smokes). Within the limitations of training and operational requirements, it would be prudent to minimise exposure to coloured smoke and masking agents.

A literature monitoring capability will be integrated within the OHS management system being developed by Defence.

The Services are taking steps to review or introduce measures to minimise or eliminate the potential for exposure to coloured smoke and masking agents, including the use of CS agent and smoke grenades. Analysis is being conducted under risk management principles consistent with the requirements of operations and training.

The Repatriation Commission will also ask the Repatriation Medical Authority to monitor the literature.

Recommendation 6

The ADF should maintain a central registry of the type and composition of coloured smokes and masking agents in order to facilitate the future risk assessment of veterans.

The Joint Ammunition Logistics Organisation, under current engineering and logistics practices, maintains a comprehensive document known as the Design Disclosure Index for each nature of explosive ordnance in stock, including coloured smokes and masking agents. The index contains a broad range of information and data needed for design certification and in-service management of the respective explosive ordnance through life of type. Beyond general information on type, dimensions, composition, mass properties and design details, the Index also includes test reports, technical assessment reports, material safety data sheets, lifting details, information on packaging, handling, transportation, storage, maintenance and disposal, as well as related information from the manufacturer, the Safety and Suitability for Service certificates and Store Design certificates.

There are some items, including smokes and masking agents, in the ADF inventory that were procured under a previous acceptance regime. These items are undergoing retrospective Safety and Suitability for Service assessment as part of an ongoing project and many smoke items have already been assessed as a matter of priority. This will ensure the required information is available for these items.

Recommendation 7

Potential exposure to asbestos in SAS veterans should be taken into account where indicated in the context of clinical investigation.

Where serving ADF members are identified with asbestos exposure symptoms, an occupational medicine or respiratory specialist will determine when exposure monitoring is appropriate on a case by case basis.

Further, Defence has in place:

  • An asbestos exposure monitoring scheme which enables all members and employees to record details of suspected asbestos exposure. The scheme provides medical screening where individuals have concern about exposure. Where the screening indicates any effects of exposure, members and employees have access, as appropriate, to further monitoring and psychological counselling, and ultimately to obtain compensation benefits;
  • Post deployment medical screening processes to identify potential asbestos, and other hazardous environmental and occupational, exposures during deployments.
  • An asbestos management program for the monitoring and management of any Defence buildings containing asbestos, and the eventual removal and replacement of asbestos materials;
  • A program for the management, removal or replacement of chrysotile asbestos in equipment; and
  • Improved awareness on the part of Commanders of the need to avoid exposure of ADF members to highly contaminated sites including for training exercises.

Where indicated, DVA will also be conducting testing as part of the investigation processes applying to claims for compensation.

Recommendation 8

Statements of Principles for common overuse injuries should be developed.

This recommendation will be referred to the Repatriation Medical Authority by the Repatriation Commission.

Recommendation 9

The RMA should continue to monitor the medical-scientific evidence on the health effects of stress and stressors and modify Statements of Principles when appropriate.

It should be noted that the Repatriation Medical Authority has undertaken extensive reviews of the effect of stress and stressors. This recommendation, which will be referred to the Repatriation Medical Authority by the Repatriation Commission, will represent a continuation of previous work.

Recommendation 10

The RMA should develop Statements of Principles for certain diving related medical conditions not currently covered, including decompression illness, pulmonary barotrauma and dysbaric osteonecrosis and should consider diving and pressure effects in relevant Statements of Principles.

This recommendation will be referred to the Repatriation Medical Authority by the Repatriation Commission.

Recommendation 11

There is no indication for or benefit from testing all SAS veterans or their offspring for chromosomal aberrations.

See below under Recommendation 12.

Recommendation 12

In view of the possible concerns arising in the context of the previous genetic testing performed on some SAS veterans, those veterans and their families should be provided with the opportunity to receive genetic counselling and, if appropriate, chromosome studies at an accredited laboratory.

This recommendation suggests that repeat testing and counselling be made available only to those who have already undergone such processes. The Government has decided to take this recommendation further.

The Department of Defence will make accredited genetic counselling and testing available for ADF members who are serving in the SAS, and their families, where they have concerns about genetic outcomes associated with their SAS service. DVA will be responsible for arrangements for such counselling and testing where former members of the SAS and their families have health concerns. Where, after counselling, it seems medical testing is warranted, arrangements will be made for appropriate testing at an accredited laboratory.

Recommendation 13

The programs to facilitate transition to civilian life currently being piloted by the ADF and DVA should be further evaluated and, if shown to be effective, disseminated as per usual practice.

There is a variety of resettlement programs and services in Defence which range from the provision of resettlement training to salary closure services on discharge.

There is also a comprehensive Transition Management Service for members discharged medically unfit. The Service is a collaborative arrangement between Defence and the Department of Veterans’ Affairs. The Service is managed by DVA, has national coverage and has been operating since January 2001. Features of the Service which covers both social and economic preparation, include the preparation of a discharge medical impact statement; the provision of advice to assist members to position themselves for post ADF employment, housing and children’s schooling resettlement; and briefings on compensation entitlements.

Details of the Service

DVA is also trialing a Defence Transition Service in Townsville that is extending these arrangements to all discharged and retiring ADF members. The pilot will run till November 2004.

Both transition services have evaluation arrangements. Defence and DVA will closely monitor and consider the experiences demonstrated through the evaluations, and subsequent opportunities for extension of the trial service.

Recommendation 14

A systematic, prospective program for health surveillance of positive and negative outcomes should be established for serving personnel and veterans and should include documentation of relevant exposures.

Health surveillance incorporating monitoring and recording of the types and levels of exposure, will be an integral component in the development of Defences’ OHS management system. Defence will work with DVA and the recently created Centre for Military and Veterans’ Health to explore approaches to deal with the long lead times that can occur between exposure and health outcomes. A project is underway to establish the data necessary to conduct post-deployment and longitudinal health reviews of individual operations as well as the effects of multiple deployments.

View the Expert Panel’s report

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