Submarine vets call for recognition of "link" between fuel, blood cancers

Dan Oakes, National Reporting Team, Australia
5 April 2016

Veterans who served on Australia's submarines are pushing for acknowledgement that exposure to fuel in their line of work can be linked to a range of potentially fatal blood cancers.
The request by the Submarines Association Australia (SAA) is another demonstration of how widespread the exposure to toxic fuels has been within the Australian Defence Force (ADF) over the decades.
The ADF said it simply did not know how many servicemen and women had been exposed to fuel.
The ABC has reported over the last 12 months that many veterans and current ADF personnel have begged the ADF and the Department of Veterans Affairs to fully investigate the possibility that exposure to fuels has caused serious and long-term health problems, including fatal cancers.
The chief of the ADF, Air Chief Marshal Mark Binskin, recently wrote to a Royal Australian Air Force (RAAF) veteran, saying he agreed with the need for a full investigation, and, if necessary, for consideration of compensation for those affected.
Some Defence personnel who worked on the infamous F-111 deseal/reseal project received small ex gratia payments for the "conditions" in which they worked, after it was revealed they were exposed to a toxic mixture of chemicals, such as solvents and other cleaners.
Others successfully fought for compensation in the courts. However, the possibility is now being considered that it was the fuel itself that caused the damage.
A spin-off study from the de-seal/re-seal investigation found that jet fuel did damage the body's cells, that the damage could be spread around the body, and that the long-term impacts of exposure were unknown.
The range of ADF occupations that led to prolonged exposure to fuel is extremely wide — from soldiers who used it to clean their weapons and navy personnel who maintained aircraft, to RAAF fuel tanker truck drivers.
Benzene — a component of many fuels, including jet fuel and diesel — is a known carcinogen and has been linked to a range of blood cancers, such as myeloma, acute myeloid leukaemia and non-Hodgkins lymphoma.
Now, in a submission to the Repatriation Medical Authority (RMA) — the little-known body that sets the medical guidelines by which compensation claims are accepted or rejected — obtained by the ABC, the SAA has called for official recognition that exposure to diesel fuel on submarines has potentially caused blood cancers in submariners.
The RMA's medical guidelines, known as Statement of Principle (SOPs), have been divided into two categories, relating to veterans who served overseas or in an "operational" environment, and those who served in Australia.

Veterans say they are treated as second-class citizens

The burden of proof is lower for those who served overseas, who only need to show it is a "reasonable hypothesis" that their medical condition was caused by their service, whereas the other larger group, who served only in Australia, need to meet a "balance of probabilities" test.
The RMA said this was because it showed a "particular generosity" to those veterans who served overseas.
But the disparity has angered many other veterans, who say they have been treated as second-class citizens because they did not leave Australia.
The division also means the number of veterans who can successfully claim their medical condition is linked to their service is considerably smaller.
The RMA recently altered a number of the "reasonable hypothesis" SOPs for a number of blood cancers, slashing the amount of benzene in a liquid necessary for a veteran to have been "exposed" to the carcinogen from 5 per cent of the total volume to 1 per cent.
But it has refused to even include benzene in the matching "balance of probabilities" SOPs, leading to the puzzling situation where the authority acknowledges that benzene is potentially dangerous at lower levels than previously thought, but that it is somehow not dangerous if the veteran was exposed to it in Australia.

Evidence linking benzene, blood cancers 'limited': RMA

Ray Kemp, the SAA's pension and welfare coordinator, has asked the RMA to include benzene exposure as a potential cause of acute lymphoblastic leukaemia, chronic lymphocytic leukaemia, myeloma and non-Hodgkin's lymphoma in former submariners, even among those who do not qualify as having served in an operational environment.
"Oberon class submarines had external fuel tanks that [had] to be vented inboard to equalise the pressure in the fuel tanks when the submarine dives ... the vents for fuel tanks were located in all compartments and accommodation messes," Mr. Kemp wrote.
"The result of the venting was diesel fumes being throughout the submarine. These fumes settled on clothing, bodies, plates, cooking equipment etc.
"In fact, when having a cup of water, coffee or tea it always had a film of diesel on the top. The smell and taste of diesel was everywhere.
"Another method of exposure to benzene is in the use of 'white spirits'. White spirits were and still are used for scrubbing through the submarine.
"The submarine was scrubbed though at least two times a day if not more. White spirit was used as it was the most effective method of cleaning."
A spokesman for the RMA told the ABC recently that the scientific evidence linking benzene and blood cancers was "limited, and generally of poor quality", but went on to say where benzene was accepted as having a causal effect, that it was "likely to be at a lower level than previously specified".