Beryllium sensitization and disease among long-term and short-term workers in a beryllium ceramics plant

Abstract

A plant-wide decline in beryllium exposures between the 1992 and 1998 surveys was not matched by a decline in the prevalence of sensitization and disease. Similar to findings from other studies, beryllium sensitization/disease was associated with specific processes and elevated exposures. The contrast in disease prevalence between long-term and short-term workers suggests that beryllium sensitization can occur after a short period of exposure, but beryllium disease usually requires a longer latency and/or period of exposure. The findings from this study motivated interventions to more aggressively protect and test workers, and new research into skin exposure as a route of sensitization and the contribution of individual susceptibility.

Sensitization and chronic beryllium disease at a primary manufacturing facility, part 3: exposure–response among short-term workers

“…Exposure-response relations for beryllium sensitization (BeS) and chronic beryllium disease (CBD) using various methods for estimating airborne exposure have been inconsistent (1)(2)(3)(4)(5). Processes or jobs worked have been used as surrogates for quantitative exposures in many studies.…”

“…Processes or jobs worked have been used as surrogates for quantitative exposures in many studies. Process-related risks have been identified in the absence of exposure-response (1)(2)(3)6), suggesting that predictive exposure factors do exist but may not have been adequately characterized. Possible explanations may include, among others: (i) quantification of airborne beryllium exposure using metrics that do not take into account biological relevance, rather than metrics that consider lung deposition (7)(8)(9), and (ii) inclusion of exposure periods not relevant to risk due to uncertainty regarding time of onset of BeS and CBD in cross-sectional epidemiologic studies.…”

“…However, many epidemiologic studies to date have used estimates of total beryllium mass concentration without consideration for particle size (1)(2)(3). Some studies have shown an association between exposure to smaller-size particles and BeS or CBD (4,11).…”

“…The interval between initial exposure to beryllium and the development of BeS can be as short as three months with several studies detecting a higher prevalence of BeS among workers with one year or less of employment tenure (3,6,(12)(13)(14). The interval between initial exposure and the development of CBD is not well understood.…”

Comparative analysis between CFSE flow cytometric and tritiated thymidine incorporation tests for beryllium sensitivity

“…Beryllium sensitization is clinically defined as positive proliferative response of lymphocytes challenged in vitro with beryllium (1,4), whereas chronic beryllium disease (CBD) is confirmed by noncaseating granulomas and/or interstitial infiltration of mononuclear phagocytes and lymphocytes (6,7). Bronchoalveolar lavage (BAL) BeLPT and transbronchial biopsy for histological examination are considered to be gold standard for CBD diagnosis (4,6,(8)(9)(10), although there is no gold standard for beryllium sensitivity (11). In the United States, 800,000 workers were considered to be at risk for developing CBD (1,12,13), but there may be over 10 million workers exposed (14).…”