Acute Beryllium Disease: Reconsideration of a Historical Entity

Details

• Personal Author:
  Cummings, Kristin J. ; Kreiss, Kathleen ; Stefaniak, Aleksandr B. ; Virji, M. Abbas
• Description:
  Introduction: While chronic beryllium disease is clearly an immune-mediated granulomatous process, acute beryllium disease is commonly considered an irritative chemical phenomenon occurring at exposures >100 mg/m3. We aimed to determine the epidemiologic and pathophysiologic associations between acute and chronic beryllium diseases. Methods: Beryllium manufacturing workers were surveyed in 1993-1994. We examined associations between beryllium sensitization or chronic beryllium disease and workers' reports of past symptoms of acute beryllium disease. We reviewed medical records to identify symptomatic workers who had undergone relevant diagnostic testing and analyzed relevant historical airborne beryllium exposure measurements. Measurements and Main Results: Of 632 survey participants, 260 (41%) reported beryllium fluoride-related skin rash, 36 (6%) beryllium fluoride-related cough or breathing problems, and 29 (5%) both rash and breathing problems. The 48 (8%) with beryllium sensitization or chronic beryllium disease had two-fold greater odds of having a history of symptoms of acute beryllium disease. Two workers with classic presentations of acute beryllium disease had undergone extensive diagnostic testing. Within weeks after exposure to beryllium fluoride began, each had systemic illness characterized by dermal and respiratory symptoms and precipitous declines in pulmonary function. Symptoms and pulmonary function abnormalities improved with cessation of exposure and, in one worker, recurred with repeat exposure. Bronchoalveolar lavage fluid analyses and blood beryllium lymphocyte proliferation tests revealed lymphocytic alveolitis and cellular immune recognition of beryllium. Workers' airborne beryllium levels were below 100 mg/m3. Conclusions: Contrary to common understanding, evidence suggests that acute and chronic beryllium diseases represent a continuum and both involve hypersensitivity reactions to beryllium. [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Beryllium Blood Dermatitis Environmental Monitoring Epidemiology Lung Diseases Occupational Exposure Occupational Health Particulate Matter Respiratory System Respiratory Tract Diseases Safety Skin Skin Diseases Workplace

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• Keywords:
  Airborne-particles Beryllium-disease Dermatosis Exposure-assessment Exposure-levels Exposure-methods Lung-disease Lung-disorders Lymphocytes Occupational-exposure Occupational-hazards Occupational-health Occupational-respiratory-disease Pathogenesis Physiological-effects Physiological-factors Respiratory-system-disorders Skin-exposure Skin-irritants Skin-sensitivity Statistical-analysis Work-analysis Work-areas Work-environment Work-organization Worker-health Workplace-studies

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• ISSN:
  1073-449X
• Document Type:
  Text
• Genre:
  Abstract or Summary
• Place as Subject:
  OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  179
• NIOSHTIC Number:
  nn:20036367
• Citation:
  Am J Respir Crit Care Med 2009 Apr; 179(Meeting Abstracts):A3193
• Email:
  cvx5@cdc.gov
• CAS Registry Number:
  Beryllium (CAS RN 7440-41-7)
• Federal Fiscal Year:
  2009
• Peer Reviewed:
  False
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Supplement:
  Meeting Abstracts
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a672923d658b709317983612266166dddc32670b47d05881b3a0449cbf43d49dd8809510875367a675fcae3387c2b9203631b44ed5712d9cd2bea1f3f73168a2
• Download URL:
  https://stacks.cdc.gov/view/cdc/187828/cdc_187828_DS1.pdf
• File Type:
  [PDF - 38.60 KB ]