Chronic beryllium disease. Long-term follow-up of sixty cases and selective review of the literature

Beryllium disease: The relation of pulmonary pathology to clinical course and prognosis based on a study of 130 cases from the U.S. Beryllium Case Registry

The unusual epidemiology of beryllium disease observed in the early studies of beryllium disease led in 1951 to the hypothesis that the chronic form of the disease is the result of an acquired sensitization to beryllium or its compounds. After 30 years, the role of sensitization has been confirmed in a number of laboratory and clinical studies. The unusual epidemiological features first summarized by Sterner and Eisenbud continue to be evident. The early studies also led to formulation of standards that have resulted in effective control of both the acute and chronic pulmonary forms of beryllium disease. No case of acute chemical pneumonitis has been reported among beryllium workers in about 15 years, and the number of chronic cases has diminished greatly despite a marked increase in the use of beryllium.

Epidemiological aspects of beryllium-induced nonmalignant lung disease: a 30-year update.

With the advent of in vitro immunologic testing, we can now detect exposed individuals who are sensitized to beryllium and those who have chronic beryllium disease (CBD) with lung pathology and impairment. Earlier detection and more accurate diagnostic tools raise new questions about the natural history of sensitization and granulomatous disease. Preliminary data suggest that early detection identifies people who are sensitized to beryllium and that these individuals are at risk for progressing into clinical disease. This article discusses the historical, recent, and ongoing studies germane to our understanding of CBD natural history, including the immunologic and inflammatory basis of the disease, the environmental and host risk factors for disease progression, biological markers of disease severity and activity that may help predict outcome, and the implications for broad-based workplace screening to identify patients at the earliest stages of beryllium sensitization and disease.

The natural history of beryllium sensitization and chronic beryllium disease.

Rationale: Beryllium continues to have a wide range of industrial applications. Exposure to beryllium can lead to sensitization (BeS) and chronic beryllium disease (CBD).Objectives: The purpose of this statement is to increase awareness and knowledge about beryllium exposure, BeS, and CBD.Methods: Evidence was identified by a search of MEDLINE. The committee then summarized the evidence, drew conclusions, and described their approach to diagnosis and management.Main Results: The beryllium lymphocyte proliferation test is the cornerstone of both medical surveillance and the diagnosis of BeS and CBD. A confirmed abnormal beryllium lymphocyte proliferation test without evidence of lung disease is diagnostic of BeS. BeS with evidence of a granulomatous inflammatory response in the lung is diagnostic of CBD. The determinants of progression from BeS to CBD are uncertain, but higher exposures and the presence of a genetic variant in the HLA-DP β chain appear to increase the risk. Periodic evaluation of affected ...

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H L Hardy

Papers

United States, Beryllium Case Registry (1952-1966). Review of its methods and utility.