Diseases chronic beryllium

Beryllium-containing materials can be potentially harm fill if mishandled. Care must be taken in the fabrication and processing of beryUium products to avoid inhalation of airborne beryllium particulate matter such as dusts, mists, or fumes in excess of prescribed workplace limits. Inhalation of fine airborne beryllium may cause chronic beryllium disease, a serious lung disorder, in certain sensitive individuals. However, most people, perhaps as many as 99%, do not react to beryUium exposure at any level (see Beryllium and beryllium alloys). 

Maier, L. A., et al., High beryllium-stimulated TNF-alpha is associated with the -308 TNF-alpha promoter polymorphism and with clinical severity in chronic beryllium disease, Am. J. Respir. Crit. Care Med., 164, 1192, 2001. 

An immunologic basis for chronic beryllium disease has been postulated and a hypersensitivity phenomenon demonstrated. Consistent with the concept of chronic berylliosis as a hypersensitivity pulmonary reaction are the following Persons with berylliosis also show delayed cutaneous hypersensitivity reactions to beryllium compounds their peripheral blood lymphocytes undergo blast transformation and release of macrophage inhibition factor after exposure to beryllium in vitro helper/suppressor T-cell ratios are depressed and there is lack of a dose-response relationship in chronic beryllium cases. Hypersensitization may lead to berylliosis in people with relatively low exposures, whereas nonsensitized individuals with higher exposures may have no effects. 

The current permissible exposure levels for beryllium of 0.01 mcg/m3 averaged over a 30-day period or 2 mcg/m3 over an 8-hour period are insufficiently protective to prevent chronic beryllium disease. Both NIOSH and the ACGIH have recommended that the PEL and TLV be reduced to 0.05 mcg/m3. These recommendations have not yet been implemented. 

H.C. Williams, Beryllium workers sarcoidosis or chronic beryllium disease sarcoidosis, 6(supp.) 34-35, 1989. 

LB = Lewis base bht = 2,6-di(f-butyl)-4-methylphenoxide bo = l-metalla-2,6-dioxo-3-aza-4,5-diphenylcyclohex-3-ene CBD = Chronic beryllium disease dbp = 2,6-di(t-butyl)phenoxide dfhd = 1,1,1,2,2,3,3,7,7,7-decafluorohept-ane-4,6-dionato dmmhd = 2,6-dimethyl-2-methoxyheptane-... 

Beryllium metal has properties that make it technologically attractive (Alderighi et al, 2000), but these advantages are counterbalanced by the toxicity of inhaled beryllium dust, which can cause chronic beryllium disease (Sauer et a/., 2002). The etiology of this immune hyper-response disease (Eontenot et a/., 2001) is poorly understood, but the final disease state is characterized by lung failure. 

Sauer, N. N., McCleskey, T. M., Taylor, T. P., et al, Ligand associated dissolution of beryllium toward an understanding of chronic beryllium disease. Technical report LA-UR-02-1986, Los Alamos National Laboratory (2002). 

Skin lesions are the most common industrial exposure symptom. Three distinct skin lesions have been noted following exposure to beryllium dermatitis, ulceration, and granulomas. There appears to be an immunological component to chronic beryllium disease, including the dermal responses. 

Kolanz ME, Madl AK, Kelsh MA, Kent MS, Kalmes RM, Paustenbach DJ. A comparison and critique of historical and current exposure assessment method for beryllium Implications for evaluating risk of chronic beryllium disease. Appl Occup Environ Hyg 2001 6 593-614. 

Madl, A. K., Unice, K. M., Brown, J. L., Kolanz, M. E., and Kent, M. S. (2007). Exposure-response analysis for beryllium sensitization and chronic beryllium disease among worka-s in a beryllium metal machining plant. J Occup Environ Hyg 4(6), 448-466. 

SALTINI, C WINESTOCK, K KIRBY, M PINKSTON, P. CRYSTAL, R.G. (1989) Maintenance of alveolitis in patients with chronic beryllium disease by beryllium-specific helper T cells. New England Journal of Medicine, 320, 1103-1109. 

Tinkle, S.S., et ah. Skin as a route of exposure and sensitization in chronic beryllium disease. Environ Health Perspect 2003, 111, 1202-1208. 

Beryllium is one of the most toxic elements in the Periodic Table. It is the agent responsible for chronic beryllium disease (CBD), an often-fatal lung disease, and is a Class A carcinogen (as determined by the U.S. Environmental Protection Agency). The primary route of human exposure to beryllium and beryllium compounds is inhalation. 

Hasan EM and Kazemi H (1974) Chronic beryllium disease a continuing epidemiological hazard. Chest 65 289-293. 

In contrast to acute beryllium disease, chronic beryllium disease still occurs but is due to an immune response to beryllium that occurs in a minority of exposed vorkers (Eisenbud and Lisson 1983). Therefore, in this condition the determination of an immune response to beryllium has more important clinical utility than the determination of beryllium levels (US Department of Energy 1999). 

In 1949, the Atomic Energy Commission adopted limits for beryllium exposure in the workplace of 25 pg m as a peak value and 2 pg m averaged over an 8-h day. These standards have essentially eliminated acute beryllium disease, and the last reported case occurred during the 1960s in the United States (Eisenbud and Lisson 1983). However, chronic beryllium disease has continued to occur, and recently the... 

Risk for the development of chronic beryllium disease has also existed for family members of workers, mainly from beryllium brought home on workdothes. In addition, individuals living in communities surrounding a beryllium plant may be exposed due to excessive plant emissions. While current plant emissions in the United States are probably safe, cases of community-acquired chronic beryllium disease continue to occur from exposures that have occurred in the past (M. Rossman, unpublished results). 

---