berylliosis

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Berylliosis

 

Definition

Berylliosis is lung inflammation caused by inhaling dust or fumes that contain the metallic element beryllium. Found in rocks, coal, soil, and volcanic dust, beryllium is used in the aerospace industry and in many types of manufacturing. Berylliosis occurs in both acute and chronic forms. In some cases, appearance of the disease may be delayed as much as 20 years after exposure to beryllium.

Description

In the 1930s, scientists discovered that beryllium could make fluorescent light bulbs last longer. During the following decade, the hard, grayish metal was identified as the cause of a potentially debilitating, sometimes deadly disease characterized by shortness of breath and inflammation, swelling, and scarring of the lungs.
The manufacture of fluorescent light bulbs is no longer a source of beryllium exposure, but serious health hazards are associated with any work environment or process in which beryllium fumes or particles become airborne. Working with pure beryllium, beryllium compounds (e.g. beryllium oxide), or beryllium alloys causes occupational exposure. So do jobs involving:
  • electronics
  • fiber optics
  • manufacturing ceramics, bicycle frames, golf clubs, mirrors, and microwave ovens
  • mining
  • nuclear weapons and reactors
  • reclaiming scrap metal
  • space and atomic engineering
  • dental and laboratory technology
Beryllium dust and fumes are classified as toxic air pollutants by the Environmental Protection Agency (EPA). It is estimated that 2-6% of workers exposed to these contaminants eventually develop berylliosis.

Causes and symptoms

Coughing, shortness of breath, and weight loss that begin abruptly can be a symptom of acute berylliosis. This condition is caused by beryllium air pollution that inflames the lungs making them rigid; it can affect the eyes and skin as well. People who have acute berylliosis are usually very ill. Most recover, but some die of the disease.

Key terms

Beryllium — A steel-grey, metallic mineral used in the aerospace and nuclear industries and in a variety of manufacturing processes.
Chelation therapy — A treatment using chelating agents, compounds that surround and bind to target substances allowing them to be excreted from the body.
Corticosteroids — A group of anti-inflammatory drugs.
Chronic berylliosis is an allergic reaction to long-term exposure to even low levels of beryllium dust or fumes. A systemic disease that causes formation of abnormal lung tissue and enlargement of the lymph nodes, chronic berylliosis also may affect other parts of the body. The symptoms of chronic berylliosis are largely the same as those seen in acute berylliosis, but they develop more slowly.

Diagnosis

Berylliosis is initially suspected if a patient with symptoms of the disease has a history of beryllium exposure. A chest x ray shows characteristic changes in the lungs. However, since these changes can resemble those caused by other lung diseases, further testing may be necessary.
The beryllium lymphocyte proliferation test (BeLPT), a blood test that can detect beryllium sensitivity (i.e. an allergic reaction to beryllium), is used to screen individuals at risk of developing berylliosis. When screening results reveal a high level of sensitivity, BeLPT is performed on cells washed from the lungs. This test is now considered the most definitive diagnostic test for berylliosis.

Treatment

Individuals with beryllium sensitivity or early-stage berylliosis should be transferred from tasks that involve beryllium exposure and regularly examined to determine whether the disease has progressed.
Acute berylliosis is a serious disease that occasionally may be fatal. Ventilators can help patients with acute berylliosis breathe. Prompt corticosteroid therapy is required to lessen lung inflammation.
Chronic beryllium disease is incurable. Corticosteroid therapy is often prescribed, but it is not certain that steroids can alter the progression of the disease, and they have no effect on scarring of lung tissue. Cleansing the lungs of beryllium is a slow process, so long-term therapy may be required. Chelation therapy is currently under investigation as a treatment for the disease.

Prognosis

Most patients with acute berylliosis recover fully 7-10 days after treatment begins, and the disease usually causes no after effects.
Patients whose lungs are severely damaged by chronic berylliosis may experience fatal heart failure because of the strain placed on the heart.

Prevention

Eliminating exposure to beryllium is the surest way to prevent berylliosis. Screening workers who are exposed to beryllium fumes or dust or who develop an allergic reaction to these substances is an effective way to control symptoms and prevent disease progression.

Resources

Organizations

American Lung Association. 1740 Broadway, New York, NY 10019. (800) 586-4872. http://www.lungusa.org.
Beryllium Support Group. P.O. Box 2021, Broomfield, CO 80038-2021. (303) 412-7065. 〈http://www.dimensional.com/∼mhj〉.
Environmental Health Center. 1025 Connecticut Ave., NW, Washington, DC 20036. (202) 293-2270.

berylliosis

 [bĕ-ril″e-o´sis]
beryllium poisoning, usually involving the lungs and less often the skin, subcutaneous tissues, lymph nodes, liver, and other structures. The fumes, oxide, salts, and finely divided dust of beryllium all may cause a tissue reaction when inhaled or implanted in the skin. Acute berylliosis is basically a toxic or allergic pneumonitis, sometimes with rhinitis, pharyngitis, and tracheobronchitis. Chronic berylliosis, which is more common, is characterized by development of granulomas and a diffuse interstitial inflammatory reaction with clinical and pathological findings often indistinguishable from those of sarcoidosis.

ber·yl·li·o·sis

(ber'il-ē-ō'sis),
Beryllium poisoning characterized by acute pneumonia or chronic interstitial granulomatous fibrosis, especially of the lungs, from inhalation of beryllium.

berylliosis

A chronic lung disease caused by inhalation of beryllium dusts, salts or fumes, regarded by some as a delayed hypersensitivity reaction, in which beryllium acts as an MHC II-restricted antigen.

Berylliosis
Acute berylliosis 
Causes chemical acute pneumonitis, ­caused by short exposures to high concentrations of beryllium due to lung toxicity.
 
Chronic berylliosis 
Causes chronic interstitial, sarcoid-like granulomatous lung disease due to beryllium levels over periods from months to years.

ber·yl·li·o·sis

(bĕ-ril'ē-ō'sis)
Beryllium poisoning characterized by granulomatous fibrosis of the lungs from chronic inhalation of beryllium.

berylliosis

Disease caused by contact with the poisonous metal element beryllium found in fluorescent light tubes and TV tubes. It is a persistent form of pneumonia caused by inhaling dust or fumes containing the metal. Severe lung damage may result.
References in periodicals archive ?
Chronic beryllium disease is characterized by a granulomatous reaction in the lung to inhaled beryllium.
the perception of beryllium as a human carcinogen." (135) An internal company document suggested that the committee would "provide the scientific basis for our cancer strategy." (136) Two other issues also dominated BISAC's deliberations: (1) the curious resurgence of Chronic Beryllium Disease (CBD) at Brush Wellman plants years after Brush Wellman scientists had concluded that the 2.0 [micro]g/ [m.sup.3] standard had all but eradicated the disease; and (2) the intriguing possibility of reducing the incidence of CBD by screening susceptible workers out of the workplace through genetic testing.
Sharing authorship with product defense specialists, beryllium industry-associated scientists published a series of papers suggesting it was possible that beryllium particle size, or particle surface area, or particle number, are more important than previously thought in the development of beryllium disease. They also raised the hypothesis that skin exposure could play a larger role in CBD risk.
A person driving a delivery truck to the plant could come down with Chronic Beryllium Disease.
KEY WORDS: acute, beryllium, beryllium disease, granuloma, hypersensitivity, immune sensitization, pneumonitis.
Independent medical consultations led to the diagnosis of seven cases of beryllium disease among employees who already had passed X-ray tests given by local doctors.
We read with great interest "Chronic Beryllium Disease and Sensitization at a Beryllium Processing Facility" (Rosenman et al.
More chronic beryllium disease (CBD) and sensitization occurred with exposure below the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) of 2 [micro]g/[m.sup.3] (OSHA 2005) than we previously reported, but no CBD or sensitization was found below the Department of Energy (DOE) guidelines of 0.2 [micro]g/[m.sup.3] (DOE 1999) or the even more protective level proposed by the American Conference of Governmental Industrial Hygienists (ACGIH 2005) of 0.02 [micro]g/[m.sup.3].
We conducted a medical screening for beryllium disease of 577 former workers from a beryllium processing facility.
Another component of the program funded through this cooperative agreement will be the activities previously conducted by the DOE's Former Beryllium Worker Medical Surveillance Program, which offers medical testing for beryllium sensitivity and chronic beryllium disease (CBD) to former employees who were potentially exposed to beryllium as a result of their work at various DOE sites not initially covered by the Former Worker Medical Screening Program.
A gene for beryllium disease is an example of a genetic marker that raises legal and ethical issues.
However, the only diseases covered by EEOICP are cancers related to radiation exposure, chronic beryllium disease, and chronic silicosis.