Beryllium disease screening in the ceramics industry. Blood lymphocyte test performance and exposure-disease relations.
We identified nine new cases of biopsy-confirmed chronic beryllium disease among 505 employees and ex-employees in a company that had manufactured beryllia ceramics from 1958 through 1975. Of tests commonly used in medical surveillance, only a confirmed blood beryllium lymphocyte transformation test had a high positive predictive value for beryllium disease (100%). However, two beryllium disease cases had either a normal or inconsistently abnormal blood test and were identified for diagnostic workup by abnormal chest radiograph. The only risk factor for beryllium disease was beryllium exposure; smoking or allergic history did not affect risk. Degree of beryllium exposure was associated with disease rates, which ranged from 2.9% to 15.8% for beryllia-exposed subgroups. One case of beryllium disease occurred in a "dust-disturber" who did not report past beryllium exposure and who began employment 8 years after commercial beryllia production had stopped. Our data support efforts to prevent beryllium disease by lowering beryllium exposures and to identify subclinical and early disease by broad-based medical surveillance using the blood beryllium lymphocyte test and chest radiograph in beryllium-using industries.
Kreiss
K
K
Occupational and Environmental Medicine Division, National Jewish Center for Immunology and Respiratory Medicine, Denver, CO 80206.
Wasserman
S
S
Mroz
M M
MM
Newman
L S
LS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001607:Berylliosis / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control*; D001608:Beryllium / Q000276:immunology*; D002516:Ceramics / Q000009:adverse effects*; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D008213:Lymphocyte Activation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control*; D011159:Population Surveillance; D011237:Predictive Value of Tests; D012307:Risk Factors
D001608:Beryllium