Beryllium sensitization progresses to chronic beryllium disease: a longitudinal study of disease risk.
The blood beryllium lymphocyte proliferation test is used in medical surveillance to identify both beryllium sensitization and chronic beryllium disease. Approximately 50% of individuals with beryllium sensitization have chronic beryllium disease at the time of their initial clinical evaluation; however, the rate of progression from beryllium sensitization to chronic beryllium disease is unknown. We monitored a cohort of beryllium-sensitized patients at 2-year intervals, using bronchoalveolar lavage and repeated transbronchial lung biopsies to determine progression to chronic beryllium disease as evidenced by granulomatous inflammation in lung tissue. Fifty-five individuals with beryllium sensitization were monitored with a range of 2 to 5 clinical evaluations. Disease developed in 17 sensitized individuals (31%) within an average follow-up period of 3.8 years (range, 1.0-9.5 years). Thirty-eight of the 55 (69%) remained beryllium sensitized without disease after an average follow-up time of 4.8 years (range, 1.7-11.6 years). Progressors were more likely to have worked as machinists. We found no difference in average age, sex, race or ethnicity, smoking status, or beryllium exposure time between those who progressed to chronic beryllium disease and those who remained sensitized without disease. We conclude that beryllium sensitization is an adverse health effect in beryllium-exposed workers and merits medical follow-up.
Newman
Lee S
LS
Department of Medicine, National Jewish Medical and Research Center, 1400 Jackson Street, Room G-010, Denver, CO 80206, USA. newmanl@njc.org
Mroz
Margaret M
MM
Balkissoon
Ronald
R
Maier
Lisa A
LA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001607:Berylliosis / Q000209:etiology / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology; D001608:Beryllium / Q000276:immunology*; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000473:pathology; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011659:Pulmonary Gas Exchange; D012130:Respiratory Hypersensitivity / Q000150:complications* / Q000473:pathology; D012307:Risk Factors; D014797:Vital Capacity
D001608:Beryllium