The beryllium lymphocyte proliferation test: Relevant issues in beryllium health surveillance.
BACKGROUND
The beryllium lymphocyte proliferation test (Be-LPT) measures beryllium-specific cellular immune response, and is useful in medical surveillance of beryllium sensitivity and chronic beryllium disease (CBD).


METHODS
Current and former employees (n = 12,194) of 18 United States Department of Energy (DOE) sites were tested for beryllium sensitization at four laboratories with Be-LPT expertise. Beryllium sensitized individuals were offered evaluations for CBD. The sensitivity, specificity, and positive predictive value (PPV) of the Be-LPT were determined, as was inter- and intra-laboratory agreement.


RESULTS
False positives were calculated to be 1.09%, with a laboratory range of 0.00-3.35% for the 10-year investigation. Be-LPTs performed on inter-laboratory split blood specimens from sensitized individuals showed a false negative rate of 31.7%. The intra-laboratory repeatability of abnormal Be-LPT results ranged from 80.4-91.9%. The sensitivity of the Be-LPT was determined to be 0.683, with a specificity of 0.969. The PPV of one abnormal Be-LPT was 0.253.


CONCLUSIONS
The Be-LPT is efficacious in medical surveillance of beryllium-exposed individuals. The PPV of the Be-LPT is comparable to other widely accepted medical tests. Confirmation of an abnormal result is recommended to assure appropriate referral for CBD medical evaluation.
Stange
Arthur W
AW
Center for Epidemiologic Research, Oak Ridge Institute for Science and Education, 9950 West 80th Avenue, Suite 17, Arvada, Colorado 80005, USA. stangea@orau.gov
Furman
F Joseph
FJ
Hilmas
Duane E
DE
D001607:Berylliosis / Q000175:diagnosis* / Q000276:immunology; D001608:Beryllium / Q000633:toxicity*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D007159:Immunologic Tests / Q000379:methods*; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009784:Occupational Diseases / Q000175:diagnosis* / Q000276:immunology; D016273:Occupational Exposure; D011159:Population Surveillance; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014481:United States
D001608:Beryllium