title: Recent chronic beryllium disease in residents surrounding a beryllium facility.
abstract: BACKGROUND
  Between 1948 and 1969, cases of community-acquired chronic beryllium disease (CA-CBD) were reported in neighborhoods surrounding beryllium facilities. Further surveillance was not performed in these communities, and additional cases have not been reported.
  
  
  OBJECTIVE
  To increase awareness of recently diagnosed cases of CA-CBD in residents surrounding a beryllium facility.
  
  
  METHODS
  Medical records were reviewed from individuals in a community surrounding a beryllium manufacturing facility in Reading, Pennsylvania. Definite cases of CBD required (1) an abnormal beryllium lymphocyte proliferation test in blood or bronchoalveolar lavage and (2) biopsy evidence of granulomatous inflammation. Probable cases of CBD either displayed an abnormal blood test to beryllium and radiographic evidence consistent with disease, or met epidemiologic criteria for CBD based on the Beryllium Case Registry criteria. Cases with occupational or potential paraoccupational exposure were excluded.
  
  
  RESULTS
  Sixteen cases of potential community-acquired CBD were evaluated. From these, eight cases of community-acquired CBD were identified (five definite and three probable). The cases' initial year of residence began between 1943 and 1953 and continued until 1956-2001. Six of the eight cases required medical treatment and three of the cases died since diagnosis.
  
  
  CONCLUSIONS
  Cases of CBD meeting current immunologic diagnostic criteria and attributable to industry-associated environmental exposure were detected among residents of a community surrounding a beryllium manufacturing facility. Most were diagnosed years after exposure cessation. The frequency and extent of beryllium disease in this community are unknown. We anticipate that not only have cases been misdiagnosed in this community but that more cases of CBD will be diagnosed in the future.
authors.affiliation: Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Medical and Research Center, 1400 Jackson Street, Denver, Colorado 80206, USA. maierl@njc.org
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Maier
authors.forename: John W
authors.initials: JW
authors.lastname: Martyny
authors.forename: Jing
authors.initials: J
authors.lastname: Liang
authors.forename: Milton D
authors.initials: MD
authors.lastname: Rossman
mesh_terms: D000368:Aged; D001607:Berylliosis / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D001608:Beryllium / Q000009:adverse effects*; D018893:Bronchoalveolar Lavage; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004781:Environmental Exposure / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013902:Radiography, Thoracic; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D001608:Beryllium