title: Beryllium lymphocyte proliferation test surveillance identifies clinically significant beryllium disease.
abstract: BACKGROUND
  Workplace surveillance identifies chronic beryllium disease (CBD) but it remains unknown over what time frame mild CBD will progress to a more severe form.
  
  
  METHODS
  We examined physiology and treatment in 229 beryllium sensitization (BeS) and 171 CBD surveillance-identified cases diagnosed from 1982 to 2002. Never smoking CBD cases (81) were compared to never smoking BeS patients (83) to assess disease progression. We compared CBD machinists to non-machinists to examine effects of exposure.
  
  
  RESULTS
  At baseline, CBD and BeS cases did not differ significantly in exposure time or physiology. CBD patients were more likely to have machined beryllium. Of CBD cases, 19.3% went on to require oral immunosuppressive therapy. At 30 years from first exposure, measures of gas exchange were significantly worse and total lung capacity was lower for CBD subjects. Machinists had faster disease progression as measured by pulmonary function testing and gas exchange.
  
  
  CONCLUSIONS
  Medical surveillance for CBD identifies individuals at significant risk of disease progression and impairment with sufficient time since first exposure.
authors.affiliation: Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Health, Denver, Colorado 80206, USA. mrozp@njhealth.org
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Mroz
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Maier
authors.forename: Matthew
authors.initials: M
authors.lastname: Strand
authors.forename: Lori
authors.initials: L
authors.lastname: Silviera
authors.forename: Lee S
authors.initials: LS
authors.lastname: Newman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001607:Berylliosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D001608:Beryllium / Q000633:toxicity*; D049109:Cell Proliferation / Q000187:drug effects*; D003120:Colorado / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008137:Longitudinal Studies; D008214:Lymphocytes / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016273:Occupational Exposure / Q000009:adverse effects*; D011159:Population Surveillance; D012129:Respiratory Function Tests; D014481:United States / Q000453:epidemiology
chemical_list: D007166:Immunosuppressive Agents; D001608:Beryllium
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