An official American Thoracic Society statement: diagnosis and management of beryllium sensitivity and chronic beryllium disease.
BACKGROUND
Beryllium continues to have a wide range of industrial applications. Exposure to beryllium can lead to sensitization (BeS) and chronic beryllium disease (CBD).


OBJECTIVE
The purpose of this statement is to increase awareness and knowledge about beryllium exposure, BeS, and CBD.


METHODS
Evidence was identified by a search of MEDLINE. The committee then summarized the evidence, drew conclusions, and described their approach to diagnosis and management.


RESULTS
The beryllium lymphocyte proliferation test is the cornerstone of both medical surveillance and the diagnosis of BeS and CBD. A confirmed abnormal beryllium lymphocyte proliferation test without evidence of lung disease is diagnostic of BeS. BeS with evidence of a granulomatous inflammatory response in the lung is diagnostic of CBD. The determinants of progression from BeS to CBD are uncertain, but higher exposures and the presence of a genetic variant in the HLA-DP β chain appear to increase the risk. Periodic evaluation of affected individuals can detect disease progression (from BeS to CBD, or from mild CBD to more severe CBD). Corticosteroid therapy is typically administered when a patient with CBD exhibits evidence of significant lung function abnormality or decline.


CONCLUSIONS
Medical surveillance in workplaces that use beryllium-containing materials can identify individuals with BeS and at-risk groups of workers, which can help prioritize efforts to reduce inhalational and dermal exposures.
John R
JR
Balmes
Jerrold L
JL
Abraham
Raed A
RA
Dweik
Elizabeth
E
Fireman
Andrew P
AP
Fontenot
Lisa A
LA
Maier
Joachim
J
Muller-Quernheim
Gaston
G
Ostiguy
Lewis D
LD
Pepper
Cesare
C
Saltini
Christine R
CR
Schuler
Tim K
TK
Takaro
Paul F
PF
Wambach
D001607:Berylliosis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D001608:Beryllium / Q000633:toxicity*; D002908:Chronic Disease; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D016273:Occupational Exposure / Q000009:adverse effects*
D001608:Beryllium