Beryllium Sensitization Leads to Chronic Disease

Lee S. Newman, M.D.
Denver, Colorado
P01ES11810

Background: Beryllium is a metal, steel grey in color with many desirable properties. It is found in over 30 different minerals and the precious stones aquamarine and emerald. It is a very light metal with a high melting point making it an ideal material for industrial uses such as in springs, electrical contacts, welding applications, and aircraft. Its strength and light weight are also beneficial in more unusual applications such as in structural components of spacecraft, communication satellites, nuclear weapons, and nuclear reactor fuel cladding. Unfortunately, it is also highly toxic. Inhalation of beryllium dust or particles can lead to beryllium sensitization and chronic beryllium disease (CBD). Beryllium sensitization is a condition in which a person’s immune system becomes highly responsive to the presence of beryllium in the body. CBD is a debilitating and often fatal lung disease characterized by lung-tumor formation. The number of cases of CBD is small, but the Department of Energy expects more workers to be exposed to beryllium as efforts move forward to decommission and deactivate former nuclear weapons production facilities.

Advance: About half of individuals with sensitization already have CBD at the time of their first clinical evaluations. However, the time-lag between the two conditions is unknown. NIEHS-supported researchers recently conducted an epidemiologic study in 55 workers with beryllium sensitization. They found that over about four years of follow-up, 17 of the subjects developed CBD. The remaining 38 workers remained disease free after almost five years. Those workers that progressed to CBD were more likely to have worked as machinists than in other occupations, however, there were no differences in age, sex, race, smoking status, or beryllium exposure time between those who developed CBD and those that remained sensitized.

Implications: This study demonstrates that beryllium sensitization is an adverse health effect that merits continued medical monitoring. It will be important to continue to follow the subjects in this study to determine if all sensitized workers eventually develop CBD and the extent to which the conditions of those with CBD worsen. Although the researchers could not identify when the beryllium sensitization initially occurred, the time period from first beryllium exposure to the development of CBD ranged from under four years to 45 years, indicating that people with beryllium sensitization have a life-long risk of developing CBD.

Citation: Newman LS, Mroz MM, Balkissoon R, Maier LA. Beryllium sensitization progresses to chronic beryllium disease: a longitudinal study of disease risk. Am J Respir Crit Care Med. 2005 Jan 1;171(1):54-60.