Make an Appointment

Ask a Question
Refer a Patient

1.877.CALL NJH
(877.225.5654)

Daily Pollen Count

Feeling sneezy or itchy? Check our daily pollen count to learn
what's in the air.

  • Reviewed on 5/11
    By Dr. Maier et al.

Chronic Beryllium Disease: Causes

 

What is beryllium sensitization?

Beryllium sensitization is an “allergic” condition to beryllium that can develop after a person that is susceptible, due to a genetic factor such as HLA-DPB Glu69 allele, breathes beryllium dust or fumes, or possibly if beryllium penetrates the skin through an open cut or from a beryllium splinter.

In individuals with beryllium sensitization, the immune system sees beryllium as a foreign substance and responds by generating a population of immune cells in the bloodstream that react to beryllium. These cells can be found in the blood using a test called the beryllium lymphocyte proliferation test (BeLPT).

 

How do you develop beryllium sensitization?

It is important to know that no one develops beryllium sensitization unless they are exposed to beryllium. Beryllium sensitization may develop after an individual breathes beryllium dust or fumes. Most people who are exposed to beryllium will not experience health effects. Particle size, type of beryllium used, amount and duration of exposure to beryllium, occupation, industry, and genetics are all factors that play a role in determining why some people develop beryllium sensitization and why others do not.   

Studies have shown that on average, 1-6% of exposed workers develop sensitivity, although the rates can be as high as 16% in workers with the highest exposures, such as beryllium machinists. Most workers who are going to develop an allergy to beryllium tend to do so early on, but follow-up testing over the years continues to identify workers with beryllium sensitization (Schuler, 2008).

 

What are the symptoms of beryllium sensitization?

As opposed to environmental allergies, such as pollen or ragweed, individuals with beryllium sensitization do not have any immediate symptoms when they are exposed to beryllium. In fact, beryllium sensitization causes no symptoms at all.

 

How do I know if I have beryllium sensitization?

Beryllium sensitization is diagnosed with a beryllium lymphocyte proliferation test (BeLPT). The BeLPT is a test that helps determine if your immune system reacts to beryllium as a foreign substance -- this reaction would lead to abnormal BeLPT results. In individuals who do not have beryllium sensitization, the immune system does not respond to beryllium in any manner, which produces normal BeLPT results. 

Individuals with two or more abnormal BeLPT results are considered to have “confirmed beryllium sensitization” and are encouraged to undergo further evaluation to determine if they have chronic beryllium disease (CBD). Individuals with other combinations of non-normal test results, such as an abnormal and a borderline BeLPT, may also be candidates for further evaluation.

 

Is beryllium sensitization treated?

Currently, there is no medication or procedure available to eliminate this immune reaction to beryllium.

 

Can beryllium sensitization be cured?

At the present time, there is not a known cure for beryllium sensitization.

 

How often should I see my doctor?

Once diagnosed with beryllium sensitization you should see your physician at least every 2 years.  During your visit, you may have testing including pulmonary function tests, exercise tolerance tests, a chest x-ray or CT scan to check for inflammation and scarring in the lungs, and a bronchoscopy with lavage and biopsy to see if granulomas or other abnormalities have developed in the lungs.  The types of testing your physician performs may be different based on your overall health.  If you develop symptoms of CBD, such as a dry cough or unexplained shortness of breath, you should see your physician as soon as possible.

 

How do you develop CBD?

It is important to know that no one develops CBD unless they are exposed to beryllium and develop an immune response (beryllium sensitization) to it. CBD may develop after an individual breathes beryllium dust or fumes. Most people who are exposed to beryllium will not experience health effects.

 

What are my chances of developing chronic beryllium disease (CBD)?

The percentage of people with beryllium sensitization who go on to develop CBD is highly variable, ranging from 10-100% in different worker populations. Individuals with very high exposure to beryllium, such as machinists, are at great risk. On average, an estimated 40-60% of workers with beryllium sensitization will go on to develop CBD. Factors such as particle size, type of beryllium used, amount and duration of exposure to beryllium, occupation, industry, and genetics may all play a role in determining why some people develop CBD and others do not. Once you are exposed to beryllium, you carry a lifelong risk of developing beryllium sensitization or CBD, even if the exposure amount was small or you are no longer exposed.

When people with beryllium sensitization undergo clinical evaluation to determine if they have CBD, between 20-100% of them are found to have a CBD diagnosis on their first evaluation. If you have undergone evaluation and are found to have beryllium sensitization at the current time, you are still at risk for developing CBD in the future. Recent research suggests that each year, 6-8% of people with beryllium sensitization will develop CBD, at least in the first 6 years.

 

For more information on beryllium, please contact National Jewish Health® at 1.800.222.5864.

 

References

  1. Mroz MM, Balkissoon R, Newman LS. Beryllium. In: Bringham E, Cohrssen B, Powell C (eds.) Patty’s Toxicology, Fifth Edition. New York: John Wiley & Sons 2001, 177-220.
  2. Balkissoon RC, Newman LS. Beryllium cooper alloy (2%) causes chronic beryllium disease. J Occup Environ Med 1999; 41: 304-308.
  3. Kreiss K, Mroz MM, Ahen B, Martyny JW, Newman LS. Epidemiology of beryllium sensitizations and disease in nuclear workers. Am Rev Respir Dis 1993; 148:985-991.
  4. Newman LS, Kreiss K. Non-occupational chronic beryllium disease masquerading as sarcoidosis: Identification by blood lymphocyte proliferative response to beryllium. Am Rev Respir Dis 1992; 145:1212-1214.
  5. Steenland K, Ward E. Lung Cancer Incidence Among Patients with Beryllium Disease: a Cohort Mortality Study. J Natl Cancer Inst 1991; 83:1380-1385.
  6. Kriebel D, et al. The pulmonary toxicity of beryllium. Am Rev Respir Dis 1988; 137: 464-473.
  7. Kreiss K, Newman LA, Mroz M, Campbell PA. Screening blood test identifies subclinical beryllium disease. J Occ Med 1989; 31:603-608.
  8. Kreiss K, Wasserman S, Mroz MM, Newman LS. Beryllium disease screening in ceramics industry: Blood test performance and exposure-disease relations. J Occup Med 1993; 35: 267-274.
  9. Kreiss K, Mroz MM, Newman LS, Martyny J, Zhen B. Machining risk of beryllium disease and sensitization with median exposures below 2 µg/m3. Am J Indust Med 1996; 30:16-25.
  10. Kreiss K, et al. Risks of beryllium disease related to work processes at a metal, alloy and oxide production plant. Occup Environ Med 1997; 54:605-612.
  11. Mroz MM, Kreiss K, Lezotte DC, Campbell PA, Newman LS. Re-examination of the blood lymphocyte transformation test in the diagnosis of chronic beryllium disease.  J Allergy Clin Immunol 1991; 88:54-60.
  12. Kreiss K, Miller F, Newman LS, Ojo-Amaize EA, Rossman MD, Saltini C. Chronic beryllium disease: From the work place to cellular immunology, molecular immunogenetics, and back. Cl Immunol Immunopath 1994; 71:123-129.
  13. Rossman MD. Differential diagnosis of chronic beryllium disease. In: Rossman MD, Preuss OP, Powers MB, eds. Beryllium: Biomedical and Environmental Aspects. Baltimore: Williams & Wilkins, 1991; 167-175.
  14. Newman LS, Mroz MM, Maier LA, Danilof EM, Balkissoon R. Efficacy of serial medical surveillance for chronic beryllium disease in a beryllium machining plant. J Occup Environ Med 2001; 43:231-237.
  15. Yoshida T, Shima S, Nagoka K et al. A study on the beryllium Lymphocyte Transformation Test and the beryllium levels in working environment. Ind Health 1997; 35:374-379.
  16. Cullen M, et al. Chronic beryllium disease in a precious metal refinery: clinical, epidemiologic, and immunologic evidence for continuing risk from exposure to low-level beryllium fume, Am Rev Respir Dis 1987; 135:201-208.
More Causes Information
Back to Chronic Beryllium Disease
Bookmark and Share

Beryllium Program

The National Jewish Health team has more experience with the diagnosis and treatment of beryllium disease than any group in the world.

Learn more.

Doctors Who Treat Chronic Beryllium Disease

more/less

Sign Up for e-Newsletters

Enter your email address to receive health tips, recent research findings and news about National Jewish Health.