Berylliosis

Definition

Berylliosis is lung inflammation caused by inhaling dust or fumes that contain the metallic element beryllium. Found in rocks, coal, soil, and volcanic dust, beryllium is used in the aerospace industry and in many types of manufacturing. Berylliosis occurs in both acute and chronic forms. In some cases, appearance of the disease may be delayed as much as 20 years after exposure to beryllium.

Description

In the 1930s, scientists discovered that beryllium could make fluorescent light bulbs last longer. During the following decade, the hard, grayish metal was identified as the cause of a potentially debilitating, sometimes deadly disease characterized by shortness of breath and inflammation, swelling, and scarring of the lungs.

The manufacture of fluorescent light bulbs is no longer a source of beryllium exposure, but serious health hazards are associated with any work environment or process in which beryllium fumes or particles become airborne. Working with pure beryllium, beryllium compounds (e.g. beryllium oxide), or beryllium alloys causes occupational exposure. So do jobs involving:

• Electronics
• Fiber optics
• Manufacturing ceramics, bicycle frames, golf clubs, mirrors, and microwave ovens
• Mining
• Nuclear weapons and reactors
• Reclaiming scrap metal
• Space and atomic engineering.
• Dental and laboratory technology.

Beryllium dust and fumes are classified as toxic air pollutants by the Environmental Protection Agency (EPA). It is estimated that 2-6% of workers exposed to these contaminants eventually develop berylliosis.

Causes & symptoms

Coughing, shortness of breath, and weight loss that begin abruptly can be a symptom of acute berylliosis. This condition is caused by beryllium air pollution that inflames the lungs making them rigid; it can affect the eyes and skin as well. People who have acute berylliosis are usually very ill. Most recover, but some die of the disease.

Chronic berylliosis is an allergic reaction to long-term exposure to even low levels of beryllium dust or fumes. A systemic disease that causes formation of abnormal lung tissue and enlargement of the lymph nodes, chronic berylliosis also may affect other parts of the body. The symptoms of chronic berylliosis are largely the same as those seen in acute berylliosis, but they develop more slowly.

Diagnosis

Berylliosis is initially suspected if a patient with symptoms of the disease has a history of beryllium exposure. A chest x ray shows characteristic changes in the lungs. However, since these changes can resemble those caused by other lung diseases, further testing may be necessary.

The beryllium lymphocyte proliferation test (BeLPT), a blood test that can detect beryllium sensitivity (i.e. an allergic reaction to beryllium), is used to screen individuals at risk of developing berylliosis. When screening results reveal a high level of sensitivity, BeLPT is performed on cells washed from the lungs. This test is now considered the most definitive diagnostic test for berylliosis.

Treatment

Individuals with beryllium sensitivity or early-stage berylliosis should be transferred from tasks that involve beryllium exposure and regularly examined to determine whether the disease has progressed.

Acute berylliosis is a serious disease that occasionally may be fatal. Ventilators can help patients with acute berylliosis breathe. Prompt corticosteroid therapy is required to lessen lung inflammation.

Chronic beryllium disease is incurable. Corticosteroid therapy is often prescribed, but it is not certain that steroids can alter the progression of the disease, and they have no effect on scarring of lung tissue. Cleansing the lungs of beryllium is a slow process, so long-term therapy may be required. Chelation therapy is currently under investigation as a treatment for the disease.

Prognosis

Most patients with acute berylliosis recover fully 7-10 days after treatment begins, and the disease usually causes no after effects.

Patients whose lungs are severely damaged by chronic berylliosis may experience fatal heart failure because of the strain placed on the heart.

Prevention

Eliminating exposure to beryllium is the surest way to prevent berylliosis. Screening workers who are exposed to beryllium fumes or dust or who develop an allergic reaction to these substances is an effective way to control symptoms and prevent disease progression.

Key Terms

Beryllium

A steel-grey, metallic mineral used in the aerospace and nuclear industries and in a variety of manufacturing processes.

Chelation therapy

A treatment using chelating agents, compounds that surround and bind to target substances allowing them to be excreted from the body.

Corticosteroids

A group of anti-inflammatory drugs.

Further Reading

For Your Information

Books

• Thoene, Jess G., ed. Physicians' Guide to Rare Diseases. 2nd ed. Montvale, NJ: Dowden Publishing Co., 1995.

  Organizations

• American Lung Association. 1740 Broadway, New York, NY 10019. (800) LUNG-USA. http://www.lungusa.org.
• Beryllium Support Group. P.O. Box 2021, Broomfield, CO 80038-2021. (303) 412-7065. http://www.dimensional.com/~mhj.
• Environmental Health Center. 1025 Connecticut Avenue, NW, Washington, DC 20036 (202) 293-2270.

  Other

• Beryllium Chemical Backgrounder. http://www.nsc.org/ehc/ew/chems/berylliu.htm (29 May 1998).
• Beryllium Disease: Reducing the Risks. http://www.njc.org/beryllium/ber.htm (29 May 1998).
• Environmental and Occupational Lung Diseases. http://www.epler.com/occu2.html (29 May 1998).

Gale Encyclopedia of Medicine. Gale Research, 1999.