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PubMed1988

Chronic beryllium disease in identical twins.

Identical male twins born in 1959 have developed chronic beryllium disease. Twin 1 was exposed to beryllium for more than 3 years. The diagnosis was first suspected at the time of his post-employment chest radiograph. Twin 2 was exposed for 21 months and ceased employment at the same time as his brother. His post-employment examination was normal. Thirty months later he developed an unusual skin rash which biopsy showed to be granulomatous. Further investigations proved the diagnosis. Both men have reduced tear secretion measured with Schirmer's test, a feature not previously reported in this condition. Bronchoalveolar lavage and laser microprobe mass spectrometry (LAMMS) were used as aids to the diagnosis. Sarcoidosis has been reported in identical twins, suggesting genetic susceptibility, which may also be of importance in chronic beryllium disease.

Adult↗

PubMed2006

Use of beryllium lymphocyte proliferation testing for screening of asymptomatic individuals: an evidence-based assessment.

OBJECTIVE: We reviewed published data describing use of beryllium lymphocyte proliferation testing (BeLPT) to determine the appropriateness of BeLPT for screening asymptomatic individuals. METHODS: Published studies were identified by computerized literature searches and hand searches of relevant bibliographies and cited references. Critical assessment of evidence focused on five elements essential to judging effectiveness of preventive services: 1) burden of suffering, 2) accuracy and reliability of screening tests, 3) effectiveness of early detection, 4) harms of screening, and 5) benefits outweighing harms. RESULTS: Important gaps and deficiencies in the evidence were found. The prevalence of beryllium sensitization and chronic beryllium disease in asymptomatic individuals are unknown. The accuracy and reliability of BeLPT are uncertain. Marked intra- and interlaboratory variability has been reported. The clinical benefits of early intervention have not been confirmed or quantified in asymptomatic individuals. CONCLUSIONS: There is currently insufficient scientific evidence to support the use of BeLPT for routine screening of asymptomatic individuals.

Berylliosis↗

PubMed2000

Risk estimation and value-of-information analysis for three proposed genetic screening programs for chronic beryllium disease prevention.

Genetic differences (polymorphisms) among members of a population are thought to influence susceptibility to various environmental exposures. In practice, however, this information is rarely incorporated into quantitative risk assessment and risk management. We describe an analytic framework for predicting the risk reduction and value-of-information (VOI) resulting from specific risk management applications of genetic biomarkers, and we apply the framework to the example of occupational chronic beryllium disease (CBD), an immune-mediated pulmonary granulomatous disease. One described Human Leukocyte Antigen gene variant, HLA-DP beta 1*0201, contains a substitution of glutamate for lysine at position 69 that appears to have high sensitivity (approximately 94%) but low specificity (approximately 70%) with respect to CBD among individuals occupationally exposed to respirable beryllium. The expected postintervention CBD prevalence rates for using the genetic variant (1) as a required job placement screen, (2) as a medical screen for semiannual in place of annual lymphocyte proliferation testing, or (3) as a voluntary job placement screen are 0.08%, 0.8%, and 0.6%, respectively, in a hypothetical cohort with 1% baseline CBD prevalence. VOI analysis is used to examine the reduction in total social cost, calculated as the net value of disease reduction and financial expenditures, expected for proposed CBD intervention programs based on the genetic susceptibility test. For the example cohort, the expected net VOI per beryllium worker for genetically based testing and intervention is $13,000, $1,800, and $5,100, respectively, based on a health valuation of $1.45 million per CBD case avoided. VOI results for alternative CBD evaluations are also presented. Despite large parameter uncertainty, probabilistic analysis predicts generally positive utility for each of the three evaluated programs when avoidance of a CBD case is valued at $1 million or higher. Although the utility of a proposed risk management program may be evaluated solely in terms of risk reduction and financial costs, decisions about genetic testing and program implementation must also consider serious social, legal, and ethical factors.

Berylliosis↗

PubMed1976

The first seven cases of chronic beryllium disease in ceramic factory workers in Japan.

In the present paper the first 7 cases in Japan of chronic beryllium disease found in workers employed in a ceramic factory utilizing beryllium have been described. Immunological examinations of these cases showed changes similar to those observed in sarcoidosis, that is, negative tuberculin test and increase in serum gamma globulin and immunoglobulins. The fact that a considerable number of workers in the same factories as the patients showed negative tuberculin reaction may suggest that there may be further cases of chronic beryllium disease among them that are still in a latent period.

Adult↗

PubMed1982

Comparison of lymphocyte transformation and macrophage migration inhibition tests in the detection of beryllium hypersensitivity.

In seven patients with chronic beryllium disease (Be) the Be lymphocyte transformation test was positive in 100%, independent of steroid therapy, and was reproducible. The Be macrophage migration inhibition test was only positive in four of seven patients (57%) not on steroids, and was not reproducible. In 72 potentially exposed healthy beryllium workers the lymphocyte transformation test was negative in all subjects. The macrophage test was positive in four of 78 and again the results were not reproducible. The workers with positive results showed no differences in age, type or duration of employment from those with negative results and showed no evidence of disease. In addition, the macrophage test was positive in two of 45 non-exposed control subjects. We also confirmed the above advantages of the lymphocyte transformation technique by using tuberculin antigen (PPD). The PPD lymphocyte transformation test gave positive results in approximately 60% of healthy beryllium workers, but the PPD macrophage test was only positive in 7%. We conclude that the Be lymphocyte transformation test is the most sensitive and reproducible and advocate its use in the diagnosis of disease and in monitoring the health of potentially exposed workers.

Adult↗

PubMed1986

New aid for diagnosing chronic beryllium disease (CBD): laser ion mass analysis (LIMA).

The value of laser ion mass analysis (LIMA) for the detection of beryllium disease in routine histological sections was investigated. Our results were based on the examination of 14 cases of confirmed and five cases of suspected chronic beryllium disease. With the exception of two cases of coal workers' lungs, all the control material, normal, tuberculous, and sarcoid lungs examined were free of beryllium. The technique may also be useful in other diseases of possible occupational origin.

Berylliosis↗

PubMed2004

Simultaneous kinetic determination of beryllium and aluminium by spectrophotometric H-point standard addition method.

The H-point standard addition method (HPSAM), based on spectrophotometric measurements for simultaneous determination of beryllium and aluminium, is described. This method is based on the difference between their rates of reactions with Chrome Azurol S (CAS) in cetyltrimethylammonium bromide (CTAB) micellar media. The results showed that beryllium and aluminium could be determined simultaneously in the ranges of 10-200 and 10-300 ng mL(-1), respectively. Under working conditions, the proposed method was successfully applied to the simultaneous determination of beryllium and aluminium in environmental, geochemical and alloy samples.

Journal Article↗

PubMed2006

Significant improvement from chronic beryllium disease following corticosteroid pulse therapy.

Chronic beryllium disease (CBD) is a rare disease characterized by diffuse interstitial pulmonary granulomatosis. We report a case of CBD which exhibited marked improvement both subjectively and objectively following pulse therapy. The patient was a 36-year-old man whose chief complaint was dyspnea and a dry cough. Since July 1990, the patient had been working in the development of an automatic or mechanical technique for producing beryllium-copper alloy. It appeared likely that the patient may have been exposed to metal beryllium fumes generated from an opening located just above the furnace. The Be concentration exceeded 25 microg/m3 transiently in the breathing zone in this workplace. A chest X-ray film taken in October 1994 showed fine granular shadows throughout the entire lung fields. Around August 1998, the patient's dyspnea became aggravated. An X-ray taken at that time showed linear and reticular shadows, in addition to the diffuse fine granular shadow. In October 1998, after 3 days of methylprednisolone pulse therapy, oral prednisolone 30 mg was initiated. With this treatment, the patient's pulmonary function tests and blood gases improved. Once the patient's condition had improved sufficiently, the dosage of prednisolone was decreased by 2.5 mg every two weeks. The patient continues to be monitored.

Adult↗

PubMed1999

Differential susceptibilities to chronic beryllium disease contributed by different Glu69 HLA-DPB1 and -DPA1 alleles.

Chronic beryllium disease (CBD) is associated with the allelic substitution of a Glu69 in the HLA-DPB1 gene. Although up to 97% of CBD patients may have the Glu69 marker, about 30-45% of beryllium-exposed, unaffected individuals carry the same marker. Because CBD occurs in only 1-6% of exposed workers, the presence of Glu69 does not appear to be the sole genetic factor underlying the disease development. Using two rounds of direct automated DNA sequencing to precisely assign HLA-DPB1 haplotypes, we have discovered highly significant Glu69-containing allele frequency differences between the CBD patients and a beryllium-exposed, nondiseased control group. Individuals with DPB1 Glu69 in both alleles were almost exclusively found in the CBD group (6/20) vs the control group (1/75). Whereas most Glu69 carriers from the control group had a DPB1 allele *0201 (68%), most Glu69 carriers from the CBD group had a non-*0201 DPB1 Glu69-carrying allele (84%). The DPB1 allele *0201 was almost exclusively (29/30) associated with DPA1 *01 alleles, while the non-*0201 Glu69-containing DPB1 alleles were closely associated with DPA1 *02 alleles (26/29). Relatively rare Glu69-containing alleles *1701, *0901, and *1001 had extremely high frequencies in the CBD group (50%), as compared with the control group (6.7%). Therefore, the most common Glu69-containing DPB1 allele, *0201, does not seem to be a major disease allele. The results suggest that it is not the mere presence of Glu69, per se, but specific Glu69-containing alleles and their copy number (homozygous or heterozygous) that confer the greatest susceptibility to CBD in exposed individuals.

Alleles↗

PubMed1999

Chronic beryllium disease prevention program. Office of Environment, Safety and Health, Department of Energy. Final rule.

The Department of Energy (DOE) is today publishing a final rule to establish a chronic beryllium disease prevention program (CBDPP) to reduce the number of workers currently exposed to beryllium in the course of their work at DOE facilities managed by DOE or its contractors, minimize the levels of, and potential for, exposure to beryllium, and establish medical surveillance requirements to ensure early detection of the disease. This program improves and codifies provisions of a temporary CBDPP established by DOE directive in 1997.

Berylliosis↗

PubMed1975

The compensation experience of patients with chronic beryllium disease.

The experience of patients with chronic beryllium disease seeking workmen's compensation indicates that the system does not meet its intentions of providing for relief of workers for job-related illness. In the instance of beryllium disease there is undue delay in adjudication of the compensation. This delay has its origin in part from litigation over the diagnosis and disability on the part of private insurers and in part on failure of the IAB to press for findings. Moreover, the process of litigation and delay may produce significant psychological distress. For others the compensation for a chronic disability is inadequate. Whether compensation acts as a system of relief depends on whether the patient has a working husband or wife. Among the women here with beryllium disease, the system worked only to the extent that they could rely on their husbands. Compensation benefits should be provided in accord with rises in the cost of living index. Compensation boards should press for prompt settlement of claims.

Adolescent↗

PubMed2003

Is chronic beryllium disease sarcoidosis of known etiology?

Sarcoidosis is a granulomatosis that predominantly affects the lungs and is of unknown etiology. Chronic beryllium disease is a granulomatosis that predominantly affects the lungs and is due to a hypersensitivity response to beryllium. Similarities and differences between these two disorders are reviewed and lessons for both sarcoidosis and chronic beryllium disease are discussed.

Berylliosis↗

PubMed1987

Fluoride complexes of aluminium or beryllium act on G-proteins as reversibly bound analogues of the gamma phosphate of GTP.

Fluoride activation of G proteins requires the presence of aluminium or beryllium and it has been suggested that AIF4- acts as an analogue of the gamma-phosphate of GTP in the nucleotide site. We have investigated the action of AIF4- or of BeF3- on transducin (T), the G protein of the retinal rods, either indirectly through the activation of cGMP phosphodiesterase, or more directly through their effects on the conformation of transducin itself. In the presence of AIF4- or BeF3-, purified T alpha subunit of transducin activates purified cyclic GMP phosphodiesterase (PDE) in the absence of photoactivated rhodopsin. Activation is totally reversed by elution of fluoride or partially reversed by addition of excess T beta gamma. Activation requires that GDP or a suitable analogue be bound to T alpha: T alpha-GDP and T alpha-GDP alpha S are activable by fluorides, but not T alpha-GDP beta S, nor T alpha that has released its nucleotide upon binding to photoexcited rhodopsin. Analysis of previous works on other G proteins and with other nucleotide analogues confirm that in all cases fluoride activation requires that a GDP unsubstituted at its beta phosphate be bound in T alpha. By contrast with alumino-fluoride complexes, which can adopt various coordination geometries, all beryllium fluoride complexes are tetracoordinated, with a Be-F bond length of 1.55 A, and strictly isomorphous to a phosphate group. Our study confirms that fluoride activation of transducin results from a reversible binding of the metal-fluoride complex in the nucleotide site of T alpha, next to the beta phosphate of GDP, as an analogue of the gamma phosphate.(ABSTRACT TRUNCATED AT 250 WORDS)

3',5'-Cyclic-GMP Phosphodiesterases↗

PubMed1985

Beryllium localization in base metal dental casting alloys.

Investigation of dissolution of base metal dental casting alloy constituents in aqueous solutions revealed an unexpectedly high level of beryllium as compared with the other constituents. Analysis of atomic emission spectroscopy is presented here showing the outer surface (0-100 A) is decidedly enriched in beryllium as compared with the bulk composition of the alloy. This localization is consistent in all samples and forms of the alloy tested.

Beryllium↗

PubMed1989

Evaluation of a chemical etching solution for nickel-chromium-beryllium and chromium-cobalt alloys.

Two chemical etching solutions were capable of providing micromechanical retention in two nickel-chromium-beryllium alloys and in a chromium-cobalt alloy. A resin matrix was used to verify the quality of etching on the metal surfaces. The chemical etching solutions created high microretentive surfaces in nickel-chromium-beryllium alloy but the chromium-cobalt alloy surfaces after etching were less retentive. Improved chemical etching technique should encourage expanded use of the resin-bonded retainers.

Acid Etching, Dental↗

PubMed1992

Leaching of nickel, chromium, and beryllium ions from base metal alloy in an artificial oral environment.

The use of base metal alloys in dentistry has gained wide popularity in recent years. However, claims of their safety have not been universally accepted. An artificial oral environment capable of reproducing three-dimensional force-movement cycles of human mastication was used to determine whether nickel, chromium, and beryllium ions were leached from base metal alloy. Twelve pairs of crowns were articulated in the following combinations: metal versus metal, metal versus enamel, metal versus porcelain, and metal versus metal without chewing as a control. In a simulated 1-year period of mastication, the results showed that nickel and beryllium metals were released both by dissolution and occlusal wear. These findings suggest that if these conditions occur in the oral cavity, the stability of base-metal alloys is subject to question. Further studies are needed to determine whether the leaching reported has long-term consequences for patients receiving base metal restorations.

Analysis of Variance↗

PubMed1979

Transfer of contact sensitivity to beryllium using dialyzable leukocyte extracts (transfer factor).

Transfer factor derived from lymphocytes of donors with strong cellular immunity against beryllium was intradermally or subcutaneously injected into unprimed or subclinically primed human recipients who were patch test-negative. These recipients were challenged with beryllium at weekly intervals thereafter. Subjects who had been subclinically primed and received transfer factor either intradermally or subcutaneously showed transient patch test reactivity to the challenge. Subjects who received transfer factor but were not primed and subjects who had been primed but did not receive transfer factor showed no such conversion. This is the first demonstration of transfer of contact sensitivity in man using transfer factor, and it suggests that subclinical priming is necessary for such transfers.

Beryllium↗

PubMed1991

Genotoxicity of beryllium, gallium and antimony in short-term assays.

The genotoxicity of beryllium, gallium and antimony compounds was studied with the rec, Salmonella mutagenicity and SCE assays. In the rec assay, all the salts of the metals, BeCl2, Be(NO3)2, GaCl3, Ga(NO3)3, SbCl3, SbCl5, and an oxide, Sb2O3, had DNA-damaging activity. None of the compounds was mutagenic to Salmonella. In the SCE assays using V79 cells, 2 antimony(III) compounds, SbCl3 and Sb2O3, and 2 beryllium compounds, BeCl2 and Be(NO3)2, induced SCEs significantly. Sb2O3, slightly soluble in water, was positive in both the rec assay and the SCE assay at very low doses.

Animals↗