Global Recognition of Chronic Beryllium Diasease: a challenge for medical surveillance and disease prevention

In the more than 70 years since the first description of diseases caused by exposure to beryllium, beryllium sensitization (BeS) and chronic beryllium disease (CBD) continue to occur throughout the world. CBD is a chronic, debilitating disease that principally affects the lungs, as well as other organs. Occupational exposures and disease have been described in a wide range of industries, including electronics, telecommunications, metal machining, alloy manufacture and machining, dental laboratories, electronics, defense industries, aluminum smelting, and copper recycling, among others. Contemporary cases have been reported from the USA, Britain, Canada, France, Germany, Sweden, Israel, Japan, Kazakhstan, Russia, among others. Current US OSHA permissible exposure limits fail to protect workers, 2-15% of whom will develop CBD. The disease can be identified in both current and former beryllium workers with a well-established blood assay, the beryllium lymphocyte proliferation test (BeLPT). Medical surveillance with the BeLPT offers the opportunity for workers who are allergic (sensitized) to reduce further exposure and help industry, labor, and government agencies to improve work practices. This presentation will examine case studies that highlight the challenges and potential solutions for medical surveillance. Examples will include the experience in detecting CBD among copper recyclers in Quebec, Canada; discovery of CBD among dental technicians in Israel; and the US experience in the nuclear weapons industry. Important steps must be taken to identify the true global scope of the problem and adopt primary and secondary prevention strategies. We have in hand the tools and knowledge necessary to prevent the global spread of CBD.