Beryllium Disease
Beryllium disease (sometimes called berylliosis) is a lung inflammation caused by inhaling dust or fumes that contain beryllium.
In the past, beryllium was commonly mined and extracted for use in the electronics and chemical industries and in the manufacture of fluorescent light bulbs. Today, it is used mainly in the aerospace industry and in beryllium-aluminum castings. Besides workers in these industries, a few people living near beryllium refineries also have developed beryllium disease.
Beryllium disease differs from other occupational lung diseases in that at low levels of exposure, lung problems seem to occur only in people who are sensitive to beryllium--about 2% of those who come in contact with it. The disease can occur in such people even with a relatively brief exposure to beryllium.
Symptoms and Diagnosis
In some people, beryllium disease develops suddenly (acute beryllium disease), mainly as an inflammation of the lungs (pneumonitis). In these people, the lungs are stiff and function poorly. People with acute disease have an abrupt onset of coughing, difficulty in breathing, and weight loss. Acute beryllium disease also can affect the skin and eyes.
Other people develop chronic beryllium disease, in which abnormal tissue forms in the lungs and the lymph nodes enlarge. In these people, coughing, difficulty in breathing, and weight loss develop gradually, often 10 to 20 years after exposure.
The diagnosis is based on the person's history of exposure to beryllium, the symptoms, and characteristic changes on a chest x-ray. However, x-rays of people with beryllium disease resemble those of another lung disease, sarcoidosis (see Section 4, Chapter 50), and additional immunologic tests (such as the beryllium lymphocyte transformation test) may be needed.
Prognosis, Prevention, and Treatment
Acute beryllium disease may be severe. Most people recover in 7 to 10 days, with appropriate treatment, such as ventilator support and corticosteroid drugs. However, some people with severe disease die.
The course of people who develop symptoms late is completely different. People with chronic beryllium disease continue to have symptoms, which tend to progress. If the lungs are severely damaged, the heart may become strained, causing a type of heart failure (cor pulmonale (see Section 4, Chapter 54)) and death. Sometimes corticosteroids, such as oral prednisone, are prescribed for chronic beryllium disease, although they generally are not very helpful. Beryllium disease can be prevented by strictly limiting exposure to beryllium.
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