Published ahead of print on January 31, 2008, doi:10.1164/rccm.200607-1042OC
© 2008 American Thoracic Society doi: 10.1164/rccm.200607-1042OC
Recent Chronic Beryllium Disease in Residents Surrounding a Beryllium Facility1 Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Medical and Research Center, Denver, Colorado; 2 Division of Pulmonary Science and Critical Care Medicine, Department of Medicine, and 3 Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado; and 4 Pulmonary, Allergy and Critical Care Division, Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania Correspondence and requests for reprints should be addressed to Lisa A. Maier, M.D., M.S.P.H., Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Medical and Research Center, 1400 Jackson Street, Denver, CO 80206. E-mail: maierl{at}njc.org Rationale: Between 1948 and 1969, cases of community-acquired chronic beryllium disease (CA-CBD) were reported in neighborhoods surrounding beryllium facilities. Further surveillance was not performed in these communities, and additional cases have not been reported. Objectives: To increase awareness of recently diagnosed cases of CA-CBD in residents surrounding a beryllium facility. Methods: Medical records were reviewed from individuals in a community surrounding a beryllium manufacturing facility in Reading, Pennsylvania. Definite cases of CBD required (1) an abnormal beryllium lymphocyte proliferation test in blood or bronchoalveolar lavage and (2) biopsy evidence of granulomatous inflammation. Probable cases of CBD either displayed an abnormal blood test to beryllium and radiographic evidence consistent with disease, or met epidemiologic criteria for CBD based on the Beryllium Case Registry criteria. Cases with occupational or potential paraoccupational exposure were excluded. Measurements and Main Results: Sixteen cases of potential community-acquired CBD were evaluated. From these, eight cases of community-acquired CBD were identified (five definite and three probable). The cases' initial year of residence began between 1943 and 1953 and continued until 1956–2001. Six of the eight cases required medical treatment and three of the cases died since diagnosis. Conclusions: Cases of CBD meeting current immunologic diagnostic criteria and attributable to industry-associated environmental exposure were detected among residents of a community surrounding a beryllium manufacturing facility. Most were diagnosed years after exposure cessation. The frequency and extent of beryllium disease in this community are unknown. We anticipate that not only have cases been misdiagnosed in this community but that more cases of CBD will be diagnosed in the future.
Key Words: chronic beryllium disease • berylliosis • beryllium • community
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