Published ahead of print on January 31, 2008, doi:10.1164/rccm.200607-1042OC Am. J. Respir. Crit. Care Med., Volume 177, Number 9, May 2008, 1012-1017 A more recent version of this article appeared on May 1, 2008
Submitted on July 27, 2006 Recent Chronic Beryllium Disease in Residents Surrounding a Beryllium FacilityLisa A Maier1*,1 Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Medical and Research Center, Denver, Colorado, USA; Division of Pulmonary Science and Critical Care Medicine, Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado, USA; Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado, USA, 2 Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Medical and Research Center, Denver, Colorado, USA, 3 Pulmonary, Allergy and Critical Care Division, Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA * To whom correspondence should be addressed. E-mail: MaierL{at}NJC.ORG.
Rationale: Between 1948 and 1969, cases of community-acquired chronic beryllium disease (CBD) were reported in neighborhoods surrounding beryllium facilities. Further surveillance was not performed in these communities, and additional cases have not been reported. Methods and Measurements: Medical records were reviewed from individuals in a community surrounding a beryllium manufacturing facility in Reading, PA. 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 para-occupational exposure were excluded. 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 1943-1953 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 is 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, community, berylliosis
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