Definition

Berylliosis is a lung disease that affects people exposed to beryllium. Beryllium is a metallic element that is found in rocks, coal, soil, and volcanic dust and used in certain industries.

The 2 types of berylliosis are:

• Acute—Caused by brief exposure. It is rare today.
• Chronic—Caused by long-term exposure. It is more common than acute, but still unusual.

Causes

Berylliosis is caused by inhalation of beryllium dust or fumes or other exposure such as through an open skin wound.

Berylliosis usually only occurs in people who have an allergic sensitivity to beryllium.

Risk Factors

The primary risk factor for berylliosis is working in an area where beryllium is processed. Industries that use beryllium include:

• Aerospace
• Electronics
• Fiber-optics
• Mining
• Nuclear weapons and reactors
• Laboratory technologies
• Dental alloy preparation
• Scrap metal
• Manufacturing of:
  • Mirrors
  • Golf clubs
  • Microwaves
  • Bicycle frames

People who live near such industries have a slightly higher risk of getting berylliosis than those who do not, but the risk is extremely low.

Symptoms

Symptoms of acute berylliosis come on suddenly and rapidly. The main symptoms are due to severe lung inflammation. These symptoms include:

• Coughing, possibly bringing up blood-tinged sputum
• Chest pain
• Shortness of breath
• Weight loss

Symptoms of chronic berylliosis may include:

• Dry cough
• Weight loss
• Fatigue
• Chest pain
• Shortness of breath

Symptoms of chronic berylliosis develop slowly. Sometimes, symptoms may not appear until many years after exposure to beryllium. Chronic berylliosis produces 2 main changes:

• Scarring of the lung tissue
• Formation of granulomas (inflammatory masses) in the lungs and sometimes other organs

In severe cases, berylliosis may lead to heart failure.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Three factors need to be present to diagnose berylliosis:

• Exposure to beryllium
• Positive blood test called BeLPT (beryllium lymphocyte proliferation test) that shows allergic sensitivity to beryllium
• Granulomas in the lungs found during a lung biopsy—a sample of lung tissue is removed and examined under a microscope

Symptoms of chronic berylliosis may not appear until years after exposure. Therefore, all workers who may have been exposed to beryllium should have BeLPT tests, even if they have no symptoms.

Other tests that may be done to look for the effects on the lungs:

• Chest x-ray
• Pulmonary function tests (PFTs)—to assess breathing and lung function

Treatment

The most important step in the management of berylliosis is to avoid further exposure to beryllium.

For acute berylliosis, you may be given corticosteroid medication. This drug helps to reduce lung inflammation. When treated rapidly, most recover fully. But in extreme cases, if not treated rapidly, acute berylliosis can be fatal.

For chronic berylliosis, corticosteroids may be used if you develop symptoms of lung disease. However, these medications do not reverse scarring that has already occurred in the lungs.

Prevention

Avoiding or limiting exposure to beryllium is the best way to prevent berylliosis. The following steps will help decrease exposure:

• Ensure good ventilation in work areas where there is beryllium dust or fumes.
• Wear a respirator when doing work that could result in high beryllium exposure.
• Avoid eating, drinking, or smoking in areas where beryllium is used.
• Do not wear street clothing when working with beryllium.
• After working with beryllium, shower and wash your hair before changing back into street clothing.

If you are exposed to beryllium, consult with your doctor about the best way to proceed. You may need to have a BeLPT blood test as well as PFTs to detect any change in lung function.

Occupational Safety & Health Administration https://www.osha.gov

TheLung Association http://www.lung.ca

Beryllium. Canadian Centre for Occupational Health and Safety website. Available at:
http://www.ccohs.ca/oshanswers/diseases/beryllium.html
Updated January 16, 2014. Accessed September 3, 2014.

Beryllium. US Department of Labor (OSHA) website. Available at:
http://www.osha.gov/SLTC/beryllium/index.html
Accessed September 3, 2013.

Chronic beryllium disease. National Jewish Health website. Available at:
http://www.nationaljewish.org/healthinfo/conditions/beryllium-disease
Updated May 2011. Accessed September 3, 2014.

Chronic beryllium disease. UCSF Medical Center website. Available at:
http://www.ucsfhealth.org/conditions/chronic_beryllium_disease/index.html
Accessed September 3, 2014.