We are providing this fact sheet about beryllium disease to physicians because beryllium disease is rare and may be hard to diagnose. We also include a summary of the study results that may relate to your patient's health.

Purpose of the Studies

Previous studies that showed a link between beryllium and lung cancer had been criticizedfor methodologic difficulties. Thus, our studies were designed to re-examine the relationship between beryllium exposure and lung cancer.

Findings of the Two Studies

The workplace study found a modest excess of lung cancer in workers exposed to beryllium after taking smoking habits into consideration. It also found an expected increase in beryllium disease.

The registry study showed that those who had had acute beryllium disease, a form of the disease associated with very high exposures to beryllium, had the highest increase in lung cancer. We believe that the most likely cause of the increase in lung cancer was exposure to beryllium.

Other diseases found in excess in the workplace study were emphysema, heart diseases, including ischemic heart disease and cor pulmonale (a known sequela of beryllium disease), chronic kidney diseases, and oral cancer. The increase in emphysema may have resulted from the misdiagnosis of beryllium disease. We do not know the cause of the increases in heart diseases (other than cor pulmonale), kidney diseases, or oral cancer. The increase in oral cancer was seen only atone plant, where some of the subjects worked. Cor pulmonale and emphysema were also elevated only in one plant.

Beryllium Disease

Beryllium disease occurs in two forms: acute and chronic. The acute form has a short latency period, usually occurs during exposure, is brief in duration, and presents clinically as a type of chemical pneumonitis.

Since the adoption of the Atomic Energy Commission beryllium standard (which later became the Occupational Safety and Health Administration standard) that has reduced exposure, acute beryllium disease is very rare and should not occur unless there is an industrial accident.

However, some patients who have had the acute form later develop the chronic form. This fact sheet focuses on chronic beryllium disease (CBD) which may occur many years after exposure to beryllium has stopped, whether or not the patient has had prior acute beryllium disease.

Chronic beryllium disease occurs from inhalation of beryllium. It is characterized mainly by pulmonary noncaseating granulomas.

Even individuals with short exposures to beryllium (less than 1 year) may eventually develop CBD. Most studies report an average time between first exposure and onset of symptoms of 10 to 15 years, although some cases do not develop disease for several decades following first exposure.

Diagnostic Criteria for Chronic Beryllium Disease

In 1952, the Beryllium Case Registry, currently inactive, was established as a means of following the effects of beryllium and beryllium disease. This registry consists of persons suspected of having several different forms of beryllium disease, including both acute and chronic beryllium disease.