Why the Workplace Study Was Done

The main purpose of the workplace study was to see if exposure to beryllium is associated with lung cancer.

Since inhaling some beryllium compounds caused lung cancer in rats, and may cause it in monkeys, there was concern that it might cause lung cancer in people.

Beryllium is already known to cause chronic beryllium disease, a lung disease. We describe its symptoms in "Steps to Protect Your Health."

How the Workplace Study Was Done

Study Group

We included 7 plants to make sure we had enough workers in the study.

The study group included all men who had worked for at least 2 days at any of the plants between 1940 and 1970.

Records

This study was done without contacting the individual worker because it was based on records. It included living and deceased workers.

Government records were used to find out which workers had died before 1989. Death certificates reported the cause of death. NIOSH used public records to find out the death rate for certain diseases in the general public.

Comparing Results

We compared how often deaths from specific diseases occurred in beryllium workers to how often they occurred in the general public.

When deaths from specific diseases are more common in beryllium workers than among the general public, beryllium exposure may be the reason.

What the Workplace Study Found

Lung Cancer

Among all workers in the study, there were 280 deaths from lung cancer, where 221 were expected. This means that all workers in the study had about 1¼ times more lung cancer deaths than expected.

Workers hired in the 1940s, when exposures were thehighest, had a significant increase in lung cancer. We found 177 deaths, but expected only 125. This was almost 1½ times the normal level.

There were slightly more lung cancer deaths than expected in workers hired in the 1950s, with 85 found and 68 expected. This was about 1¼ times the normal level.

There were noticeably fewer lung cancer deaths than expected in workers hired in the 1960s. We found 18 deaths, but expected 28 or 29.

Other factors which may elevate lung cancer deaths in groups of workers are cigarette smoking and living in an area with a high risk of lung cancer.

NIOSH investigators analyzed smoking data from a beryllium workers' survey in 1968. This survey found that, at least at that time, beryllium workers were heavier smokers than the general population. This increased smoking was predicted to result in 1 1/8 times more deaths from lung cancer than expected.

Adjustment for county lung cancer rates did not affect the expected number of lung cancer deaths. NIOSH investigators concluded that neither smoking nor geographic location fully explained the lung cancer risk. 

Beryllium Disease Registry Results

The increase in lung cancer in beryllium-exposed workers was also seen in another NIOSH study of people who were reported to a national beryllium disease registry.

In that other study, we found 28 lung cancer deaths, but expected 14. Those who developed acute beryllium disease, a form of the disease caused by very high exposures to soluble forms of beryllium, had the highest risk. We saw 17 deaths, but expected only 7 or 8.

Additional Findings of the Workplace Study

Lung Diseases, Including Chronic Beryllium Disease

At all plants combined, we saw an increase in the group of lung diseases that includes chronic beryllium disease. We found 101 deaths, but expected only 68.

Heart Disease

We also saw an increase in heart disease at all plants combined. We saw 1,314 deaths, but expected 1,240. Most of this increase was in heart attacks. This was an unusual finding, but we do not know if it was related to beryllium exposure.

Kidney Disease

Deaths from kidney diseases were 1½ times more common in workers who worked at beryllium processing plants than in the general public. We found 30 deaths, but expected 20.

This is a rare cause of death, and very few workers are likely to die from it.

Since beryllium passes through the kidneys, it is possible that it can damage them. However, this is a new finding. We do not know if this increase is related to beryllium exposure.

Mouth Cancer

We found an increase in mouth and salivary gland cancers at one plant that was not found at other plants. At the one plants we found 9 deaths, but expected only 2 or 3.

This is the first time that an increase in these cancers has been seen in beryllium workers. We do not know what caused this increase.

Mouth and salivary gland cancers are very rare. Only a very few workers developed these cancers.

What the Study Means

This study showed an increase in lung cancer in workers exposed to beryllium.

We believe that the most likely cause of the increase in lung cancer was exposure to beryllium.

Other scientists believe that smoking or exposure to acid mists, uranium, or nickel caused part or all of the increase in lung cancer.

Our study also confirmed that exposure to beryllium can cause lung diseases, especially chronic beryllium disease.

Even employees who worked with beryllium for less than a year may be at risk of developing chronic beryllium disease and lung cancer.

The lung cancer seen in this study generally occurred many years after first exposure to beryllium. Therefore, it is possible that workers will continue to have an increased risk of lung cancer.

Any Questions?

If you, your doctor, or a family member would like more information, call our toll free number: 1-800-356-4674.



Steps to Protect Your Health

Symptoms of Chronic Beryllium Disease and Lung Cancer

If you have been exposed to beryllium, you may be at increased risk of lung cancer or chronic beryllium disease. Although only a few people will develop these diseases, you may want to know the symptoms.

The main symptoms of chronic beryllium disease are shortness of breath while exercising or walking, cough, fatigue, weight loss, or chest pain.

These symptoms, as well as coughing up blood, may also be symptoms of lung cancer.

Even if you have these symptoms, it may not mean you have a serious illness.

If you have these problems and they do not go away, see your doctor.

If you do not have symptoms, you do not need to make a special trip to the doctor.

Chronic Beryllium Disease

Chronic beryllium disease is a rare disease that only occurs in a small percentage of people who have been exposed to beryllium.

The amount of exposure to beryllium (the dose) plays a role in the development and severity of the disease. However, sensitization (an allergy-type reaction) to beryllium is a major factor. Hence, a small number of people will develop chronic beryllium disease even with minimal beryllium exposure.

Chronic beryllium disease often causes scarring of the lungs. Doctors can sometimes see these scars on chest x-rays. The scars may make it difficult to breathe. A simple breathing test tells your doctor how well your lungs are working.

Although there is no cure for chronic beryllium disease, corticosteroids (not the type used by athletes) can often control the symptoms. However, these drugs have side effects. Thus, they mustbe used under the care of a doctor.

If you have chronic beryllium disease or other chronic lung problems, you should ask your doctor to give you a flu shot every fall. You should also make sure that you have been vaccinated against pneumonia.

Lung Cancer

If lung cancer is present, it may also show up on the chest x-ray.

If your doctor suspects cancer, he or she will do other tests.

Mouth Cancer

Mouth cancers can often be detected early by having your dentist examine your mouth. Ask your dentist to check your mouth for cancer at your regular checkup.

Preventing Lung and Mouth Cancer

Smoking causes lung and mouth cancers and may make the symptoms of chronic beryllium disease worse. You should not smoke. Chewing tobacco causes mouth cancer. You should not chew tobacco. Many organizations have programs that can help you quit.

For information on how to stop smoking, call the American Cancer Society at 1-800-227-2345. They have information on smoking cessation programs in your local area.

They also have free information on the treatment and diagnosis of various cancers. The American Lung Association has programs to help you stop smoking. For information, call them at 1-800-LUNG-USA. They can also direct you to doctors that treat lung diseases.

Exposure to Beryllium

The Occupational Safety and Health Administration'spermissible exposure limit (PEL) for beryllium exposure is 0.002 mg/cubic meter (2µg/m3) averaged over 8 hrs.

However, because NIOSH believes that beryllium is a potential workplace cancer causing agent, it recommends the lowest possible exposure. The NIOSH recommended exposure limit (REL) is 0.0005 mg/cubic meter (.5µg/m3) for beryllium.

Other Sources of Information

The National Jewish Center for Immunology and Respiratory Medicine in Denver, Colorado does research on chronic beryllium disease.

Their toll free number provides information about lung diseases. If you have questions about chronic beryllium disease or lungcancer, call them at 1-800-222-LUNG.

For more information on the diagnosis and treatment of cancer, call The National Cancer Institute at 1-800-4-CANCER.

If you, your doctor, or members of your family have any questions, or would like a copy of the technical reports, call NIOSH at 1-800-356-4674.