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Nearly 20 years ago, I entered the hospital room of a retired nuclear physicist who had worked on the Manhattan Project with Enrico Fermi. He had been suffering for several years from shortness of breath and a nagging cough, and he was tethered to an oxygen tank. He had never expected that working around "a little beryllium" would someday destroy his lungs. I thought he must be one of the last remaining patients with this disease. I didn't expect to spend the next 20 years treating hundreds of workers for beryllium disease. Nor did I expect to encounter so many obstacles to the elimination of a preventable illness. But ignorance and misinformation about the health hazards of beryllium die hard.

Microgram for microgram, beryllium is one of the most toxic elements on the periodic table. When engineers select beryllium alloys for new applications, they consider its desirable properties of light weight, durability, conductivity, or neutron moderation. Unfortunately, they are often condemning workers "downstream" to a lifelong risk for an incurable illness that affects up to 20% of people exposed.

In 1985, a younger metal machinist came to my clinic. He had an identical illness to the physicist. The difference: John was actively milling, sawing, sanding, and polishing beryllium parts for nuclear weapons at Rocky Flats, in Golden, Colo. He later became known as "the index case" for an epidemic of beryllium disease in U.S. industry. Ten percent of his fellow beryllium machinists developed chronic beryllium disease. Since then, studies have detected sick workers in dozens of companies worldwide, not only among those who work directly with beryllium, but even among bystanders with "secondhand" contact.

EXPOSED Workers pouring molten beryllium-copper alloy into a mold. The process and the level of protection against beryllium have remained largely unchanged during the past 50 years.
Seventy years after the discovery that beryllium dust causes disease, the depth of this epidemic is unplumbed, probably involving more than a million exposed workers. Because of the growing number of new applications of beryllium-containing materials in industry, disease is now being detected among workers in the manufacture of beryllium, electronics, jewelry, dental prostheses, and aircraft, as well as in metal machine shops, aircraft repair industries, aerospace and defense industries, and the recycling of beryllium-alloy-containing products. Cases are being reported in Europe, Asia, Israel, and Canada.

The disease can be caused by virtually any form of beryllium dust or fumes, ranging from beryllium alloys (for example, aluminum-, copper-, nickel-, and magnesium-beryllium) and beryllia ceramics to pure metal. Once inhaled, beryllium is like a time bomb in the body. In some people, disease develops within a few months, or it can take 40 years. Workers who breathed beryllium dust even for a few days carry a lifelong risk of developing sensitization to the metal and disease. In our clinics at National Jewish, we now care for hundreds of patients who have developed this serious, chronic allergic reaction to beryllium.

Fortunately, not everyone's immune system will overreact to beryllium. But when it does, the immune cells that are combating beryllium particles produce collateral damage to the lungs, lymph nodes, skin, and other organs where the cells detect beryllium. The illness is worse for some patients than for others. Those with the more severe form of the illness develop steadily worsening symptoms, become dependent on immune-suppressant medicines and an oxygen bottle, and eventually may die of respiratory failure after a decade or more of suffering.

My generation of health researchers has learned a lot. We have well-validated blood and lung tests for diagnosing chronic beryllium disease with great accuracy. The beryllium lymphocyte proliferation test is now used extensively as a medical surveillance tool. With it, we have learned how to detect beryllium allergy and disease early and have developed better methods for monitoring the progression of the disease.

With the help of cooperative companies, labor unions, management, and workers, we know that when any form of beryllium is milled, lathed, deburred, sanded, polished, or otherwise machined, it liberates micron- and submicron-sized particles that deposit deeply and invisibly in the lungs. We have learned that strict control of beryllium use in the workplace can reduce health risk, but that the best choice is to select safer substitute materials. There is agreement in the medical research community that current Occupational Safety & Health Administration permissible exposure limits fail to protect workers from beryllium.

What have I learned? We should stop using beryllium whenever possible. We need broader medical surveillance and better exposure control for people working in industries that continue to ignore beryllium's risks. And we have the knowledge needed to prevent beryllium-related disease from occurring in the future. Will we?

Lee S. Newman is professor of medicine and head of the Division of Environmental & Occupational Health Sciences, National Jewish Medical & Research Center, and professor of medicine and preventive medicine/biometrics,University of Colorado School of Medicine, Denver.


Chemical & Engineering News
Copyright © 2003 American Chemical Society

Name: Named for the mineral beryl.
Atomic mass: 9.01.
History: Discovered in 1798 by French chemist Nicholas L. Vauquelin, but first isolated independently in 1828.
Occurrence: Relatively scarce. Found in some 30 mineral species.
Appearance: Whitish gray, solid metal.
Behavior: Inhalation of finely powdered Be compounds can lead to berylliosis, a painful and sometimes fatal disease.
Uses: Alloyed with copper, aluminum, or nickel, beryllium imparts excellent electrical and thermal conductivities. It is applied as a structural material for high-speed aircraft and spacecraft.

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