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| {{Infobox |
{{Infobox medical condition (new) | ||
| | name = Acute beryllium poisoning | |||
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| | image = Be-TableImage.svg | |||
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| |Field = occupational medicine}} | |||
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| ''' |
'''Acute beryllium poisoning''' is acute ] resulting from the toxic effect of ] in its elemental form or in various chemical compounds, and is distinct from ] (also called chronic beryllium disease). After ] procedures were put into place following the realization that the metal caused berylliosis around 1950, acute beryllium poisoning became extremely rare.<ref name=OSHAhealtheffects/> | ||
| == Signs and symptoms == | |||
| Since its discovery in the 1920s, Beryllium has been used in electronics, ceramics, research and development labs, aircraft, and the atomic energy and defense industry.<ref>{{cite journal|last=Dobis|first=D.R|title=Modulation of lymphocyte proliferation by antioxidants in chronic beryllium disease|journal=Am J Respir Crit Care Med|year=2008|volume=9|pages=1002–1011|doi=10.1164/rccm.200707-1021oc}}</ref><ref>{{cite journal|last=Klein|first=R|title=Diagnostic Revelance of the Lymphocyte Transformation Test for Sensitization to Beryllium and Other Metals|journal=Pure and Applied Chemistry|year=2004|page=12169-1281|doi=10.1351/pac200476061269|volume=76}}</ref><ref>{{cite journal|last=Lang|first=L|title=Beryllium: A Chronic Problem|journal=Environ Health Perspect|year=1994|volume=102|issue=6-7|pages=526–531|doi=10.1289/ehp.94102526|pmid=9679108|pmc=1569745}}</ref><ref>{{cite journal|last=Middleton|first=D|title=The BeLPT: algorithms and implications|journal=Am J Ind Med|year=2006|volume=49|issue=1|pages=36–44|doi=10.1002/ajim.20241}}</ref> In the 1940s the United States first recorded respiratory and dermal reactions among residents of communities surrounding beryllium manufacturing facilities and workers within them.<ref name="Rossman 1996 945–947">{{cite journal|last=Rossman|first=M|title=Chronic beryllium disease: diagnosis and management.|journal=Environ Health Perspect|year=1996|volume=104 Suppl 5|pages=945–947|doi=10.1289/ehp.96104s5945}}</ref><ref>{{cite journal|last=Maier|first=L|title=Recent chronic beryllium disease in residents surrounding a beryllium facility|journal=Am J Respir Crit Care Med|year=2008|volume=177|issue=9|pages=1012–1017|doi=10.1164/rccm.200607-1042oc}}</ref> At that time most construction trades and industries were unaware of the potential risks associated with beryllium exposure.<ref>{{cite journal|last=Welch|first=L|title=Beryllium Disease Among Construction Trade Workers at Department of Energy Nuclear Sites|journal=American Journal of Industrial Medicine|year=2013|volume=56|pages=1125–1136|doi=10.1002/ajim.22202}}</ref> | |||
| Generally associated with exposure to beryllium levels at or above 100 μg/m<sup>3</sup>,<ref name=OSHAhealtheffects/> it produces severe cough, sore nose and throat, weight loss, labored breathing, anorexia, and increased fatigue.<ref>Agency for Toxic Substances and Disease Registry. September 2002 . See also </ref>{{rp|46}} | |||
| In addition to beryllium's toxicity when inhaled, when brought into contact with skin at relatively low doses, beryllium can cause local irritation and ], and contact with skin that has been scraped or cut may cause rashes or ulcers.<ref>Agency for Toxic Substances and Disease Registry via the CDC. Page last reviewed: 3 March 2011. Page last updated: 3 June 2015</ref> Beryllium dust or powder can irritate the eyes.<ref>NIOSH Page last reviewed: 22 July 2015. Page last updated: 1 July 2014</ref> | |||
| Chronic ] is a ] and ] ] disease caused by exposure to beryllium. Acute beryllium disease in the form of ] was first reported in Europe in 1933 and in the United States in 1943. Cases of chronic berylliosis were first described in 1946 among workers in plants manufacturing ]s in ].<ref name="Lang">{{Cite journal|journal=Environmental Health Perspectives|volume=102|issue=6–7|date=June–July 1994|title=Beryllium: A Chronic Problem|author=Lang, Leslie|pmc=1569745|pmid=9679108|pages=526–31|doi=10.1289/ehp.94102526}}</ref> Chronic berylliosis resembles ] in many respects, and the ] is often difficult. It occasionally killed early workers in nuclear weapons design, such as ].<ref>{{Cite web|url = http://www.atomicarchive.com/Photos/CP1/image5.shtml|title = Photograph of Chicago Pile One Scientists 1946|date = 19 June 2006|publisher = Office of Public Affairs, Argonne National Laboratory|accessdate = 2008-09-18}}</ref> | |||
| == Risk factors == | |||
| Although the use of beryllium compounds in ]ing tubes was discontinued in 1949, potential for exposure to beryllium exists in the ] production and aerospace industries and in the refining of beryllium metal and melting of beryllium-containing alloys, the manufacturing of electronic devices, and the handling of other beryllium-containing material. | |||
| ] | |||
| Acute beryllium poisoning is an ].<ref name=OSHAhealtheffects>OSHA Page retrieved 29 March 2016</ref> Relevant occupations are those where beryllium is mined, processed or converted into metal alloys, or where machining of metals containing beryllium or recycling of scrap alloys occurs.<ref>ATSDR. September 2002</ref> | |||
| Metallographic preparation equipment and laboratory work surfaces must be damp-wiped occasionally to inhibit buildup of particles. Cutting, grinding, and polishing procedures that generate dust or fumes must be handled within sufficiently vented coverings supplied with particulate filters.<ref>Batich, Ray and James M. Marder. (1985) Beryllium In (Ed. 9), Metals Handbook: Metallography and Microstructures (pp. 389-391). Metals Park, Ohio: American Society for Metals.</ref> | |||
| Early researchers tasted beryllium and its various compounds for sweetness in order to verify its presence. Modern diagnostic equipment no longer necessitates this highly risky procedure. Beryllium and its compounds should be handled with great care and special precautions must be taken when carrying out any activity which could result in the release of beryllium dust (] is a possible result of prolonged exposure to beryllium laden dust). | |||
| ==Diagnosis== | |||
| Beryllium in air and on surfaces can be detected using dilute ] for dissolution and fluorescence detection with beryllium bound to sulfonated hydroxybenzoquinoline, allowing detection up to 100 times lower than the recommended limit for beryllium concentration in the workplace.<ref>{{Cite web|url=http://www.astm.org/Standards/D7458.htm|title=ASTM D7458 – 08|accessdate=2009-08-08|publisher=American Society for Testing and Materials}}</ref><ref>{{Cite journal|doi=10.1520/JAI13168|title=Development of a New Fluorescence Method for the Detection of Beryllium on Surfaces|year=2005|last1=Minogue|first1=EM|last2=Ehler|first2=DS|last3=Burrell|first3=AK|last4=McCleskey|first4=TM|last5=Taylor|first5=TP|journal=Journal of ASTM International|volume=2|pages=13168|issue=9}}</ref> | |||
| {{Empty section|date=November 2017}} | |||
| == |
== Management== | ||
| Therapy is supportive and includes removal from further beryllium exposure.<ref name="OSHAhealtheffects" /> For very severe cases mechanical ventilation may be required.<ref>Newman, LS for the Merck Manual. Last full review/revision May 2014</ref> | |||
| Beryllium is harmful if inhaled and the effects depend on the duration, intensity, and frequency of exposure. When inhaled, beryllium becomes deposited into the lungs, from which the body has difficulty expelling it.<ref name="Rossman 1996 945–947"/> If beryllium concentrations in air are high enough (greater than {{nowrap|100 µg/m<sup>3</sup>}}), an acute condition can result, called acute beryllium disease, which resembles ]. Occupational and community air standards are effective in preventing most acute lung damage. Long-term beryllium exposure can increase the risk of developing ].{{Citation needed|date = August 2015}} | |||
| == Prognosis == | |||
| The more common serious health problem from beryllium today is chronic beryllium disease (CBD). It continues to occur in industries as diverse as metal recycling, dental laboratories, alloy manufacturing, nuclear weapons production and metal machine shops that work with alloys containing small amounts of beryllium. CBD can occur even when levels of beryllium are lower than the legal limits for workers.<ref name=Rosenman>{{cite journal|last=Rosenman|first=Kenneth|title=Chronic Beryllium Disease and Sensitization at a Beryllium Processing Facility|url=http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.7845|work=Environmental Health Perspectives|publisher=National Institute of Environmental Health Sciences|accessdate=2011-06-03|volume=113|issue=10|date=Oct 2005|doi=10.1289/ehp.7845|pages=1366–72|pmid=16203248|pmc=1281281|display-authors=etal}}</ref> A 2008 report from the ] said that worker exposure to beryllium should be kept "at the lowest feasible level," as the agency's research could not establish any safe level of exposure.<ref>{{Cite journal|title=NRC urges minimal Beryllium Exposure|journal=]|volume=86|issue=33|date=18 August 2008|pages=26}}</ref> | |||
| The signs and symptoms of acute beryllium pneumonitis usually resolve over several weeks to months, but may be fatal in 10 percent of cases,<ref name=OSHAhealtheffects/> and about 15–20% of cases may progress to ].<ref>{{Cite journal|doi=10.1056/NEJM196511252732205|pmid=5847559|year=1965|last1=Hardy|first1=HL|title=Beryllium poisoning--lessons in control of man-made disease|volume=273|issue=22|pages=1188–99|journal=The New England Journal of Medicine}}</ref> | |||
| Acute beryllium poisoning approximately doubles the risk of lung cancer.<ref name=ntp>National Toxicology Program, Department of Health and Human Services. Report on Carcinogens, Thirteenth Edition </ref> The mechanism by which beryllium is carcinogenic is unclear, but may be due to ionic beryllium binding to nucleic acids; it is not mutagenic.<ref name=ntp/> | |||
| ===Acute beryllium disease=== | |||
| Overexposure to beryllium can cause inflammation of the upper and/or lower respiratory tracts. The symptoms of acute beryllium disease are non-specific, resembling other inhalational injuries, viral infections, or pneumonia.<ref name="Tepper">Tepper LB, Hardy HL, Chamberlain RI. Toxicity of beryllium compounds. In: Browning E, Ed. Elsevier monographs on toxic agents. Amsterdam: Elsevier Publishing Co.; 1961. pp1-190.</ref> Upper respiratory findings include ] and ]. Symptoms may include irritation of the ] and ], ], cough, and a metallic taste. Nasopharyngitis can progress to formation of nasal fissures, ulcerations, or perforation.{{Citation needed|date = August 2015}} | |||
| == Pathophysiology == | |||
| Therapy is supportive and includes removal from further beryllium exposure. Acute beryllium pneumonitis produces severe cough (occasionally with blood-streaked sputum), chest pain or burning, and shortness of breath.<ref name="Tepper"/> The patient is usually ill-appearing, and presents with ], ], ], and shallow rapid breathing. Systemic symptoms include fever (usually low-grade), malaise, and anorexia. The chest X-ray can reveal diffuse, bilateral ] infiltrates.{{Citation needed|date = August 2015}} | |||
| {{empty section|date=January 2021}} | |||
| == History == | |||
| There is no specific diagnostic test for acute beryllium disease. Biopsy of the lungs reveals a nonspecific granulomatous inflammation. Treatment is supportive, including oxygen supplementation as needed, and removal from further beryllium exposure. Corticosteroids are sometimes tried, but no good controlled studies are reported. The signs and symptoms of acute beryllium pneumonitis usually resolve over several weeks to months, but it may be fatal, and about 15–20% of cases may progress to CBD.<ref>{{Cite journal|doi=10.1056/NEJM196511252732205|pmid=5847559|year=1965|last1=Hardy|first1=HL|title=Beryllium poisoning--lessons in control of man-made disease|volume=273|issue=22|pages=1188–99|journal=The New England Journal of Medicine}}</ref><ref>{{Cite journal|pmid=9248221|year=1997|last1=Yoshida|first1=T|last2=Shima|first2=S|last3=Nagaoka|first3=K|last4=Taniwaki|first4=H|last5=Wada|first5=A|last6=Kurita|first6=H|last7=Morita|first7=K|title=A study on the beryllium lymphocyte transformation test and the beryllium levels in working environment|volume=35|issue=3|pages=374–9|journal=Industrial health|doi=10.2486/indhealth.35.374}}</ref> | |||
| Acute beryllium disease was first reported in Europe in 1933 and in the United States in 1943.<ref name="Lang">{{Cite journal|journal=Environmental Health Perspectives|volume=102|issue=6–7|date=June–July 1994|title=Beryllium: A Chronic Problem|author=Lang, Leslie|pmc=1569745|pmid=9679108|pages=526–31|doi=10.1289/ehp.94102526}}</ref> | |||
| ==References== | |||
| ===Chronic beryllium disease (CBD)=== | |||
| {{Reflist}} | |||
| {{Main|Berylliosis}} | |||
| {{OSHA|article=Beryllium|url =https://www.osha.gov/SLTC/beryllium/healtheffects.html|accessdate=2016-03-28}} | |||
| Sensitization is not an illness, but some exposed individuals, after inhaling sufficient quantities of beryllium dust in the micrometer-size range, may have an inflammatory reaction that principally targets the respiratory system and skin. This condition is called chronic beryllium disease (CBD),<ref>{{cite journal|last=Bartell|first=S|title=Risk estimation and value-of-information analysis for three proposed genetic screening programs for chronic beryllium disease prevention|journal=Risk Anal|year=2000|volume=20|issue=1|pages=87–99|doi=10.1111/0272-4332.00009}}</ref> and can occur within a few months or many years (average 10 years in some series<ref>{{Cite journal|pmid=3277503|year=1988|last1=Kriebel|first1=D|last2=Brain|first2=JD|last3=Sprince|first3=NL|last4=Kazemi|first4=H|title=The pulmonary toxicity of beryllium|volume=137|issue=2|pages=464–73|journal=The American review of respiratory disease|doi=10.1164/ajrccm/137.2.464}}</ref>) after exposure to higher-than-normal levels of beryllium (greater than {{nowrap|0.2 µg/m<sup>3</sup>}}). This disease causes fatigue, weakness, night sweats and can cause difficulty in breathing and a persistent dry cough. It can result in ], weight loss, and may also lead to right-side heart enlargement and heart disease in advanced cases.{{Citation needed|date = August 2015}} | |||
| {{HHS content|article=ToxGuide for Beryllium|url =http://www.atsdr.cdc.gov/toxguides/toxguide-4.pdf}} | |||
| Typically, CBD has an insidious onset and runs an indolent course. Some people who are sensitized to beryllium may not have symptoms,<ref>{{cite web|title=The Beryllium Lymphocyte Proliferation Test|url=https://www.osha.gov/SLTC/beryllium/be_and_chronic_be_disease.html.|accessdate=10 September 2013}}</ref> and just being sensitized is not a recognized health effect. CBD occurs when the body's ] recognizes beryllium particles as foreign material and mounts an immune system attack against the particles. Because these particles are typically inhaled into the lungs, the lungs become the major site where the immune system responds. The lung sacs become inflamed and fill with large numbers of ] that accumulate wherever beryllium particles are found. These cells form balls around the beryllium particles called "]s."<ref name="Stange 1996 213–224">{{cite journal|last=Stange|first=A|title=Possible health risks from low level exposure to beryllium.|journal=Toxicology|year=1996|volume=111|issue=1-3|pages=213–224|doi=10.1016/0300-483x(96)03378-1}}</ref> When enough of these develop, they interfere with the normal function of the organ. Over time, the lungs become stiff and lose their ability to transfer oxygen from the air into the bloodstream. Early on in the disease, there may be a mild obstructive ventilatory defect. In advanced cases, there is a restrictive defect and reduced ]. Patients with CBD develop difficulty inhaling and exhaling sufficient amounts of air, and the amount of oxygen in their bloodstreams falls.{{Citation needed|date = August 2015}} | |||
| Most of the clinical features of CBD are indistinguishable from thoracic involvement with ]. The chest radiograph usually reveals bilateral, mid- and upper-lobe predominant reticulonodular infiltrates, as well as hilar and mediastinal ]. For suspected cases of CBD, fiber-optic ] with ] (BAL) is indicated. Beryllium ] (BAL BeLPT) of the lavage fluid is the gold standard for diagnosis, detecting approximately 70-90% of cases. The measurement of beryllium in urine or tissue is not sufficient to diagnose CBD.{{Citation needed|date = August 2015}} | |||
| CBD is treatable, but not curable with traditional drugs and medicine. Removal from further beryllium exposure is advisable. Treatment includes supplemental oxygen and corticosteroids (such as ]) to lower the body's overreaction to beryllium. If corticosteroid therapy is successful, treatment is usually continued for the rest of the affected person's life due to potential relapse after steroid cessation.<ref name="Tepper"/> In general, CBD worsens without treatment. Prognosis is best for those diagnosed at an earlier stage. Overall mortality rates are 5-38%.<ref>{{Cite journal|pmc=1469683|pmid=8933038|year=1996|last1=Newman|first1=LS|last2=Lloyd|first2=J|last3=Daniloff|first3=E|title=The natural history of beryllium sensitization and chronic beryllium disease|volume=104 Suppl 5|pages=937–43|journal=Environmental Health Perspectives|issue=Suppl 5|doi=10.2307/3433014}}</ref> | |||
| The general population is unlikely to develop acute or chronic beryllium disease because ambient air levels of beryllium are normally very low (<0.03 ng/m<sup>3</sup>).<ref>{{Cite book|url=https://books.google.com/books?id=xGwF6fXn5rQC&pg=PA11|page=11|title=Health effects of beryllium exposure|publisher=National Academies Press|year=2007|isbn=0-309-11167-6|author=National Research Council (U.S.). Committee on Beryllium Alloy Exposures, National Research Council (U.S.). Committee on Toxicology}}</ref> | |||
| ==Ingestion== | |||
| Swallowing beryllium has not been reported to cause effects in humans because very little beryllium is absorbed from the stomach and intestines. Harmful effects have sometimes been seen in animals ingesting beryllium.<ref>{{Cite journal|url=http://jn.nutrition.org/cgi/reprint/11/4/371.pdf|volume=11|issue=4|page=371|year=1935|title=Results of feeding various levels of soil containing beryllium to chickens, dogs and rats|author=Duncan, C. W.; Miller, E. J.}}</ref> | |||
| ==Dermatological effects== | |||
| Beryllium can cause local irritation and ]. Beryllium contact with skin that has been scraped or cut may cause ]es, ulcers, or bumps under the skin called ]s.<ref>{{Cite book|url=https://books.google.com/books?id=dQBAzfyCeQ8C&pg=PA651|page=651|title=Fisher's Contact Dermatitis|author=Robert L. Rietschel, Joseph F. Fowler, Alexander A. Fisher|publisher=PMPH-USA|year=2008|isbn=1-55009-378-9}}</ref><ref>{{cite journal|last=Tinkle|first=S|title=Skin as a route of exposure and sensitization in chronic beryllium disease.|journal=Environ Health Perspect|year=2003|volume=111|issue=9|pages=1202–1208|doi=10.1289/ehp.5999}}</ref> Beryllium dust or powder can irritate the eyes, producing itching, burning, or ].{{Citation needed|date = August 2015}} | |||
| ==Effects on children== | |||
| There are no studies on the health effects of children exposed to beryllium, although individual cases of CBD have been reported in children of beryllium workers from the 1940s. It is unknown whether children differ from adults in their susceptibility to beryllium. It is unclear whether beryllium is ].<ref>{{Cite book|url=https://books.google.com/books?id=PyUSgdZUGr4C&pg=PA333|page=333|title=Clinical environmental health and toxic exposures|author=John Burke Sullivan, Gary R. Krieger|publisher=Lippincott Williams & Wilkins|year=2001|isbn=0-683-08027-X}}</ref> | |||
| ==Detection in the body== | |||
| Beryllium can be measured in the urine and blood. The amount of beryllium in blood or urine may not indicate time or quantity of exposure. Beryllium levels can also be measured in lung and skin samples. While such measurements may help establish that exposure has occurred, other tests are used to determine if that exposure has resulted in health effects.{{Citation needed|date = August 2015}} | |||
| Beryllium sensitivity testing was first performed as a cutaneous beryllium patch test in the early 1950s but was discontinued due to the test stimulating sensitization or aggravating existing chronic beryllium disease.<ref>{{cite journal|last=Barna|first=B|title=Clinical application of beryllium lymphocyte proliferation testing|journal=Clin Diagn Lab Immunol|year=2003|volume=10|issue=6|pages=990–994|doi=10.1128/cdli.10.6.990-994.2003}}</ref><ref>{{cite journal|last=Donovan|first=E|title=Performance of the beryllium blood lymphocyte proliferation test based on a long-term occupational surveillance program.|journal=Int Arch Occup Environ Health|year=2007|volume=81|issue=2|pages=165–178|doi=10.1007/s00420-007-0202-3}}</ref> | |||
| A blood test, the blood beryllium lymphocyte proliferation test (BeLPT), identifies beryllium sensitization by measuring immune cell response, and has predictive value for CBD.<ref name="Stange 1996 213–224"/> It is detected immunologically in peripheral blood cells. Although there is a variability of results between laboratories,<ref>{{cite journal|last=Henneberger|first=P|title=Beryllium sensitization and disease among long-term and short-term workers in a beryllium ceramics plant|journal=International Archives of Occupational and Envirnmental Health|year=2001|volume=74|pages=167–176|doi=10.1007/s004200100237}}</ref> the BeLPT has become the standard test for detecting beryllium sensitization and CBD in individuals who are suspected of having CBD. The test can help distinguish it from similar conditions such as sarcoidosis. The test can detect disease that is at an early stage, or can detect disease at more advanced stages of illness as well. The BeLPT can also be performed using cells obtained from a person's lung by bronchoscopy.<ref>{{Cite book|url=https://books.google.com/books?id=p5-_2rBnQFAC&pg=PA257|page=257|title=Air pollution and lung disease in adults|author=Witorsch, Philip and Spagnolo, Samuel V.|publisher=CRC Press|year=1994|isbn=0-8493-0181-5}}</ref> | |||
| BeLPT is also the main test used in industry health programs to monitor whether disease is occurring among current and former workers who have been exposed to beryllium on the job. Using the BeLPT as a surveillance test gives companies information needed to take preventative measures against beryllium exposure.<ref>{{cite journal|last=Muller|first=C|title=Beryllium contamination and exposure monitoring in an inhalation laboratory setting|journal=Toxicol Ind Health|year=2010|volume=26|issue=1|pages=39–45|doi=10.1177/0748233709359276}}</ref><ref>{{cite journal|last=Marshall|first=E|title=Beryllium screening raises ethical issues|journal=Science|year=1999|volume=285|issue=5425|pages=178–179|doi=10.1126/science.285.5425.178b}}</ref><ref>{{cite journal|last=Kolanz|first=M|title=Evaluating beryllium exposure data|journal=Environ Health Perspect|year=2006|volume=114|issue=4|page=A213-A215|doi=10.1289/ehp.114-a213a}}</ref> | |||
| ==Industrial release and occupational exposure limits== | |||
| Typical levels of beryllium that industries may release into the air are of the order of {{nowrap|0.01 µg/m<sup>3</sup>}}, averaged over a 30-day period, or {{nowrap|2 µg/m<sup>3</sup>}} of workroom air for an 8-hour work shift. Compliance with the current U.S. ] (OSHA) ] for beryllium of {{nowrap|2 µg/m<sup>3</sup>}} has been determined to be inadequate to protect workers from developing beryllium sensitization and CBD. The ] (ACGIH), which is an independent organization of experts in the field of occupational health, has proposed a threshold limit value (TLV) of {{nowrap|0.05 µg/m<sup>3</sup>}} in a 2006 Notice of Intended Change (NIC). This TLV is 40 times lower than the current OSHA permissible exposure limit, reflecting the ACGIH analysis of best available peer-reviewed research data concerning how little airborne beryllium is required to cause sensitization and CBD.{{Citation needed|date = August 2015}} | |||
| Because it can be difficult to control industrial exposures to beryllium, it is advisable to use any methods possible to reduce airborne and surface contamination by beryllium, to minimize the use of beryllium and beryllium-containing alloys whenever possible, and to educate people about the potential hazards if they are likely to encounter beryllium dust or fumes.<ref name="Lang" /> | |||
| On 29 January 2009, the Los Alamos National Laboratory announced it was notifying nearly 2,000 current and former employees and visitors that they may have been exposed to beryllium in the lab and may be at risk of disease. Concern over possible exposure to the material was first raised in November 2008, when a box containing beryllium was received at the laboratory's short-term storage facility.<ref>{{Cite news|title = Beryllium exposure|url = http://www.cnn.com/2009/HEALTH/01/29/los.alamos.beryllium/index.html?eref=rss_us|publisher=CNN | date=29 January 2009}}</ref> | |||
| Researchers from the ] (NIOSH) estimate that as many as 134,000 workers in the government and private industry are potentially exposed to beryllium in the United States.<ref>{{Cite journal|pmid=15631056|year=2004|last1=Henneberger|first1=PK|last2=Goe|first2=SK|last3=Miller|first3=WE|last4=Doney|first4=B|last5=Groce|first5=DW|title=Industries in the United States with airborne beryllium exposure and estimates of the number of current workers potentially exposed|volume=1|issue=10|pages=648–59|journal=Journal of Occupational and Environmental Hygiene|doi=10.1080/15459620490502233}}</ref> | |||
| ==References== | |||
| {{Reflist|2}} | |||
| ==External links== | |||
| {{Medical resources | |||
| | DiseasesDB = | |||
| | ICD10 = {{ICD10|T|56|7|t|51}} | |||
| | ICD9 = {{ICD9|985.3}} | |||
| | ICDO = | |||
| | OMIM = | |||
| | MedlinePlus = | |||
| | eMedicineSubj = | |||
| | eMedicineTopic = | |||
| | MeshID = | |||
| }} | |||
| {{Poisoning and toxicity}} | {{Poisoning and toxicity}} | ||
| {{Elements in biology}} | |||
| {{DEFAULTSORT:Beryllium Poisoning}} | {{DEFAULTSORT:Beryllium Poisoning}} | ||
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Latest revision as of 23:46, 29 December 2023
Medical condition
| Acute beryllium poisoning | |
|---|---|
 | |
| Beryllium | |
| Specialty | Occupational medicine |
Acute beryllium poisoning is acute chemical pneumonitis resulting from the toxic effect of beryllium in its elemental form or in various chemical compounds, and is distinct from berylliosis (also called chronic beryllium disease). After occupational safety procedures were put into place following the realization that the metal caused berylliosis around 1950, acute beryllium poisoning became extremely rare.
Signs and symptoms
Generally associated with exposure to beryllium levels at or above 100 μg/m, it produces severe cough, sore nose and throat, weight loss, labored breathing, anorexia, and increased fatigue.
In addition to beryllium's toxicity when inhaled, when brought into contact with skin at relatively low doses, beryllium can cause local irritation and contact dermatitis, and contact with skin that has been scraped or cut may cause rashes or ulcers. Beryllium dust or powder can irritate the eyes.
Risk factors
Acute beryllium poisoning is an occupational disease. Relevant occupations are those where beryllium is mined, processed or converted into metal alloys, or where machining of metals containing beryllium or recycling of scrap alloys occurs.
Metallographic preparation equipment and laboratory work surfaces must be damp-wiped occasionally to inhibit buildup of particles. Cutting, grinding, and polishing procedures that generate dust or fumes must be handled within sufficiently vented coverings supplied with particulate filters.
Diagnosis
 | This section is empty. You can help by adding to it. (November 2017) |
Management
Therapy is supportive and includes removal from further beryllium exposure. For very severe cases mechanical ventilation may be required.
Prognosis
The signs and symptoms of acute beryllium pneumonitis usually resolve over several weeks to months, but may be fatal in 10 percent of cases, and about 15–20% of cases may progress to chronic beryllium disease.
Acute beryllium poisoning approximately doubles the risk of lung cancer. The mechanism by which beryllium is carcinogenic is unclear, but may be due to ionic beryllium binding to nucleic acids; it is not mutagenic.
Pathophysiology
| This section is empty. You can help by adding to it. (January 2021) |
History
Acute beryllium disease was first reported in Europe in 1933 and in the United States in 1943.
References
- ^ OSHA Beryllium Health Effects Page retrieved 29 March 2016
- Agency for Toxic Substances and Disease Registry. September 2002 Toxicological Profile: Beryllium. See also 2009 Addendum
- Agency for Toxic Substances and Disease Registry via the CDC. TOX FAQs: Beryllium Page last reviewed: 3 March 2011. Page last updated: 3 June 2015
- NIOSH International Chemical Safety Cards: Beryllium Page last reviewed: 22 July 2015. Page last updated: 1 July 2014
- ATSDR. ToxGuide for Beryllium September 2002
- Batich, Ray and James M. Marder. (1985) Beryllium In (Ed. 9), Metals Handbook: Metallography and Microstructures (pp. 389-391). Metals Park, Ohio: American Society for Metals.
- Newman, LS for the Merck Manual. Beryllium Disease Last full review/revision May 2014
- Hardy, HL (1965). "Beryllium poisoning--lessons in control of man-made disease". The New England Journal of Medicine. 273 (22): 1188–99. doi:10.1056/NEJM196511252732205. PMID 5847559.
- ^ National Toxicology Program, Department of Health and Human Services. Report on Carcinogens, Thirteenth Edition Beryllium and Beryllium Compounds
- Lang, Leslie (June–July 1994). "Beryllium: A Chronic Problem". Environmental Health Perspectives. 102 (6–7): 526–31. doi:10.1289/ehp.94102526. PMC 1569745. PMID 9679108.
This article incorporates public domain material from Beryllium. Occupational Safety and Health Administration. Retrieved 28 March 2016.
This article incorporates public domain material from ToxGuide for Beryllium (PDF). United States Department of Health and Human Services.
External links
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