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Beryllium

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Beryllium is a silvery-white metal that is lighter than aluminum but stronger than steel. Its strength-to-weight ratio, reflectivity, transparency to X-rays, thermal stability and conductivity, and high melting point makes it an essential material in the defense, nuclear, aerospace, medical, information technology, and telecommunications industries.

Beryllium is toxic as both a skin irritant and an inhaled substance and can result in dermatitis, acute pneumonitis, and chronic pulmonary disease. The first signs of serious or life-threatening acute beryllium exposure may involve difficulty breathing, chest pain, or shortness of breath. Despite increasing governmental regulations limiting exposure to beryllium in high-risk occupations, any amount of beryllium can cause short-term and long-term diseases. 

References:

Stearney ER, Jakubowski JA, Regina AC. Beryllium Toxicity. [Updated 2023 Apr 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK585042/

What does it mean if your Beryllium result is too high?

Humans are exposed to it via airborne particles of beryllium metal, alloys, oxides, and ceramics—including golf clubs, bicycles, dental appliances, automotive parts, computer parts, and microwaves.

Beryllium particles are inhaled into the lungs and the upper respiratory tract. Additionally, hand-to-mouth exposures and skin contact with ultrafine particles may also occur.

The mechanism of beryllium toxicity is not well understood. Mostly likely, beryllium combines with certain proteins, releasing toxic substances.

Acute beryllium toxicity can cause pneumonitis, cough, chest pain, dyspnea, and pneumonia. Chronically, it results in sarcoid-like granulomata mainly in the lungs and is occasionally subcutaneous. It is a skin irritant and can also cause conjunctivitis, rhinitis, and pharyngitis.

Additionally, some individuals exposed to beryllium develop sensitization and are at risk of developing chronic beryllium disease (CBD) which is characterized by abnormally exaggerated immune responses.

What is beryllium disease?

Beryllium-induced lung disease can occur when beryllium dust or fumes are inhaled. There are 2 types of beryllium disease, acute and chronic:

Acute beryllium disease:

Acute beryllium disease is very rare today. Current workplace safety regulations prevent the massive quantities of beryllium that cause acute beryllium disease from being released into the air.

Chronic beryllium disease (CBD, berylliosis):

Chronic beryllium disease (CBD, berylliosis) is associated with inhaling beryllium powder or fumes (although inhaling beryllium does not always lead to CBD). An exposed person usually gets sensitized to beryllium prior to progressing to CBD. Sensitization is similar to an allergy; when allergic or sensitized, the body reacts negatively to that particular substance. Beryllium sensitivity (BeS) and CBD can develop soon after exposure or many (30-40) years later. Of those working around beryllium, about 10% get sensitized to it and about half of those progress to develop CBD.

There is no health threat associated with contact with solid beryllium; however, both the solid and powder forms can cause irritation if they come in contact with broken skin.

What are the symptoms of beryllium disease?

In the early stages of the disease, little or no symptoms are experienced by the individual. When a person begins to develop CBD, inflammation (swelling) occurs in the lungs because they are reacting to a foreign object. The lungs' typical response to the beryllium exposure is to develop collections of cells known as granulomas that may eventually cause scarring within the lungs. This scarring, in turn, reduces the lungs' ability to function. Over time, the inflammation response continues, and eventually symptoms may appear, including:

- Difficulty breathing/shortness of breath
- Weakness
- Fatigue
- Loss of appetite
- Weight loss
- Joint pain
- Cough
- Fever

Treatmenet options for Chronic Beryllium Disease:

There is no cure for chronic beryllium disease (CBD), but the symptoms can be treated.

All individuals diagnosed with beryllium sensitivity (BeS) or CBD are advised to avoid further beryllium exposure. Corticosteroids, which decrease inflammation, are the most frequent treatment for CBD.

The most common corticosteroid used for CBD is prednisone. Although there is no standard dosage for CBD, most doctors begin with 40 mg taken either daily or every other day. Since everyone responds differently to this treatment, your doctor will monitor your response to the drug and adjust the dosage as needed.

For patients who don't improve with steroids, the doctor may prescribe the drug methotrexate.

How can beryllium poisoning be prevented?

Avoiding exposure to beryllium is the most effective way to prevent chronic beryllium disease (CBD). 

If you work with beryllium, there are a number of actions you can take to avoid exposing your family:

- Remove street clothes and put on a uniform before entering the work area.
- Before leaving work, leave the uniform in a hamper with a lid at the workplace.
- Shower before leaving work.
- Clean work shoes before leaving the work area and don't wear them home.

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