• John R Balmes, Jerrold L Abraham, Raed A Dweik, Elizabeth Fireman, Andrew P Fontenot, Lisa A Maier, Joachim Muller-Quernheim, Gaston Ostiguy, Lewis D Pepper, Cesare Saltini, Christine R Schuler, Tim K Takaro, Paul F Wambach, and ATS Ad Hoc Committee on Beryllium Sensitivity and Chronic Beryllium Disease.
• Am. J. Respir. Crit. Care Med.. 2014 Nov 15;190(10):e34-59.

RationaleBeryllium continues to have a wide range of industrial applications. Exposure to beryllium can lead to sensitization (BeS) and chronic beryllium disease (CBD).ObjectivesThe purpose of this statement is to increase awareness and knowledge about beryllium exposure, BeS, and CBD.MethodsEvidence was identified by a search of MEDLINE. The committee then summarized the evidence, drew conclusions, and described their approach to diagnosis and management.Main ResultsThe beryllium lymphocyte proliferation test is the cornerstone of both medical surveillance and the diagnosis of BeS and CBD. A confirmed abnormal beryllium lymphocyte proliferation test without evidence of lung disease is diagnostic of BeS. BeS with evidence of a granulomatous inflammatory response in the lung is diagnostic of CBD. The determinants of progression from BeS to CBD are uncertain, but higher exposures and the presence of a genetic variant in the HLA-DP β chain appear to increase the risk. Periodic evaluation of affected individuals can detect disease progression (from BeS to CBD, or from mild CBD to more severe CBD). Corticosteroid therapy is typically administered when a patient with CBD exhibits evidence of significant lung function abnormality or decline.ConclusionsMedical surveillance in workplaces that use beryllium-containing materials can identify individuals with BeS and at-risk groups of workers, which can help prioritize efforts to reduce inhalational and dermal exposures.

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