Beryllium Disease

What is berylliosis?

Berylliosis (beryllium disease) is chronic inflammation in your lungs due to inhaling fumes or dust containing beryllium. Beryllium is a metal used to manufacture many different products.

Beryllium disease is an immune system response, which means only people who have an allergy to beryllium (beryllium sensitization, or BeS) develop symptoms. Just because you’ve been exposed to beryllium doesn’t mean you have the disease.

Most people who get beryllium disease have symptoms like coughing and difficulty breathing, which lead to scarring of their lung tissue. Treatment for the disease can involve corticosteroids and oxygen therapy to help with breathing.

What is beryllium?

Beryllium is a metal that’s used in the manufacturing of dozens of products, including cars, computers, golf clubs and electrical equipment. Beryllium is light, non-magnetic, and a good conductor of heat and electricity, which is why it’s so common.

Types of beryllium disease

There are two types of beryllium disease.

Chronic beryllium disease (CBD, berylliosis)

Chronic beryllium disease is a lung disease that develops in people who have become sensitized to beryllium (BeS). It’s an autoimmune condition and can be mistaken for diseases like sarcoidosis. Chronic beryllium disease can develop at any time after someone becomes sensitized to beryllium — even if they have no more exposure to beryllium-containing products.

Acute beryllium disease

Acute beryllium disease is very rare today. Current workplace safety regulations prevent the quantities of beryllium that can cause acute beryllium disease from being released into the air. Acute beryllium disease has a rapid onset and progresses quickly. It’s also caused by breathing in beryllium.

Beryllium can also cause a skin rash called contact dermatitis. People who develop this rash (and work with beryllium) are very likely to develop beryllium sensitization and should seek treatment from a healthcare provider.

How common is berylliosis?

Most studies show that between 2% and 6% of workers who are susceptible to beryllium sensitization will develop the disease after exposure to beryllium. Many people work regularly with beryllium and do not develop beryllium sensitization or CBD.

What are the symptoms of berylliosis (CBD)?

Symptoms typically progress slowly and intensify over time. Many people with chronic berylliosis disease (CBD) may not have symptoms when they receive a diagnosis. When you develop CBD, inflammation (swelling) occurs in your lungs because they’re reacting to a foreign substance (beryllium). Your lungs respond to beryllium by developing collections of cells known as granulomas, which may eventually cause scarring. This scarring reduces your lungs’ ability to function. As the inflammation response continues, over time, symptoms may eventually appear, including:

• Difficulty breathing/shortness of breath.
• Cough.
• Fatigue.
• Chest pain.
• Loss of appetite.
• Joint pain.
• Night sweats.

What causes beryllium disease?

You can only get beryllium disease if you’re exposed to it and develop an immune response to it. This immune response occurs because your T-cells become sensitized to beryllium. Healthcare providers also believe there is a genetic component to beryllium sensitivity.

Most people who are exposed to beryllium don’t get the disease. You must have sensitization to it first.

Who gets berylliosis?

Beryllium disease mainly affects people who work in jobs where they’re exposed to beryllium. While higher-level exposures can increase the risk of developing the disease, even people with very limited exposure to beryllium can become sensitized to beryllium and develop CBD. If you work in a job where you have known beryllium exposure, your employer should offer regular screenings for beryllium sensitization and chronic beryllium disease.

You can develop symptoms of CBD decades after your last exposure to beryllium. Even if you are no longer working with beryllium, if you have a diagnosis of beryllium sensitization you should have regular check-ups to make sure you have not developed CBD.

What are the complications of berylliosis?

Strain placed on your heart when your lungs are damaged can lead to an enlarged heart and heart disease. The most common complication is a continuation of symptoms or not finding relief from treatment.

How is beryllium disease diagnosed?

Your healthcare provider can diagnose CBD by getting your full health history, including history of exposure to beryllium. They may look for certain signs that may indicate CBD, including unusual breath sounds in your lungs and swollen lymph nodes. These signs develop in later stages of the disease.

Your healthcare provider may order all or some of the following tests:

• Blood tests: A blood test called beryllium lymphocyte proliferation test (BeLPT) measures your white blood cells’ reaction to beryllium.
• CT scan of your chest: Your provider can look at your lungs to see how much scarring or inflammation is occurring.
• Breathing tests: Spirometry is the most common way to measure how much air you can inhale and exhale.
• Bronchoscopy: Your provider inserts a tube with a camera into your lungs. They look for evidence of BeS in your lungs and take biopsies of your lung tissues. A biopsy is when a healthcare provider removes and examines a sample of tissue. They’ll look for granulomas or test for an allergic reaction to beryllium in your lung fluid.

Is there a cure for berylliosis?

There isn’t a cure for chronic beryllium disease (CBD). The goal of treatment is to reduce your symptoms and stop the disease from progressing. Some people feel better within a few weeks of treatment. Other people may live with severe symptoms for the rest of their lives.

Most healthcare providers treat CBD with medication to suppress the immune system. Treatment will typically include a mix of a corticosteroid called prednisone, as well as long-term treatment with a medication like methotrexate or azathioprine. These medications can help suppress the inflammation in your lungs, prevent scarring and manage symptoms.

Your healthcare provider may also prescribe oxygen therapy (supplemental oxygen) to help you breathe. You can receive oxygen therapy in many ways. Each oxygen delivery method has its pros and cons. You can discuss which method works best for you with your provider.

Pulmonary rehabilitation can help improve your symptoms and rebuild lung function. This is typically recommended for people who have severe symptoms or who still feel short of breath after starting treatment.

In severe cases, a person may require a lung transplant. This isn’t common.

How can beryllium disease be prevented?

Avoiding exposure to beryllium is the most effective way to prevent chronic beryllium disease (CBD). Your employer and all employees must try to minimize exposure. In the U.S., employers must follow standards set by the Occupational Safety and Health Administration (OSHA), including:

• Adequate ventilation of workspaces.
• Minimal use of beryllium over other equivalent metals.
• Isolation of procedures using beryllium.
• Safe use of high-efficiency particulate air (HEPA) vacuums for cleaning.
• The use of personal protective devices, including face masks and respirators.

Although there’s a permissible exposure limit (PEL) set by OSHA for CBD-causing beryllium forms, this standard may still be too high. Inquire with your employer about the company’s specific PEL.

If you work with beryllium, there are several 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 your workplace.
• Shower before leaving work.
• Clean work shoes before leaving your work area and don’t wear them home.

Can genetic testing identify who is at higher risk of developing beryllium sensitivity (BeS)?

Genetic testing may be able to identify individuals with a higher risk of developing BeS and/or progression to CBD. More studies are needed before testing becomes commonplace. Currently, genetic testing for Bes is offered on a case-by-case basis, after careful discussion with a genetic counselor and your healthcare provider.

What is the outlook for someone with berylliosis?

Healthcare providers still don’t fully understand why chronic beryllium disease (CBD) progresses differently in different people. Some people have granulomas in their lungs without experiencing symptoms, while others develop symptoms like breathing difficulties that worsen over time. Some only learn of having the disease once it’s become life-threatening.

There’s no way to predict how CBD will affect you. This is why it’s important to visit a healthcare provider for an evaluation and monitoring.

Is chronic beryllium disease fatal?

It can be. People with CBD can experience severe lung damage, which can put added strain on their heart. This can lead to heart failure or death. With early diagnosis and treatment, the risk of severe CBD is much lower. Because of this, making sure you get regular screening if you’ve been diagnosed with beryllium sensitization is very important.

When should I see my healthcare provider?

Contact your healthcare provider if you have any symptoms of beryllium disease, especially if you’ve worked in a job with exposure to beryllium.

What questions should I ask my provider?

It’s normal to have questions about a diagnosis. Some questions you may have for your healthcare provider could include:

• What can I expect from this condition?
• How do I prevent future exposure?
• Can I go back to work around beryllium?
• Should people in my family be tested for a beryllium allergy?
• What’s the best treatment for my symptoms?
• Will I have to be on medication or oxygen forever?

Is berylliosis the same as chronic beryllium disease?

Yes. These terms are typically used interchangeably. This is only because the acute form of the disease is rare.

How cancerous is beryllium?

The International Agency for Research on Cancer (IARC) lists beryllium as a human and animal carcinogen. This means studies have shown it can increase your risk of developing cancer.

What foods contain beryllium?

Some vegetables contain deposits of beryllium because it’s naturally found in soil. According to the U.S. Department of Health, garden peas, kidney beans and pears contain the highest amounts. There isn’t a risk of developing beryllium sensitization from the food you eat.