Reviewed by Lisa A. Maier, MD, MSPH, FCCP

What is beryllium sensitization?

Beryllium sensitization is an “allergic” condition to beryllium that may develop after a susceptible person breathes beryllium dust or fumes, or if beryllium penetrates the skin through an open cut or from a beryllium splinter. Individuals that have a certain gene called HLA-DPB Glu69 are susceptible and more likely to become sensitized after exposure to beryllium.

In individuals with beryllium sensitization, the immune system sees beryllium as a foreign substance and responds by generating a population of immune cells in the bloodstream that react to beryllium. These cells can be found in the blood using a test called the beryllium lymphocyte proliferation test (BeLPT).

 

How do you develop beryllium sensitization?

It is important to know that no one develops beryllium sensitization unless he or she is exposed to beryllium. Beryllium sensitization may develop after an individual breathes beryllium dust or fumes. Most people who are exposed to beryllium will not experience health effects. Beryllium particle size and form, amount and duration of exposure, occupation, industry and genetics are all factors that play a role in determining why some people develop beryllium sensitization and others do not.

Studies have shown that, on average, 1 – 6 percent of exposed workers develop sensitivity, although the rates can be as high as 16 percent in workers with the highest exposures, such as beryllium machinists. Most workers who are going to develop an allergy to beryllium tend to do so early, but follow-up testing over the years continues to identify workers with beryllium sensitization years after first exposure.

 

What are the symptoms of beryllium sensitization?

As opposed to environmental allergies, such as pollen or ragweed, individuals with beryllium sensitization do not have any immediate symptoms when they are exposed to beryllium. In fact, beryllium sensitization causes no symptoms at all.

 

How do I know if I have beryllium sensitization?

Beryllium sensitization is diagnosed with a blood test called the beryllium lymphocyte proliferation test (BeLPT). The BeLPT is a test that helps determine if your immune system reacts to beryllium as a foreign substance — this reaction leads to abnormal BeLPT results. In individuals who do not have beryllium sensitization, the immune system does not respond to beryllium in any manner, which produces normal BeLPT results.

Individuals with two or more abnormal BeLPT results are considered to have “confirmed beryllium sensitization” and are encouraged to undergo further medical testing to determine if they have chronic beryllium disease (CBD). Individuals with other combinations of non-normal test results, such as an abnormal and a borderline BeLPT or three borderline results, are also considered sensitized and should be candidates for further evaluation.

 

Is beryllium sensitization treated?

Currently, there is no medication or procedure available to eliminate this immune reaction to beryllium.

 

Can beryllium sensitization be cured?

At the present time, there is not a known cure for beryllium sensitization.

 

How often should I see my doctor?

Once diagnosed with beryllium sensitization, you should see your physician at least every 2 years. During your visit, you may have testing, including pulmonary function tests, exercise tolerance tests, a chest X-ray or CT scan to check for inflammation and scarring in the lungs, and a bronchoscopy with lavage (lung washing) and biopsy to see if granulomas or other abnormalities have developed in the lungs. The types of testing your physician performs may be different based on your overall health. If you develop symptoms of CBD, such as a dry cough or unexplained shortness of breath, you should see your physician as soon as possible.

 

How do you develop CBD?

It is important to know that no one develops CBD unless he or she is exposed to beryllium and develops an immune response (beryllium sensitization) to it. CBD may develop after an individual breathes beryllium dust or fumes. Most people who are exposed to beryllium will not experience health effects.

 

What are my chances of developing chronic beryllium disease (CBD)?

The percentage of people with beryllium sensitization who go on to develop CBD is highly variable, ranging from 10 – 100 percent in different worker populations. Individuals with very high exposure to beryllium, such as machinists, are at great risk. On average, an estimated 40 – 60 percent of workers with beryllium sensitization will go on to develop CBD. Factors such as beryllium particle size and form, amount and duration of exposure, occupation, industry and genetics (or susceptibility) may all play a role in determining why some people develop CBD and others do not. Once you are exposed to beryllium, you carry a lifelong risk of developing beryllium sensitization or CBD, even if you had low exposures or you are no longer exposed.

When people with beryllium sensitization undergo clinical evaluation to determine if they have CBD, between 10 – 100 percent of them are found to have a CBD diagnosis on their first evaluation. If you have undergone evaluation and are found to have beryllium sensitization with no evidence of CBD, you are still at risk for developing CBD in the future. Recent research suggests that each year, 6 – 8 percent of people with beryllium sensitization will develop CBD, at least in the first 6 years.

 

For more information on beryllium, please contact National Jewish Health® at 1.800.222.5864, extension 1722.

 

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