Occupational Lung Diseases -- Printable Tables

TITLE:	OCCUPATIONAL LUNG DISEASES
AUTHORS:	RAED A. DWEIK, MD -- Department of Pulmonary and Critical Care Medicine
	PETER J. MAZZONE, MD -- Department of Pulmonary and Critical Care Medicine
PUBLISHED:	JULY 6, 2004

Table 1:

Common Uses of Beryllium

Inertial guidance systems
Turbine rotor blades
Laser tubes
Rocket engine liners
Springs
Aircraft brakes and landing gear
Ball bearings
Injection and blow mold tooling
Electrical contacts
Automotive electronics
X-ray tube windows
Spark plugs
Electrical components
Ceramic applications
Gears
Aircraft engines
In oil and gas industries
Welding electrodes
Computer electronics
Golf clubs

Table 2:
Industries That Use Beryllium
Industries With Heavy Use of Beryllium	Other Industries That Use Beryllium Less Heavily
Beryllium extraction	Aerospace
Beryllium and beryllium alloy machine shops	Ceramics
Electronics	Computers
Nuclear weapons manufacturing	Automotive
	Dental appliances

Table 3:

Selected Locations for Beryllium Lymphocyte
Proliferation Testing in the United States

Cleveland Clinic Foundation
Department of Clinical Pathology, L40
9500 Euclid Avenue
Cleveland, OH 44195-0001
Ph: (216) 444-2200 or 1-800-223-2273, ext 48844 or 55763
Fx: (216) 445-8160
Hospital of the University of Pennsylvania
Pulmonary Immunology Laboratory
833 BRB II/III
421 Curie Boulevard
Philadelphia, PA 19104-4283
Ph: (215) 573-9906
Fx: (215) 349-5172
National Jewish Center for Immunology
and Respiratory Medicine
Cellular Immunology Tests
Pulmonary Division and Occupational/
Environmental Medicine Division
1400 Jackson Street
Denver, CO 80206
Ph: (303) 388-4461
Specialty Laboratories, Inc.
OncQuest
2211 Michigan Avenue
Santa Monica, CA 90404-3900
Ph: (310) 828-6543 or 1-800-421-4449

Table 4:
Clinical and Laboratory Features of Chronic Beryllium Disease (CBD) and Sarcoidosis
Feature	Chronic Beryllium Disease	Sarcoidosis
Occupational exposure to beryllium	Yes	No
Onset	Acute or insidious	Acute or insidious
Respiratory symptoms	Predominant organ affected	Predominant organ affected
Erythyma nodosum	No	Yes
Dermatitis	Yes	No
Cardiac	Rare	Common
Pulmonary physiology	Gas exchange abnormalities common; obstruction early, mixed obstruction/restriction or pure restriction late	Gas exchange abnormalities common; restriction, obstruction, or mixed pattern
Bilateral hilar adenopathy	Uncommon	Common
Infiltrates	Diffuse nodular or linear opacities, can be absent	Nodular and/or linear opacities, may be more focal than in CBD
Computed tomography	Small nodules, septal lines, ground-glass appearance, adenopathy	Small nodules, septal lines, adenopathy
Beryllium lymphocyte proliferation test	Positive	Negative
Granulomas	Yes, noncaseating granuloma	Yes, noncaseating granuloma
Other histology	Diffuse mononuclear cell infiltrate common, bronchial submucosa involved occasionally	Diffuse mononuclear cell infiltrate common, bronchial submucosa involved occasionally
Beryllium in tissues	Yes	No
Skin tests
- Tuberculin	Negative	Negative
- Kveim	Negative	Positive
- Beryllium patch	Positive	Negative
Elevated serum angiotensin-converting enzyme	Uncommon	Common
Response to steroid therapy	Often stabilizes disease, may improve pulmonary physiology and symptoms, usually requires continuous therapy	Often stabilizes disease that has not spontaneously remitted, may require continuous therapy
Prognosis	Variable, cor pulmonale and progressive fibrosis in some patients, more benign in others	Good prognosis for approximately 80%, may progress to end-stage fibrosis and cor pulmonale.

This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.

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