EPIDEMIOLOGY OF BERYLLIUM SENSITIZATION AND DISEASE IN NUCLEAR WORKERS

We examined the epidemiology of chronic beryllium disease among a stra tified, random sample (n = 895) of nuclear weapons workers using the b lood beryllium lymphocyte transformation (BeLT) test and chest radiogr aph for case identification. Of 18 new cases of beryllium sensitizatio n, 12 had beryllium disease, and three more developed pulmonary granul omas on lung biopsy over the succeeding 2 yr. Beryllium-sensitized cas es did not differ from noncases in age, gender, race, ethnicity, smoki ng, most respiratory symptoms, spirometric or radiographic abnormaliti es, or job tenure. The six sensitized cases without initial disease di ffered from beryllium disease cases in having greater pack-years of sm oking. Sensitization occurred among workers with inadvertent or bystan der exposure, such as a secretary and security guard. However, berylli um sensitization risk was higher for machinists (4.7%) and for persons reporting measured overexposure (7.4%, odds ratio 5.1); exposure begi nning before 1970 (3.6%, odds ratio 2.7); consistent beryllium exposur e (3.4%); and sawing (4.7%) or band sawing (6.0%) of beryllium metal. We conclude that both individual susceptibility to sensitization and e xposure circumstances are important in developing disease.