Lung function, biological monitoring, and biological effect monitoring of gemstone cutters exposed to beryls

Objectives-Gemstone cutters are potentially exposed to various carcinogenic and fibrogenic metals such as chromium, nickel, aluminium, and beryllium, as well as to lead. Increased beryllium concentrations had been reported in the air of workplaces of beryl cutters in Idar-Oberstein, Germany. The aim of the survey was to study the excretion of beryllium in cutters and grind ers with occupational exposure to beryls-for example, aquamarines and emera lds-to examine the prevalence of beryllium sensitisation with the beryllium lymphocyte transformation test (BeLT), to examine the prevalence of lung d isease induced by beryllium, to describe the internal load of the respectiv e metals relative to work process, and to screen for genotoxic effects in t his particular profession. Methods-In a cross sectional investigation, 57 out of 100 gemstone cutters working in 12 factories in Idar-Oberstein with occupational exposure to ber yls underwent medical examinations, a chest radiograph, lung function testi ng (spirometry, airway resistance with the interrupter technique), and biol ogical monitoring, including measurements of aluminium, chromium, and nicke l in urine as well as lead in blood. Beryllium in urine was measured with a newly developed direct electrothermal atomic absorption spectroscopy techn ique with a measurement limit of 0.06 mu g/l. Also, cytogenetic tests (rate s of micronuclei and sister chromatid exchange), and a BeLT were performed. Airborne concentrations of beryllium were measured in three factories. As no adequate local control group was available, the cutters were categorised into those with an exposure to beryls of >4 hours/week (group A) and less than or equal to 4 hours/week (group B). Results-Clinical, radiological, or spirometric abnormalities indicating pne umoconiosis were detected in none of the gemstone cutters. Metal concentrat ions in biological material were far below the respective biological limit values, and beryllium in urine was only measurable in subjects of group A. Cytogenetic investigations showed normal values which were independent of t he duration of beryllium exposure. In one subject, the BeLT was positive. B eryllium stimulation indices were significantly higher in subjects with det ectable beryllium in the urine than in those with beryllium concentrations below the detection limit (p<0.05). In one factory, two out of four measure ments of airborne beryllium concentrations were well above the German thres hold limit value of 2 mu g/m(3) (twofold and 10-fold), and all gemstone cut ters working in this factory had measurable beryllium concentrations in uri ne. Conclusion-No adverse clinical health effects were found in this cross sect ional investigation of gemstone cutters working with beryls. However, an im provement in workplace hygiene is recommended, accompanied by biological mo nitoring of beryllium in urine.