CHRONIC BERYLLIUM DISEASE AMONG BERYLLIUM EXPOSED WORKERS

铍的职业空气标准的起源是基于砷、铅和汞等其他重金属的毒性，并进行了修改，以反映铍的较低原子量和对其较大毒性的担忧。没有使用关于健康结果和暴露的流行病学研究，以就最初建议的2微克/立方米的空气标准达成共识。近50年后，这仍然是OHSA和DOE在工作场所执行的当前空气水平。最近关于铍疾病和暴露的大多数研究都使用了暴露的替代物，并发现随着暴露的增加，疾病增加。此外，在没有同时检查暴露水平的情况下，以单变量的方式检查了宿主因素的贡献。慢性铍病现在可以通过肺灌洗液或外周血中的淋巴细胞增殖试验来诊断。然而，还需要后续研究来确定增殖试验阳性结果的临床意义。该项目将调查各种暴露措施的可能暴露-反应关系，包括化学和物理形式、铍敏化和临床疾病。将结合接触数据检查宿主因素，以更好地解决宿主易感性问题。最后，将确定增殖试验呈阳性的个体中铍病的自然病史。

The origin of the occupational air standard for beryllium was based on the toxicity of other heavy metals such as arsenic, lead and mercury and modified to reflect beryllium's lower atomic weight and concern about its greater toxicity. No epidemiological studies of health outcomes and exposure were used to reach a consensus on the initial recommended air standard of 2ug/m3. Almost 50 years later this remains the current air level that OHSA and DOE enforce in the work place. Most recent studies looking at beryllium disease and exposure have used surrogates of exposure and found increased disease with increased exposure. In addition, the contributions of host factors have been examined in an unvariate fashion without simultaneously examining exposure levels. Chronic beryllium disease can now be diagnosed using proliferation lymphocyte tests from either the lung lavage fluid or peripheral blood. However, follow-up studies to characterize the clinical significance of positive findings of the proliferation tests are needed. This project will investigate possible exposure-response relationships for various measures of exposure, including chemical and physical form, beryllium sensitization and clinical disease. Host factors will be examined in conjunction with exposure data to better address the issue of host susceptibility. Finally, the natural history of beryllium disease in individuals with positive proliferation tests will be determined.