Berylliosis - Types, Causes, Diagnosis and Treatment

Introduction

Berylliosis occurs due to exposure to beryllium metal. People working in the industries like cars, computers, and electrical equipment manufacturing are exposed to beryllium metal. Berylliosis occurs due to inhalation of the fumes from the metal while heating. It results in exaggerated immune responses. There are two types of berylliosis. They are as follows;

• Acute Beryllium Disease - The beryllium dust that is released into the air enters the respiratory tract during inhalation. It occurs due to a rapid onset. It is a very rare condition.

• Chronic Beryllium Disease - Constant exposure to beryllium fumes causes chronic beryllium disease. The individual becomes sensitized to beryllium. The body starts showing symptoms as the disease progresses. It usually occurs 30 to 35 years after exposure to beryllium.

What Are the Symptoms of Berylliosis?

Acute beryllium disease does not show any symptoms. The following symptoms are observed in chronic beryllium disease;

• Cough - The beryllium fumes cause inflammation in the lung tissue and result in a cough.

• Difficulty Breathing - Long-term exposure to beryllium leads to scarring in the lungs. It interferes with the lungs and reduces their breathing mechanism. Severe berylliosis causes unusual sounds while breathing.

• Weight Loss - The individual becomes weak and loses body weight.

• Loss of Appetite - The individual is unable to consume food due to discomfort.

• Fever - The body shows inflammatory responses like fever and pain in the joints.

• Lymph Node - The lymph node appears enlarged and swollen due to the infection.

How Is Berylliosis Diagnosed?

Chronic beryllium disease can be diagnosed with the help of the following procedures;

• Blood Test - The beryllium dust particles enter the body through inhalation and are present in blood circulation. It can be examined using the beryllium sensitivity test (BeS). The proliferation of lymphocytes in the blood due to beryllium can be detected with the beryllium lymphocyte proliferation test (BeLPT). It is used to determine the reaction of white blood cells to the beryllium dust particles. It is repeated once in 12 weeks to prevent chronic beryllium disease.

• Chest X-Rays - Since the beryllium fumes affect the respiratory tract and lungs, a noninvasive radiographic image is taken to observe the lung condition. The infected lungs and the air passages appear dark in the chest X-rays. The scarring in the lungs appears in shades of gray in the X-rays.

• Bronchoscopy - Severe beryllium disease leads to the formation of granulomas in the lungs and the air passages or bronchi. The accumulation of unwanted cells leads to granuloma formation. So it is observed with the help of a camera attached to the bronchoscope. The unwanted fluid present in the lungs is also collected for examination. It is used to examine the severity of berylliosis. Increased concentration of lymphocytes in the fluid shows the presence of chronic beryllium disease.

• Genetic Test - It helps to identify the employers who are at high risk for berylliosis. It is done by a genetic counselor. Each employer's health condition is discussed carefully during the genetic test. It helps to determine the immune response and inflammatory reactions in the body. Genetic markers are used to determine the risk of exposure to beryllium.

• Chest CT (Computed Tomography) Scan - Chest CT would show interstitial fibrosis and nodules, which are common in the upper lobe.

What Is the Treatment for the Individual With Berylliosis?

• Corticosteroids - Since berylliosis causes inflammatory reactions, it can be reduced with the help of Corticosteroids. The most commonly used steroid is Prednisone, with a dosage of 40mg. It is prescribed as a daily dose or on alternate days. The dosage of the drug is reduced depending on the prognosis of the lungs.

• Immunosuppressive Drugs - Immunosuppressive drugs are used to diminish the immune reactions produced in the body due to beryllium dust particles. The commonly used immunosuppressive drug to treat berylliosis is Methotrexate. The dosage used is 7.5 mg. It is usually prescribed once a week. Folic acid, with a dosage of 1 mg, is also used along with immunosuppressive drugs.

How to Prevent Beryllium Poisoning?

The employer of the industries manufacturing various products using beryllium must follow the guidelines given by the occupational safety and health administration (OSHA). The guidelines include the following;

• There must be adequate ventilation in the working place because a closed environment increases the risk of exposure to beryllium metal.

• Other metals with similar physical properties equivalent to beryllium can be used to manufacture the products.

• The individual must isolate themself with gloves, masks, safety glasses, and uniforms while handling the beryllium metal.

• After work, place the uniform in a box and cover it to avoid contamination.

• The employer must use high-efficiency particulate air (HEPA) vacuum to clean the beryllium dust particles in the ground.

• Employers must use respirators to prevent the inhalation of fumes and dust particles from beryllium metal.

• The employer must wash his hands after work. He should not eat or drink without cleaning his hands. It is better to take a shower immediately after work. This helps to prevent the spread to other family members through the skin.

• The occupational safety and health administration has set a limit of 0.2 mcg/m3 of beryllium exposure for eight hours. This is known as the permissible exposure limit (PEL). The employee must keep track of this limit strictly.

• Keep a separate shoe for the workplace to avoid foot contact with the beryllium powder. Clean the shoes regularly after work. Leave them in the workplace after work. Do not take the shoe home.

Conclusion

The individual must take necessary measures to minimize exposure to beryllium. Ensure safety regulations in the workplace to prevent berylliosis. It is the responsibility of the employer to educate the workers about the hazards. Solid beryllium is not harmful. But if the beryllium powder contacts the broken skin, it irritates. Patients with chronic beryllium disease must avoid working in an environment filled with beryllium dust. The employee must do a regular health examination and consult the physician to avoid complications of berylliosis in the future. Chronic berylliosis cannot be cured completely, but the symptoms can be controlled using medications.