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• W6891004 abstract "Exposure to metals in the workplace can result in a spectrum of lung diseases from a self-limited metal-fume fever to asthma to interstitial lung disease. Berylliosis, or chronic beryllium disease (CBD), is an immune-mediated pulmonary granulomatous disease that results from the inhalation of respirable particulate beryllium. Of those workers exposed, some will develop an immune sensitivity to beryllium without disease known as beryllium sensitization (BeS), while others will develop the chronic disease. Increased risk of disease is evident in machinists producing a fine beryllium aerosol, and in individuals with a specific human leukocyte antigen class II HLA-DPB1 with a glutamic acid residue at amino acid position 69. It is likely that gene-by-environment interactions are important in disease pathogenesis, although this has not been well defined to date. The cell-mediated (type IV) hypersensitivity reaction in which beryllium probably functions as a hapten, results from the interaction of class II restricted antigen-presenting cells and CD4 + cells. Release of the cytokines tumor necrosis factor alpha (TNF- α ) and interferon gamma (IFN- γ ) promotes proliferation and local accumulation of beryllium-specific CD4 + T cells leading to progressive granuloma formation and end-stage fibrosis. The proliferative response to beryllium is assessed in a diagnostic test, the beryllium lymphocyte proliferation test (BeLPT), which detects BeS, a precursor to CBD, and CBD at an early stage, and differentiates it from other lung diseases. Individuals with BeS have no evidence of pulmonary impairment, while individuals with CBD may have a variable manifestation. The disease presentation ranges from asymptomatic individuals without evidence of radiographic or physiologic impairment to those with severe disabling symptoms and physiology along with chest radiographic abnormalities consistent with an interstitial disease. Although there is no cure for CBD, standard of care includes removal from exposure and use of immunosuppressant agents, such as corticosteroids. To reduce the burden of disease, exposure to beryllium should be reduced to levels below the current standards and the BeLPT should be used in medical surveillance to detect BeS and CBD at an early stage, before irreversible impairment occurs." @default.
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• W6891004 date "2006-01-01" @default.
• W6891004 modified "2023-10-14" @default.
• W6891004 title "OCCUPATIONAL DISEASES | Hard Metal Diseases – Berylliosis and Others" @default.
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• W6891004 doi "https://doi.org/10.1016/b0-12-370879-6/00271-4" @default.
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