Beryllium sensitization and disease among long-term and short-term workers in a beryllium ceramics plant.

OBJECTIVE: Workers at a beryllium ceramics plant were tested for beryllium sensitization and disease in 1998 to determine whether the plant-wide prevalence of sensitization and disease had declined since the last screening in 1992; an elevated prevalence was associated with specific processes or with high exposures; exposure-response relationships differed for long-term workers hired before the last plant-wide screening and short-term workers hired since then. METHODS: Current workers were asked to complete a questionnaire and to provide blood for the beryllium lymphocyte proliferation test (BeLPT). Those with an abnormal BeLPT were classified as sensitized, and were offered clinical evaluation for beryllium disease. Task- and time-specific measurements of airborne beryllium were combined with individual work histories to compute mean, cumulative, and peak beryllium exposures for each worker. RESULTS: The 151 participants represented 90% of 167 eligible workers. Fifteen (9.9% of 151) had an abnormal BeLPT and were split between long-term workers (8/77 = 10.4%) and short-term workers (7/74 = 9.5%). Beryllium disease was detected in 9.1% (7/77) of long-term workers but in only 1.4% (1/74) of short-term workers (P = 0.06), for an overall prevalence of 5.3% (8/151). These prevalences were similar to those observed in the earlier survey. The prevalence of sensitization was elevated in 1992 among machinists, and was still elevated in 1998 among long-term workers (7/40 = 18%) but not among short-term workers (2/36 = 6%) with machining experience. The prevalence of sensitization was also elevated in both groups of workers for the processes of lapping, forming, firing, and packaging. The data suggested a positive relationship between peak beryllium exposure and sensitization for long-term workers and between mean, cumulative, and peak exposure and sensitization for short-term workers, although these findings were not statistically significant. Long-term workers with either a high peak exposure or work experience in forming were more likely to have an abnormal BeLPT (8/51 = 16%) than the other long-term workers (0/26, P = 0.05). All seven sensitized short-term workers either had high mean beryllium exposure or had worked longest in forming or machining (7/55 = 13% versus 0/19, P = 0.18). CONCLUSIONS: A plant-wide decline in beryllium exposures between the 1992 and 1998 surveys was not matched by a decline in the prevalence of sensitization and disease. Similar to findings from other studies, beryllium sensitization/disease was associated with specific processes and elevated exposures. The contrast in disease prevalence between long-term and short-term workers suggests that beryllium sensitization can occur after a short period of exposure, but beryllium disease usually requires a longer latency and/or period of exposure. The findings from this study motivated interventions to more aggressively protect and test workers, and new research into skin exposure as a route of sensitization and the contribution of individual susceptibility.

Dose-response relationships between occupational aerosol exposures and cross-shift declines of lung function in poultry workers: recommendations for exposure limits.

Numerous articles have been published regarding the adverse respiratory health consequences of working in intensive livestock and poultry housing. Threshold limit exposure guidelines are not currently applied to this environment, but they are essential to implement and monitor effective environmental controls. Previous dose-response research work with swine workers has resulted in exposure limit recommendations of 2.5 mg/m3 total dust, 0.23 mg/m3 respirable dust, 100 EU/m3 endotoxin, and 7 ppm ammonia. No similar recommendations have been reported previously for poultry workers. Therefore, an industry-wide study was conducted to examine dose-response relationships of bioaerosol exposures and worker respiratory health. A total of 257 poultry workers were studied for respiratory symptoms, pulmonary function, and exposure to dust (total and respirable), endotoxin (respirable and total), and ammonia. Details of the sampling plan and environmental assessment are described elsewhere. Relationships between exposures and response were studied by correlation and multiple regressions. Significant dose-response relationships were observed between exposures and pulmonary function decrements over a work shift. Exposure concentrations associated with significant pulmonary function decrements were as follows: 2.4 mg/m3 total dust, 0.16 mg/m3 respirable dust, 614 EU/m3 endotoxin, and 12 ppm ammonia.