An official American Thoracic Society statement: diagnosis and management of beryllium sensitivity and chronic beryllium disease

Rationale: Beryllium continues to have a wide range of industrial applications. Exposure to beryllium can lead to sensitization (BeS) and chronic beryllium disease (CBD). Objectives: The purpose of this statement is to increase awareness and knowledge about beryllium exposure, BeS, and CBD. Methods: Evidence was identified by a search of MEDLINE. The committee then summarized the evidence, drew conclusions, and described their approach to diagnosis and management. Main Results: The beryllium lymphocyte proliferation test is the cornerstone of both medical surveillance and the diagnosis of BeS and CBD. A confirmed abnormal beryllium lymphocyte proliferation test without evidence of lung disease is diagnostic of BeS. BeS with evidence of a granulomatous inflammatory response in the lung is diagnostic of CBD. The determinants of progression from BeS to CBD are uncertain, but higher exposures and the presence of a genetic variant in the HLA-DP β chain appear to increase the risk. Periodic evaluation of affected individuals can detect disease progression (from BeS to CBD, or from mild CBD to more severe CBD). Corticosteroid therapy is typically administered when a patient with CBD exhibits evidence of significant lung function abnormality or decline. Conclusions: Medical surveillance in workplaces that use beryllium-containing materials can identify individuals with BeS and at-risk groups of workers, which can help prioritize efforts to reduce inhalational and dermal exposures. Read More: http://www.atsjournals.org/doi/abs/10.1164/rccm.201409-1722S

Lung cancer (exposure assessment, pathology, and epidemiology)

Lung cancer is the most common malignancy worldwide and the most common cause of a cancer-related death. Tobacco smoking is the most important cause of lung cancer in most populations although occupational exposures cause an increased risk of lung cancer more than any other malignancy. This chapter will review the histomorphology and classification of carcinoma of the lung and the evidence for specific occupational exposures reported to cause lung cancer. © Springer-Verlag London 2014