Donovan Ellen P, Kolanz Marc E, Galbraith David A, Chapman Pamela S, Paustenbach Dennis J
ChemRisk, Inc., 25 Jessie St. at Ecker Square, Suite 1800, San Francisco, CA 94105, USA.
Int Arch Occup Environ Health. 2007 Nov;81(2):165-78. doi: 10.1007/s00420-007-0202-3. Epub 2007 May 5.
Data from surveys of the general workforce and new employees at a beryllium manufacturer were used to evaluate the performance of the beryllium blood lymphocyte proliferation test (BeBLPT).
Over 10,000 results from nearly 2,400 participants collected over 12 years were analyzed using consistent criteria to describe the performance characteristics of the BeBLPT.
Approximately 2% of new employees had at least one positive BeBLPT result at the time of hire, and approximately 1% of new employees with no known potential occupational or possible take-home exposures to beryllium were confirmed positive (two positive results) from the time of hire. Positive results were observed in some workers within weeks or months of initial exposure, and the median time to the first positive result in confirmed positive individuals was 5 months. The prevalence of positive BeBLPT results was greatest during the first year of employment with an apparent peak in months 4-8. At least one negative or borderline/negative result was observed in 100% of new workers who underwent follow-up testing after they had been confirmed positive. There was no correlation between time of employment and an increasing prevalence of confirmed positive BeBLPT results in individual surveys; however, the cumulative incidence of confirmed positive results in subsets of workers that participated in multiple surveys increased over time.
The detection of confirmed positive results in non-occupationally exposed persons, the apparent reversions of previously confirmed positive results, the identification of a positive BeBLPT peak prevalence period, and the variation in intra- and inter-laboratory test methods and interpretation should be considered when interpreting results from studies utilizing the BeBLPT, especially when considering worker-specific interventions. Additional research to refine the BeBLPT or develop a new test is needed to properly characterize the relationship between sensitization and subclinical or clinical indicators of chronic beryllium disease.
利用对一家铍制造商的普通员工和新员工的调查数据，评估铍血淋巴细胞增殖试验（BeBLPT）的性能。
对12年期间收集的近2400名参与者的10000多个结果进行分析，使用一致的标准来描述BeBLPT的性能特征。
大约2%的新员工在入职时至少有一次BeBLPT阳性结果，大约1%的新员工在入职时被确认阳性（两次阳性结果），这些新员工没有已知的潜在职业或可能的家庭铍接触史。在初次接触后的数周或数月内，一些工人出现了阳性结果，确诊阳性个体首次出现阳性结果的中位时间为5个月。BeBLPT阳性结果的患病率在就业的第一年最高，在第4至8个月出现明显峰值。在所有被确认阳性后接受随访检测的新员工中，100%至少有一次阴性或临界/阴性结果。在个体调查中，就业时间与确诊阳性BeBLPT结果患病率的增加之间没有相关性；然而，参与多次调查的工人亚组中确诊阳性结果的累积发病率随时间增加。
在解释使用BeBLPT的研究结果时，尤其是在考虑针对工人的干预措施时，应考虑在非职业暴露人群中检测到确诊阳性结果、先前确诊阳性结果的明显逆转、确定BeBLPT阳性患病率高峰期以及实验室内部和实验室之间检测方法和解释的差异。需要进一步研究以完善BeBLPT或开发新的检测方法，以正确表征致敏与慢性铍病亚临床或临床指标之间的关系。
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