Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Health, Denver, Colorado 80206, USA.
Am J Ind Med. 2009 Oct;52(10):762-73. doi: 10.1002/ajim.20736.
Workplace surveillance identifies chronic beryllium disease (CBD) but it remains unknown over what time frame mild CBD will progress to a more severe form.
We examined physiology and treatment in 229 beryllium sensitization (BeS) and 171 CBD surveillance-identified cases diagnosed from 1982 to 2002. Never smoking CBD cases (81) were compared to never smoking BeS patients (83) to assess disease progression. We compared CBD machinists to non-machinists to examine effects of exposure.
At baseline, CBD and BeS cases did not differ significantly in exposure time or physiology. CBD patients were more likely to have machined beryllium. Of CBD cases, 19.3% went on to require oral immunosuppressive therapy. At 30 years from first exposure, measures of gas exchange were significantly worse and total lung capacity was lower for CBD subjects. Machinists had faster disease progression as measured by pulmonary function testing and gas exchange.
Medical surveillance for CBD identifies individuals at significant risk of disease progression and impairment with sufficient time since first exposure.
工作场所监测可识别慢性铍病（CBD），但铍致敏患者（BeS）中轻度 CBD 进展为更严重形式需要多长时间尚不清楚。
我们对 1982 年至 2002 年间诊断的 229 例铍致敏（BeS）和 171 例 CBD 监测确定的病例进行了生理学和治疗检查。从未吸烟的 CBD 病例（81 例）与从未吸烟的 BeS 患者（83 例）进行了比较，以评估疾病进展情况。我们比较了 CBD 机械师和非机械师，以检查暴露的影响。
在基线时，CBD 和 BeS 病例在暴露时间或生理学方面没有显著差异。CBD 患者更有可能接触过铍加工。在 CBD 病例中，有 19.3%的患者需要口服免疫抑制治疗。从首次接触到 30 年时，CBD 患者的气体交换测量值明显更差，肺活量更低。通过肺功能测试和气体交换测量，机械师的疾病进展更快。
对 CBD 的医学监测可识别出有足够长的首次接触时间后，处于疾病进展和受损高风险的个体。
