Division of Occupational and Environmental Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Am J Ind Med. 2022 Sep;65(9):708-720. doi: 10.1002/ajim.23411. Epub 2022 Jul 14.
Construction workers at U.S. Department of Energy (DOE) nuclear weapons facilities are screened to identify DOE-related occupational illnesses, including beryllium sensitization (BeS) and chronic beryllium disease (CBD). The study objectives were to estimate beryllium disease risks and the CBD claims acceptance rate in the energy workers' benefits program.
Workers diagnosed with BeS via beryllium lymphocyte proliferation test (BeLPT) included in screening examinations were interviewed about subsequent diagnosis of CBD. We estimated the proportion who developed CBD based on the ratio of CBD cases, based on self-reported compensation claim status, to all workers with BeS interviewed. We used stratified analyses to explore trends in disease frequency by age, race, sex, DOE employment duration, site, trade group, and cigarette smoking history.
Between 1998 and 2020, 21,854 workers received a BeLPT; 262 (1.20%) had BeS (two abnormals or one abnormal plus one borderline test); 212 (0.97%) had a single abnormal BeLPT. Of 177 BeS workers interviewed, 35 (19.8%) reported an accepted CBD compensation claim. The claims acceptance rate among BeS workers increased with years of DOE employment, from 8.4% with <5 years to 33.3% for >25 or more years. Five of 68 interviewed workers with a single positive BeLPT reported CBD claim acceptance; an additional CBD case was confirmed by chart review (8.8%).
Years of DOE work predict the risk of developing CBD among those sensitized and getting a claim for CBD accepted. Ongoing surveillance and increased awareness of the risk of beryllium exposure and CBD as an occupational disease among construction workers are needed.
美国能源部 (DOE) 核武器设施的建筑工人接受筛查,以确定与 DOE 相关的职业疾病,包括铍敏化 (BeS) 和慢性铍病 (CBD)。本研究的目的是估计能源工人福利计划中铍病的风险和 CBD 索赔接受率。
通过筛查检查中包含的铍淋巴细胞增殖试验 (BeLPT) 诊断为 BeS 的工人接受了 CBD 后续诊断的访谈。我们根据基于自我报告的赔偿索赔状况的 CBD 病例比例,基于基于自我报告的赔偿索赔状况,估计了 CBD 病例的比例,所有接受 BeS 访谈的工人中 CBD 病例的比例。我们使用分层分析来探讨按年龄、种族、性别、DOE 就业时间、地点、行业群体和吸烟史划分的疾病频率趋势。
1998 年至 2020 年间,21854 名工人接受了 BeLPT 检查;262 人(1.20%)患有 BeS(两个异常或一个异常加一个边缘测试);212 人(0.97%)单次 BeLPT 异常。在接受 BeS 检查的 177 名工人中,有 35 人(19.8%)报告了 CBD 赔偿索赔。随着 DOE 就业年限的增加,BeS 工人的索赔接受率也在增加,从 5 年以下的 8.4%到 25 年以上的 33.3%。在接受采访的 68 名单次 BeLPT 阳性工人中,有 5 人报告 CBD 索赔被接受;通过病历审查额外确认了一个 CBD 病例(8.8%)。
DOE 工作年限预测了致敏工人中 CBD 的发病风险,并接受了 CBD 的索赔。需要对建筑工人的铍暴露和 CBD 作为职业疾病的风险进行持续监测和提高认识。