Kreiss K, Mroz M M, Zhen B, Martyny J W, Newman L S
Occupational and Environmental Medicine Division, National Jewish Center for Immunology and Respiratory Medicine, Denver, CO 80206.
Am Rev Respir Dis. 1993 Oct;148(4 Pt 1):985-91. doi: 10.1164/ajrccm/148.4_Pt_1.985.
We examined the epidemiology of chronic beryllium disease among a stratified, random sample (n = 895) of nuclear weapons workers using the blood beryllium lymphocyte transformation (BeLT) test and chest radiograph for case identification. Of 18 new cases of beryllium sensitization, 12 had beryllium disease, and three more developed pulmonary granulomas on lung biopsy over the succeeding 2 yr. Beryllium-sensitized cases did not differ from noncases in age, gender, race, ethnicity, smoking, most respiratory symptoms, spirometric or radiographic abnormalities, or job tenure. The six sensitized cases without initial disease differed from beryllium disease cases in having greater pack-years of smoking. Sensitization occurred among workers with inadvertent or bystander exposure, such as a secretary and security guard. However, beryllium sensitization risk was higher for machinists (4.7%) and for persons reporting measured overexposure (7.4%, odds ratio 5.1); exposure beginning before 1970 (3.6%, odds ratio 2.7); consistent beryllium exposure (3.4%); and sawing (4.7%) or band sawing (6.0%) of beryllium metal. We conclude that both individual susceptibility to sensitization and exposure circumstances are important in developing disease.
我们使用血液铍淋巴细胞转化（BeLT）试验和胸部X光片对核武器工作者的分层随机样本（n = 895）进行了慢性铍病的流行病学调查，以识别病例。在18例新的铍致敏病例中，12例患有铍病，另外3例在随后的2年中经肺活检发现出现了肺部肉芽肿。铍致敏病例与非病例在年龄、性别、种族、民族、吸烟情况、大多数呼吸道症状、肺功能或影像学异常以及工作年限方面没有差异。6例最初未患病的致敏病例与铍病病例的不同之处在于吸烟包年数更多。致敏发生在意外接触或旁观者接触的工人中，如一名秘书和一名保安。然而，机械师的铍致敏风险更高（4.7%），报告有测量到的过度暴露的人员的铍致敏风险更高（7.4%，比值比为5.1）；1970年前开始接触（3.6%，比值比为2.7）；持续接触铍（3.4%）；以及铍金属锯切（4.7%）或带锯切割（6.0%）。我们得出结论，个体对致敏的易感性和接触情况在疾病发展中都很重要。
