Berylliosis

One of the variants of pneumoconiosis is berylliosis, which is caused by dust or vapors of metallic beryllium that is widely used in space, aviation and nuclear engineering, rocketry, instrument making, etc. Therefore, beryllium intoxication is possible in employees of the above-mentioned industries who have contact with metallic beryllium or its compounds, as well as in workers of the mining industry who extract beryllium from ore. The incidence of berylliosis among workers who have contact with beryllium and its compounds is 0.3%–7.5%. People with different contact periods became sick from several days to 10 or more years. However, no direct relationship was found between the concentration of a toxic substance in the body and the severity of intoxication. The pathogenesis of the toxic effects of beryllium and its compounds is not definitively realized. Numerous scientific studies have established their toxic, pro-inflammatory, allergic, and carcinogenic effects. Berylliosis has acute and chronic forms. Acute forms are relatively rare and usually occur in emergencies in smelting or casting shops of industrial enterprises and mild, moderate, or severe forms. Outcomes of acute beryllium poisoning vary from complete recovery with complete normalization of the X-ray findings to the development of interstitial pneumosclerosis with interstitial lung tissue compaction, transition to a chronic form, or death. The mortality rate in beryllium pneumonia reaches 20%. Death occurs at 2–3 weeks of the disease, and in extremely severe cases, patients die on the first day due to respiratory center paralysis. Chronic berylliosis is either the outcome of acute intoxication with beryllium and its compounds or as a primary chronic form that occurs in interstitial or granulomatous forms. The prognosis depends on prompt disease detection and treatment initiation. Berylliosis diagnosis is based on the data of a professional history assessment, information about possible beryllium contact, and a characteristic clinical and radiological picture and positive beryllium tests. A lung biopsy is performed for diagnosis in severe cases. Berylliosis has no specific treatment, thus the therapy is exclusively pathogenetic and symptomatic. The scope and treatment measures depend on the form, disease severity and stage, and depth of the respiratory system lesion. Berylliosis prevention includes the improvement of the production process and use of air-purifying respirators and special protective clothing to limit contact with beryllium and its compounds that are contained in the surrounding air, which refers to preliminary and periodic medical examinations that are performed once every 2 years. The examination of the patient’s ability to work should be decided with the stages of berylliosis and pathological process activities.