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DOI: 10.1055/s-0039-3403062
Cluster of Beryllium-sensitized individuals may be related to beryllium-containing concrete dust
Publication History
Publication Date:
28 February 2020 (online)
Chronic beryllium disease (CBD) is a granulomatous disease with significant clinical, radiological and histological similarities to sarcoidosis. The disease can arise in individuals exposed to beryllium-containing dusts. Inhaled Beryllium induces a T-cell-dominated alveolitis and the development of non-necrotizing granulomata. CBD can be distinguished from sarcoidosis by demonstrating Beryllium sensitization that can be tested ex-vivo in a lymphocyte proliferation test (BE-LPT). For this test, peripheral blood mononuclear cells or cells obtained by bronchoalveolar lavage can be cultured with Beryllium. In Beryllium-sensitized individuals cells demonstrate an increased proliferation rate when stimulated ex-vivo with Beryllium. Typically individuals were occupationally exposed to Beryllium, when workers are exposed to dust of Beryllium containing alloys released by e.g. grinding, polishing, drilling or other dust producing activities.
Here we describe a cluster of Beryllium-sensitized workers from a non-Beryllium-related industry who were sensitized due to environmental exposure to beryllium-containing concrete dust. Initially a patient with diagnosed sarcoidosis demonstrated beryllium-sensitization, leading to the reclassification of his diagnosis as CBD. Thorough assessment of his working place did not identify a source of Beryllium. However, BeLPTs were also performed for his colleagues demonstrating Beryllium-sensitization in 5 out of 20 individuals tested.
Therefore we hypothesized an environmental factor inducing Beryllium sensitization. Further analysis revealed concrete dust used for construction works near the working place as potential source. Notably the concrete factory is located near the working place of the affected persons.
This concrete dust contained sevenfold as much Beryllium as “control” dust from a northern region of Germany (Hamburg), which supports the role of concrete dust as a potential trigger for Beryllium sensitization.