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Acute beryllium poisoning
Specialty	Emergency medicine

Acute beryllium poisoning is acute illness resulting from the toxic effect of beryllium in its elemental form or in various chemical compounds, and is distinct from berylliosis (also called chronic beryllium disease). The toxicity of beryllium depends upon the duration, intensity and frequency of exposure (features of dose), as well as the form of beryllium and the route of exposure (i.e. inhalation, dermal, ingestion).

Although the use of beryllium compounds in fluorescent lighting tubes was discontinued in 1949, potential for exposure to beryllium exists in the nuclear weapons production and aerospace industries and in the refining of beryllium metal and melting of beryllium-containing alloys, the manufacturing of electronic devices, and the handling of other beryllium-containing material.

Classification

Acute beryllium poisoning is an occupational disease.

Signs and symptoms

Acute beryllium pneumonitis produces severe cough (occasionally with blood-streaked sputum), chest pain or burning, and shortness of breath. Beryllium can cause local irritation and contact dermatitis and contact with skin that has been scraped or cut may cause rashes or ulcers. Beryllium dust or powder can irritate the eyes.

Causes

Acute beryllium disease is a rapid onset form of chemical pneumonia that results from breathing high airborne concentrations of beryllium. ABD is generally associated with exposure to beryllium levels at or above 100 μg/m.

Diagnosis

There is no specific diagnostic test for acute beryllium disease. Biopsy of the lungs reveals a nonspecific granulomatous inflammation. The chest X-ray can reveal diffuse, bilateral alveolar infiltrates.

Management

Therapy is supportive and includes removal from further beryllium exposure. Treatment is supportive, including oxygen supplementation as needed, and removal from further beryllium exposure. Corticosteroids are sometimes tried, but no good controlled studies are reported.

Outcomes

The signs and symptoms of acute beryllium pneumonitis usually resolve over several weeks to months, but be may be fatal in 10 percent of cases, and about 15–20% of cases may progress to CBD.

Epidemiology

After occupational safety procedures were put into place following the realization that the metal caused berylliosis, as of 2016 acute beryllium poisoning was considered to be extremely rare.

History

Acute beryllium disease was first reported in Europe in 1933 and in the United States in 1943.

References

1. ^ OSHA Beryllium Health Effects Page accessed March 29, 2016
2. Tepper LB, Hardy HL, Chamberlain RI. Toxicity of beryllium compounds. In: Browning E, Ed. Elsevier monographs on toxic agents. Amsterdam: Elsevier Publishing Co.; 1961. pp1-190.
3. Agency for Toxic Substances and Disease Registry via the CDC. TOX FAQs: Beryllium Page last reviewed: March 3, 2011. Page last updated: June 3, 2015
4. NIOSH International Chemical Safety Cards: Beryllium Page last reviewed: July 22, 2015. Page last updated: July 1, 2014
5. Hardy, HL (1965). "Beryllium poisoning--lessons in control of man-made disease". The New England Journal of Medicine. 273 (22): 1188–99. doi:10.1056/NEJM196511252732205. PMID 5847559.
6. Lang, Leslie (June–July 1994). "Beryllium: A Chronic Problem". Environmental Health Perspectives. 102 (6–7): 526–31. doi:10.1289/ehp.94102526. PMC 1569745. PMID 9679108.

 This article incorporates public domain material from Beryllium. Occupational Safety and Health Administration. Retrieved 28 March 2016.

• Use dmy dates from June 2013
• Beryllium
• Toxic effects of metals