The Standard for Control of Chronic Beryllium Disease

Abstract

It is now almost 50 years since 2 μg/m³ was established by the U.S. Atomic Energy Commission for control of occupational chronic beryllium disease (CBD). This was one of three standards proposed at the time to also control the acute disease and CBD from pollution of community air. Although intended to be limited to its contractors, the standard for control of CBD was soon adopted by several regulatory agencies and has remained unchanged. For several decades it was believed by many that the standard was achieving its purpose, and some specialists even suggested that the standard was unnecessarily restrictive. However, with the introduction of new diagnostic techniques beginning in the 1980s, cases have been identified that would have formerly been missed, resulting in a resurgence of cases and casting doubt on the efficacy of the existing standard. The first such doubts were raised in Japan in the 1970s, but there were major gaps in the published information that made evaluation of the data difficult. More recently, there have been two surveys of plants in the United States in which exposures are purported to have been below the standard but in which cases of CBD have been reported. The epidemiology of beryllium disease has always been confusing and the picture remains confused. While there are questions about the efficacy of the present standard, there is still no epidemiological basis for a different one. It may in time be necessary to rely on measures other than industrial hygiene controls to prevent the occurrence of diseases such as CBD that have an immunologic basis that subjects hypersensitive subsets of the work force to risk at indeterminately low exposures.