NORA Manufacturing Sector Strategic Goals
9278208 - Beryllium Disease Surveillance/ResearchStart Date: 10/1/1997
End Date: 9/30/2012
Principal Investigator (PI)Name: Christine Schuler
Funded By: NIOSH
Primary Goal Addressed5.0
Secondary Goal Addressed
Attributed to Manufacturing
Chronic beryllium disease is a lung disease that occurs in workers who become sensitized to the metal in such manufacturing sector industries as metal fabrication, nuclear, dental laboratory work, and electronics applications, among others. This research is focused on understanding key risk factors predicting beryllium-related health outcomes so that preventive strategies can be implemented and evaluated. This work will contribute to prevention of beryllium disease by showing which beryllium work environments are hazardous, which exposure metrics best predict disease, the role of dermal exposure in sensitization, genetic risk factors, and gene-environment interactions.
The primary goal of the longitudinal beryllium research program is to understand key risk factors predicting beryllium-related health outcomes so that preventive strategies can be implemented and evaluated. The specific aims of this longitudinal research include developing biologically-relevant exposure estimates for epidemiologic investigation, evaluating potential new metrics for assessing beryllium exposure, such as the size, shape and chemical form of inhaled beryllium particles, in relation to risk of beryllium sensitization and chronic beryllium disease (CBD); evaluating the role of dermal exposure with respect to risk of sensitization; and evaluating the interaction of genetic markers and beryllium exposure in sensitization and CBD. The project team is multidisciplinary, comprising epidemiologists, industrial hygienists, physicians, genetic researchers and others from two NIOSH divisions, and collaborates and communicates with researchers from several other divisions. The project team also works in partnership with the primary US producer of beryllium and beryllium-containing products, which has been sharing its medical and environmental surveillance data with NIOSH since 1998 under a Memorandum of Understanding. The project team has access to information collected on two cohorts of this company's workers who were first screened in 1992-94 and has conducted follow-up testing and interviewing of former workers from these groups. The industry collaboration has enabled research results to be made immediately available for communication to the workplace and for use in preventive efforts. This longitudinal follow-up study of current and former beryllium workers will provide up to 15 years follow-up for beryllium sensitization and disease in relation to new metrics for beryllium exposure to the lungs and skin and in relation to genetic characteristics. The stability of NIOSH institutional commitment is especially important in that the longitudinal aspect of this work is critical for determining true burden of disease in relation to risk factors, since academic investigators are often unable to undertake longitudinal follow-up studies. We are still analyzing the data collected thus far, and the relationship of the physicochemical characterization and dermal exposure research that are continuing through NORA 2007 projects to the epidemiologic data have yet to be evaluated. Products of this research have and will include peer-reviewed scientific publications; a beryllium alert; communications at worker, company, and public health meetings; and newsletter communications to study participants.
Ongoing bimonthly and biennial meetings with our research collaborators will allow us to determine how research results are being used to refine and/or improve their comprehensive preventive program. Successful development of an experimental mouse model will lead to that model's commercial availability to the wider research community. Discussions with OSHA will enable us to determine how they use these results in considering the current occupational exposure limit and how it may be improved.
This research is focused on the prevention of chronic beryllium disease (CBD), a lung disease that occurs in workers who become sensitized to the metal in metal fabrication, the nuclear industry, dental laboratory work, and electronics applications, among others. As many as 134,000 current US workers may have occupational exposure to beryllium. And, as use of beryllium has become more widespread, sensitization and CBD are also being identified in previously unsuspected areas and industries. The lifetime risk of sensitization and CBD among some cohorts of primary industry workers may be as high as 16% and 11%, respectively. The work in this program is targeted to the NORA Program Portfolio Manufacturing sector. It contributes to the NIOSH Cross-Sector programs in Respiratory Diseases and Exposure Assessment, and may have relevance for Immune and Dermal Diseases, Communication and Information Dissemination, and Surveillance. This research arose from needs identified by company medical surveillance, and the company's ongoing preventive interventions are informed by research results. The program is primarily epidemiologic, and is designed to assess prevalence, process-related risks, exposure-response relations, and gene-environment interactions among primary beryllium industry workers. OSHA has placed beryllium on its regulatory agenda, and information about exposure-response relations resulting from this project's research will be critical for standard setting. Program outcomes are also critical to companies and trade unions trying to protect their workers, or in planning medical surveillance appropriate for particular exposure categories. The Department of Energy (DOE) has responsibility for medical surveillance of thousands of current and former beryllium workers. The Energy Workers Occupational Illness Compensation Program, administered by the Department of Labor for DOE, provides medical and monetary benefits to workers with beryllium-related health effects who contributed to Cold War defense efforts. Accordingly, this research will be pertinent to the current and future efforts of DOE to improve the health of its former and current beryllium workers.
Strategic Goal 5 (09PPMNFSG5): Reduce the number of respiratory conditions and diseases due to exposures in the manufacturing sector.
– This project will contribute to the following intermediate and activity/output goals: (09PPRDRAOG2.4.3): perform a cohort study assessing the longitudinal development of immunological sensitization to beryllium and chronic beryllium disease in workers at a beryllium oxide/ceramics plant over an eleven-year follow-up period;
– (09PPRDRAOG2.4.4): develop, refine and validate improved methods to assess exposure to beryllium; and determine whether complex exposure metrics taking estimated dissolved beryllium dose and dermal exposure into account are better predictors of adverse health effects than simple mass-based exposure metrics;
– (09PPRDRAOG2.4.5): perform epidemiological and laboratory studies to elucidate mechanisms of beryllium-induced disease, including studies that clarify the role of genetic susceptibility in developing immunological sensitization to beryllium and chronic beryllium disease; and the role of gene-environment interactions;
– (09PPEXAAOG1.1.3): Production of new or improved statistical approaches to exposure assessment sampling, including treatment of results below the limit of quantification and below the limit of detection, as well as treatment of within worker and between worker variability.
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