The occurrence of chronic beryllium (7440417) disease in a precious metal refinery was investigated. Five workers at a facility that refined and reclaimed gold and silver from industrial scrap (SIC- 3341) developed granulomatous lung disease between 1972 and 1985. The patients were males, four Hispanics and one black, aged 31 to 41 years. The original diagnosis was sarcoidosis. Immunologic studies were performed on the four Hispanic patients utilizing in-vitro proliferative responses of lymphocytes obtained by bronchoalveolar lavage. Hypersensitivity to beryllium salts was found. The entire work force at the facility was surveyed by questionnaire and by review of prior X-rays and spirometry results for evidence of granulomatous lung disease. No current workers had radiographic or spirometric evidence suggestive of chronic beryllium disease. Industrial hygiene air monitoring of the facility showed beryllium concentrations of 0.22 to 42.3 micrograms per cubic meter (microg/m3), mean 1.2microg/m3. Ten percent of the samples were in excess of the current permissible exposure limit of 2.0microg/m3. Moderate concentrations of other metal contaminants, such as arsenic (7440382), lead (7439921), and cadmium (7440439), were also found. The authors conclude that chronic beryllium disease mimicking sarcoidosis still occurs from modern industrial exposures. A significant risk for chronic beryllium disease exists among approximately 30000 to 800000 American workers exposed to beryllium, especially those, workers, who smelt, burn, refine, or weld the metal or its alloys, possibly even if exposure concentrations are below presently adopted standards.