CURRENT CONCEPTS OF BERYLLIUM POISONING

Abstract

The author and his colleagues have had the opportunity of observing all of the clinical manifestations of beryllium poisoning since 1940. Examples of each are shown, including the clinical and pathologic findings. A summary of the extensive and excellent research work being carried out in various parts of the country and elsewhere is presented. It has been demonstrated clearly that the eczematous contact type dermatitis in Be workers is a hypersensitization phenomena. There is much to suggest that the acute Be lung problem may also be an allergic reaction. Facts and theories have been presented as to the pathogenesis of the chronic granulomatous form of the disease. Independent research conducted at 3 places in this country and one in Great Britain suggests that Be has an inhibitory effect on alkaline phosphatase. The hypothesis that Be may compete for Mg in Mg-activated enzymes may provide an explanation of the toxic properties of Be, although much remains to be clarified. Expansion of our knowledge of this occupational disease may give basic clues to the body''s reactions in the large group of granulomatous diseases. Multiple treatments have been employed, but no specific antidote has been found. ACTH and cortisone therapy have been encouraging and have produced noticeable symptomatic benefits; they have proved to exert a regressive influence in a number of patients demonstrating the chronic and progressive granulomatous forms of the disease. A remarkable reduction in the incidence of Be poisoning has occurred since the institution of safety engineering and industrial hygiene in the involved industries.