ally observed only at high doses. ATSDR (2002) provides a comprehensive review of both human and animal data. Cardiovascular effects in humans (cor pulmonale) and animals (heart enlargement or decreased arterial oxygen tension) were judged to be probably secondary to lung disease. Human case studies did not report significant effects on hematologic measures, but intermediate-duration, high-dose exposures caused anemia in several species. Hepatic effects, other than granulomas, have not been reported in humans or animals. Kidney stones and increased blood and urinary calcium have been reported in people with CBD, and a cohort mortality study of beryllium workers found an increased risk of death from chronic and unspecified nephritis, renal failure, and other renal sclerosis (Ward et al. 1992). Renal effects in animals were noted by ATSDR (2002) to be minor at sublethal doses. Some adrenal effects have been reported in animals. Neurologic effects have not been noted in humans or animals after inhalation of beryllium. No literature published after the ATSDR review that would cause increased concern about extrapulmonary effects of beryllium compounds was identified.
Studies of the extrapulmonary effects of different forms of beryllium have not comprehensively evaluated doses relevant to current occupational exposures, but there is little indication that such studies would yield useful information. Studies of reproductive and development effects and studies of other extrapulmonary effects have generally been conducted only at doses higher than the lowest doses that induce CBD or cancer. The committee concludes that effects other than cancer and sensitization that leads to CBD do not need to be considered in establishing worker health-protection standards. Protection against such health effects will be afforded by exposure guidance designed to prevent CBD or cancer.