BOX S-1

Statement of Task of the Committee on Beryllium Alloy Exposures

In its first report, the committee will provide an independent review of the toxicologic, epidemiologic, and other relevant data on beryllium. It will review both carcinogenic and noncarcinogenic effects. In its second report, the committee will estimate chronic inhalation exposure levels for military personnel and civilian contractor workers that are unlikely to produce adverse health effects. The committee will provide carcinogenic risk estimates for various inhalation exposure levels. It will consider genetic susceptibility among worker subpopulations. If sufficient data are available, the committee will evaluate whether beryllium-alloy exposure levels should be different from those of other forms of beryllium because of differences in particle size. The committee will identify specific tests for worker surveillance and biomonitoring. It will also comment on the utility of the beryllium lymphocyte proliferation test (BeLPT). Specifically, the committee will determine the value of the borderline or a true positive test in predicting CBD, its utility in worker surveillance, further followup tests needed for workers with positive BeLPT results (such as thin-slice computed-tomography bronchoscopy and biopsy), the likelihood of developing CBD after a true positive test, and a standardized method for achieving consistent test results in different laboratories. The committee will consider whether there are more suitable tests that would be more accurate as screening or surveillance tools. The committee will also identify data gaps relevant to risk assessment of beryllium alloys and make recommendations for further research.

The primary health effects of interest in connection with beryllium are beryllium sensitization (BeS), CBD, and lung cancer. After critically reviewing the available literature on those outcomes, the committee concluded that available scientific information does not enable the identification of an inhalation exposure that is unlikely to lead to BeS or CBD. The best approach for protecting the Air Force’s workforce from the effects of beryllium exposure is to establish a beryllium exposure- and disease-management program. The program should be designed to reduce exposure to beryllium to the lowest feasible level and should include a medical-surveillance program for identifying and following affected workers. The committee also found that uncertainties in the epidemiologic evidence limit the ability to derive quantitative carcinogenic risk estimates associated with current magnitudes of beryllium exposure. How the committee came to those conclusions and recommendations is elaborated below.

BERYLLIUM SENSITIZATION AND CHRONIC BERYLLIUM DISEASE

It is well established that beryllium can cause sensitization and CBD. BeS is an immune response triggered by beryllium exposure in susceptible people. It



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