Chronic beryllium disease among dental technicians in Israel

Background and aim: The potential risks of beryllium use in the dental industry have been recognized for some time. This is the first case series that focuses on the effect of a number of potentially harmful effects of substances that induce lung disease among dental technicians with emphasis on beryllium as a major risk factor in the work environment of dental technicians. Methods: All the dental technicians consecutively recruited to this study had past occupational exposure to beryllium. They were evaluated in order to confirm immunological evidence of beryllium exposure for differential diagnosis between sarcoidosis and chronic beryllium disease (CBD). They were tested for beryllium sensitization by the beryllium lymphocyte proliferation test (BeLPT), and underwent lung function and induced sputum (IS) studies. Each had earlier undergone a comprehensive evaluation that included high-resolution computerized tomography, bronchoscopy and transbronchial biopsy to establish the final diagnosis of their condition. Results: There were 24 enrollees (mean age 49.7 ± 13.7 years, 17 males, 7 females) of whom 12 (50%) had positive BeLPT findings and were finally diagnosed as suffering from CBD, 7 (29%) had negative BeLPT findings and were diagnosed as suffering from another pulmonary pathology (sarcoidosis, chronic obstructive pulmonary disease, rejection of transplanted lung), and 5 (20.8%) had negative BeLPT findings and were diagnosed as being free of pulmonary disease. Conclusion: This case series study demonstrates that dental technicians are exposed to beryllium and various other occupational dusts and chemicals and are at high risk of developing CBD and other lung diseases. Our findings emphasize the need for awareness of the medical community to detect occupation related diseases in this profession.