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Crooks J, Mroz MM, VanDyke M, McGrath A, Schuler C, McCanlies EC, Virji MA, Rosenman KD, Rossman M, Rice C, Monos D, Fingerlin TE, Maier LA. HLA-DPB1 E69 genotype and exposure in beryllium sensitisation and disease. Occup Environ Med 2022; 79:120-126. [PMID: 34535537 PMCID: PMC8760148 DOI: 10.1136/oemed-2021-107736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/09/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Human leukocyte antigen-DP beta 1 (HLA-DPB1) with a glutamic acid at the 69th position of the ß chain (E69) genotype and inhalational beryllium exposure individually contribute to risk of chronic beryllium disease (CBD) and beryllium sensitisation (BeS) in exposed individuals. This retrospective nested case-control study assessed the contribution of genetics and exposure in the development of BeS and CBD. METHODS Workers with BeS (n=444), CBD (n=449) and beryllium-exposed controls (n=890) were enrolled from studies conducted at nuclear weapons and primary beryllium manufacturing facilities. Lifetime-average beryllium exposure estimates were based on workers' job questionnaires and historical and industrial hygienist exposure estimates, blinded to genotype and case status. Genotyping was performed using sequence-specific primer-PCR. Logistic regression models were developed allowing for over-dispersion, adjusting for workforce, race, sex and ethnicity. RESULTS Having no E69 alleles was associated with lower odds of both CBD and BeS; every additional E69 allele increased odds for CBD and BeS. Increasing exposure was associated with lower odds of BeS. CBD was not associated with exposure as compared to controls, yet the per cent of individuals with CBD versus BeS increased with increasing exposure. No evidence of a gene-by-exposure interaction was found for CBD or BeS. CONCLUSIONS Risk of CBD increases with E69 allele frequency and increasing exposure, although no gene by environment interaction was found. A decreased risk of BeS with increasing exposure and lack of exposure response in CBD cases may be due to the limitations of reconstructed exposure estimates. Although reducing exposure may not prevent BeS, it may reduce CBD and the associated health effects, especially in those carrying E69 alleles.
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Affiliation(s)
- James Crooks
- Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, Colorado, USA
| | - Margaret M Mroz
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | - Michael VanDyke
- Department of Environmental & Occupational Health, Colorado School of Public Health, Aurora, Colorado, USA
| | - Alison McGrath
- Environmental Health and Safety, University of Colorado, Denver, Colorado, USA
| | - Christine Schuler
- DRDS/Field Studies Branch, U.S. National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Erin C McCanlies
- HELD, Health Effects Laboratory, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - M Abbas Virji
- DRDS/Field Studies Branch, U.S. National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Kenneth D Rosenman
- Department of Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Milton Rossman
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Carol Rice
- Department of Environmental & Public Health Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - Dimitri Monos
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tasha E Fingerlin
- Center for Genes, Environment & Health, National Jewish Health, Denver, Colorado, USA
| | - Lisa A Maier
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
- Department of Medicine, University of Colorado, Denver, Colorado, USA
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MacMurdo MG, Mroz MM, Culver DA, Dweik RA, Maier LA. Chronic Beryllium Disease: Update on a Moving Target. Chest 2020; 158:2458-2466. [PMID: 32768458 DOI: 10.1016/j.chest.2020.07.074] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/05/2020] [Accepted: 07/19/2020] [Indexed: 10/23/2022] Open
Abstract
Beryllium exposure remains an ongoing occupational health concern for workers worldwide. Since the initial Occupational Safety and Health Administration (OSHA) ruling on a permissible exposure limit (PEL) for beryllium in 1971, our understanding of the risks of beryllium sensitization and chronic beryllium disease (CBD) has evolved substantially. A new OSHA ruling released in early 2017 and implemented in late 2018 reduced the PEL for beryllium, increased requirements for medical screening and monitoring, and may ultimately enhance worker protection. This review highlights advances in our understanding of the pathway from beryllium exposure to sensitization and progression to CBD that guided the development of this OSHA ruling. Screening workers exposed to beryllium and management of CBD will also be discussed. Finally, we will discuss the role of beryllium as a cause of morbidity and mortality among exposed workers in this potentially preventable occupational lung disease.
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Affiliation(s)
| | - Margaret M Mroz
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO
| | | | - Raed A Dweik
- Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Lisa A Maier
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO
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Lack of an Exposure Response and Interaction With HLA-DPβ1 and DRβ1 Polymorphisms in the Development of Beryllium Toxicity in a High Beryllium Exposure Cohort. J Occup Environ Med 2019; 62:64-73. [PMID: 31743304 DOI: 10.1097/jom.0000000000001766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate interaction of HLA-DPβ1 and DRβ1 polymorphisms with metrics of beryllium exposure, in the development of beryllium sensitization (BeS) and chronic beryllium disease (CBD). METHODS A matched case-control study of 61 CBD, 41 BeS, and 259 controls from two beryllium-processing facilities. RESULTS BES and CBD were significantly associated with presence of DPβE69. Dose response of exposure was not observed for the development of BES and CBD with/without adjustment for DPβE69 (P > 0.05). The DRβE71 polymorphism was more common in BeS than CBD after adjusting for exposure and maybe a protective factor (aOR 0.4, 95% CI 0.2 to 0.9) against the progression of BeS to CBD. CONCLUSION No exposure-response association was found, which may reflect that the workers in this high exposure cohort were above a threshold level where an exposure-response could be observed.
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Cummings KJ, Johns DO, Mazurek JM, Hearl FJ, Weissman DN. NIOSH's Respiratory Health Division: 50 years of science and service. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2019; 74:15-29. [PMID: 30501580 PMCID: PMC6490691 DOI: 10.1080/19338244.2018.1532387] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The year 2017 marked the 50th anniversary of NIOSH's Respiratory Health Division (RHD). RHD began in 1967 as the Appalachian Laboratory for Occupational Respiratory Diseases (ALFORD), with a focus on coal workers' pneumoconiosis. ALFORD became part of NIOSH in 1971 and added activities to address work-related respiratory disease more generally. Health hazard evaluations played an important role in understanding novel respiratory hazards such as nylon flock, diacetyl, and indium-tin oxide. Epidemiologic and laboratory studies addressed many respiratory hazards, including coal mine dust, silica, asbestos, cotton dust, beryllium, diesel exhaust, and dampness and mold. Surveillance activities tracked the burden of diseases and enhanced the quality of spirometry and chest radiography used to screen workers. RHD's efforts to improve scientific understanding, inform strategies for prevention, and disseminate knowledge remain important now and for the future.
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Affiliation(s)
- Kristin J. Cummings
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Doug O. Johns
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Jacek M. Mazurek
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Frank J. Hearl
- Office of the Director, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Washington, DC, USA
| | - David N. Weissman
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
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