Beryllium hypersensitivity and chronic beryllium lung disease

Beryllium contamination and its risk management in terrestrial and aquatic environmental settings

Beryllium (Be) is a relatively rare element and occurs naturally in the Earth's crust, in coal, and in various minerals. Beryllium is used as an alloy with other metals in aerospace, electronics and mechanical industries. The major emission sources to the atmosphere are the combustion of coal and fossil fuels and the incineration of municipal solid waste. In soils and natural waters, the majority of Be is sorbed to soil particles and sediments. The majority of contamination occurs through atmospheric deposition of Be on aboveground plant parts. Beryllium and its compounds are toxic to humans and are grouped as carcinogens. The general public is exposed to Be through inhalation of air and the consumption of Be-contaminated food and drinking water. Immobilization of Be in soil and groundwater using organic and inorganic amendments reduces the bioavailability and mobility of Be, thereby limiting the transfer into the food chain. Mobilization of Be in soil using chelating agents facilitates their removal through soil washing and plant uptake. This review provides an overview of the current understanding of the sources, geochemistry, health hazards, remediation practices, and current regulatory mandates of Be contamination in complex environmental settings, including soil and aquatic ecosystems.

Health aspects of exposure to emissions from burning coal of high beryllium content: interactions with the immune system

Beryllium has an impact on the human health of professionally or non-occupationally exposed people. Current evidence suggests that beryllium acts as a hapten with limited antigenic properties and is presented by antigen presenting cells to CD4⁺ T cells, which possess specific antigen receptors. The immunological changes in humoral immunoreactivity were considered biomarkers of beryllium exposure. In the present, due to the development of immunologic knowledge, tests of cellular immunity have promising potential for further research in this field. The historical view of the immune response to beryllium in acute and/or chronic beryllium disease is an example of the development of the interaction between mechanisms of innate and adaptive (specific), humoral and cellular immunity. The authors emphasize the increasing importance of immunological aspects in the studies of health impacts of human exposure to environmental pollutants.

Imaging of Occupational Lung Disease

Occupational lung diseases span a variety of pulmonary disorders caused by inhalation of dusts or chemical antigens in a vocational setting. Included in these are the classic mineral pneumoconioses of silicosis, coal worker's pneumoconiosis, and asbestos-related diseases as well as many immune-mediated and airway-centric diseases, and new and emerging disorders. Although some of these have characteristic imaging appearances, a multidisciplinary approach with focus on occupational exposure history is essential to proper diagnosis.

Gene-environment interaction from international cohorts: impact on development and evolution of occupational and environmental lung and airway disease

Environmental and occupational pulmonary diseases impose a substantial burden of morbidity and mortality on the global population. However, it has been long observed that only some of those who are exposed to pulmonary toxicants go on to develop disease; increasingly, it is being recognized that genetic differences may underlie some of this person-to-person variability. Studies performed throughout the globe are demonstrating important gene-environment interactions for diseases as diverse as chronic beryllium disease, coal workers' pneumoconiosis, silicosis, asbestosis, byssinosis, occupational asthma, and pollution-associated asthma. These findings have, in many instances, elucidated the pathogenesis of these highly complex diseases. At the same time, however, translation of this research into clinical practice has, for good reasons, proceeded slowly. No genetic test has yet emerged with sufficiently robust operating characteristics to be clearly useful or practicable in an occupational or environmental setting. In addition, occupational genetic testing raises serious ethical and policy concerns. Therefore, the primary objective must remain ensuring that the workplace and the environment are safe for all.

Guiding the pulmonologist's hand: What they need to know about lung pathology and what is lost in translation

Increasing subspecialization in the practice of medicine has led to certain discrepancies in how pathologists and pulmonologists imagine lung disease. This article, written by a pathologist who also practices pulmonology at a large, academic hospital, highlights his perspective on the important role of the pathologist in guiding the hand of the pulmonary clinician.