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Beryllium Disease in BC Workers: A Pilot Surveillance Project Using Linked Administrative Data
RS2007-DG05
Final Report Date: April 2010
| Principal Investigator: | Tim Takaro (SFU) |
| Co-Investigators: | Paul Demers, Christopher McLeod, Mieke Koehoorn (UBC) |
For more information about this project, please contact Tim Takaro.
Issue
Beryllium – a strong, light-weight metal used in several industries – can cause a serious lung disease called Chronic Beryllium Disease (CBD), even at low exposure levels. Although beryllium is used in B.C., no cases of CBD have been diagnosed in the province to date. This could be because CBD can be easily confused with sarcoidosis, another lung disease which can only be distinguished from CBD with a specific diagnostic test. To explore whether unrecognized cases of CBD may have occurred in B.C., the study examined the incidence of sarcoidosis in B.C. industries from 1991 to 2006.
Key findings
- In some of the industries that use beryllium, rates of sarcoidosis were two to three times higher than the overall rate. These industries included: electric power generation; transmission and distribution; boiler, tank and shipping container manufacturing; support activities for air transportation; communications equipment manufacturing; and pulp and paper.
- The findings suggest that some of the cases diagnosed as sarcoidosis for workers in those industries were actually CBD.
- Based on the findings, the researchers recommend conducting exposure assessments and screening for beryllium sensitization in the industries with higher rates of sarcoidosis, and in other industries involving likely beryllium exposures.
Objectives
- To determine whether Chronic Beryllium Disease (CBD) risk exists in B.C.
- To determine in which industries CBD surveillance should be undertaken in B.C.
Methods
Cases of sarcoidosis were linked with “industry of employment” information, using data from provincial health service registration records, workers’ compensation records, out-patient medical services records and hospitalization separation records, for the period from 1991 to 2006. The data was accessed through Population Data BC, a provincial data resource for population health and health services research.
After determining overall and industry-specific rates of sarcoidosis, potential relationships between beryllium hazard and sarcoidosis incidence were examined. Other demographic and employment variables were also considered.
Results
In several industries with potential beryllium exposure, the incidence of ICD-9 (International Classification of Diseases) coded sarcoidosis was significantly higher than the overall rate of 11.26 per 10,000 workers. These industries included:
- Electric power generation transmission and distribution (35.5 per 10,000)
- Support activities for air transportation (27.4 per 10,000)
- Boiler, tank and shipping container manufacturing (34.9 per 10,000)
- Communications equipment manufacturing (20.7 per 10,000)
- Pulp and paper (18.7 per 10,000)
The industry with the highest incidence of sarcoidosis was electric power generation transmission and distribution.
While women usually have a greater risk of sarcoidosis, male rates of sarcoidosis in some of the high risk industries, such as pulp, paper and paperboard mills, and highway and bridge construction, exceeded or were close to the rates for females.
Conclusions
The researchers conclude that some of the cases of sarcoidosis occurring in the high risk industries in B.C. may have actually been CBD (rather than sarcoidosis). They recommend the following actions:
- Conducting more detailed exposure assessments and initial screening for beryllium sensitization in the industries that were found to have a significantly higher incidence of sarcoidosis
- Continuing surveillance in any workplaces in which cases of CBD are identified in future
- Conducting exposure assessments in other industries where beryllium products may be used, including an analysis of the materials and work practices used
Future directions
The researchers also note the need for further research on beryllium and CBD in B.C., which could include:
- Investigating where beryllium containing products are used in the province
- Tracking alloyed beryllium products in the power industry
- Evaluating work practices that may produce beryllium exposures
- Testing potentially exposed workers to identify cases of beryllium sensitization
- Enhancing efforts to identify cases of beryllium sensitization and CBD through workplace screening or education of healthcare providers
- Conducting a cohort study that includes workers from all potentially high risk industries (including those that were not included in this analysis due to limitations of the “industry of employment” variable).
Publications and presentations
Poster presentation. American Thoracic Society meeting in New Orleans, May 14‑19, 2010.
Platform Presentation. Canadian Association for Research on Work and Health. May 28-29, 2010.