Beryllium is the second lightest metal in the periodical table of elements, it has many characteristics which are of benefit to the world of industry, and is widely used in the world of work, particularly in the form of a variety of alloys. The group of people who are exposed to beryllium during their work is also large. Beryllium is used in a variety of different forms, for example,

• in automotive design,
• in household technology,
• in telecommunications,
• in computing technology,
• in the arms industry,
• in tool and mould-making for castings,
• in aircraft and aerospace technology,
• in nuclear technology,
• in the ceramics industry

Health risks due to beryllium

Illnesses caused by beryllium or its compounds have been on the list of recognised occupational diseases as BK 1110 for several decades. It is known that even very low airborne concentrations of beryllium can trigger diseases. In the field of occupational health, chronic beryllium disease (CBD) is the key illness associated with beryllium. CBD is a dust disease and has a wide-ranging clinical picture. In addition to shortness of breath, chronic coughing, fatigue and chest pains, its symptoms include weight loss, night sweats and fever. CBD can be fatal in patients who suffer from cardiovascular problems. In addition to CBD, further clinical pictures are also associated with beryllium which result from the sensitising attributes of the substance, such as skin disorders (facial dermatitis).

False diagnoses possible

At the clinical level, it is difficult to distinguish CBD from so-called sarcoidosis (Morbus Boeck). The symptoms of both diseases are similar, making false diagnoses possible. On this basis, the statistics of the employers' liability insurers are unable to state the true extent of occupational exposure to beryllium because many chronic cases of berylliosis are unknown. The only difference, as proven by biological research, is a sensitivity towards beryllium which can be used with the diagnosis of CBD.

Guidelines help with the diagnosis of CBD

To improve the health monitoring of employees with occupational exposure to beryllium and to prevent false diagnoses, evidence-based recommendations are helpful. In this respect, under the guidance of the German Society for Occupational and Environmental Medicine e.V. (DGAUM), the Federal Agency for Occupational Safety and Health has coordinated the development of the S3 Occupational Health Guideline. This is oriented to doctors from every area of healthcare, particularly occupational healthcare. Its goal is to make rational decisions surrounding the provision of occupational healthcare to people exposed to beryllium in their working lives or people who are suspected of suffering from CBD. The guideline answers questions relating to exposure, and provides evidence-based, generally acknowledged recommendations to questions regarding diagnosis, dosage-effectiveness ratios and prognoses.