DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health

Preventing Sensitization and Disease

from Beryllium Exposure

Workplace

Safety and Health
This document is in the public domain and may be freely copied or 

reprinted.

DISCLAIMER

Mention of any company or product does not constitute endorsement by the National 

Institute for Occupational Safety and Health (NIOSH). In addition, citations to Web sites 

external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations 

or their programs or products. Furthermore, NIOSH is not responsible for the content of 

these Web sites.

ORDERING INFORMATION

To receive documents or more information about occupational safety and health topics, 

contact NIOSH at

1–800–CDC–INFO (1–800–232–4636)

TTY: 1–888–232–6348

E-mail: cdcinfo@cdc.gov

or visit the NIOSH Web site at www.cdc.gov/niosh

For a monthly update on news at NIOSH, subscribe to NIOSH eNews by visiting www.cdc.

gov/niosh/eNews.

DHHS (NIOSH) Publication Number 2011–107

February 2011

SAFER • HEALTHIER • PEOPLETM
Preventing Sensitization and Disease 

from Beryllium Exposure

— Participate in skin protection programs. These 

programs may include wearing gloves and 

company-issued clothing (with long sleeves 

and long pants) and showering at the end of 

the workday.

 Do not store or consume food, drinks, tobacco 

products, or cosmetics in beryllium work areas.

 Do not use cleaning methods that may cause 

dust to become resuspended in air (dry sweeping, compressed air, and other dust-generating 

methods, for example). Better methods include 

HEPA-filtered vacuums or wet cleaning methods 

that do not produce splash or spray.

 Prevent beryllium dusts and other contaminants from leaving beryllium work areas on your 

skin, clothing, shoes, and tools.

 Participate in workplace medical surveillance 

so that risks related to job tasks can be identified and prevented.

WARNING!

Workers exposed to particles, fumes, mists, or solutions from beryllium-containing materials may develop beryllium sensitization or chronic beryllium disease, a potentially 

disabling or even fatal respiratory disease.

What Workers Should Do

NIOSH recommends that workers exposed to particles, 

fumes, mists, or solutions from beryllium-containing 

materials take the following steps to protect themselves:

 Understand the risks and follow all proper procedures for working with beryllium—including 

participation in safety training.

 Keep beryllium out of the lungs: 

— Make sure that beryllium dusts, fumes, mists, 

and beryllium-containing solutions and suspensions are controlled at their sources.

— Participate in respiratory protection programs 

when advised to do so. 

 Keep beryllium-containing dusts and solutions 

off the skin:

— Keep work surfaces and work areas clean.
Preventing Sensitization and Disease 

from Beryllium Exposure

— Participate in skin protection programs. These 

programs may include wearing gloves and 

company-issued clothing (with long sleeves 

and long pants) and showering at the end of 

the workday.

 Do not store or consume food, drinks, tobacco 

products, or cosmetics in beryllium work areas.

 Do not use cleaning methods that may cause 

dust to become resuspended in air (dry sweeping, compressed air, and other dust-generating 

methods, for example). Better methods include 

HEPA-filtered vacuums or wet cleaning methods 

that do not produce splash or spray.

 Prevent beryllium dusts and other contaminants from leaving beryllium work areas on your 

skin, clothing, shoes, and tools.

 Participate in workplace medical surveillance 

so that risks related to job tasks can be identified and prevented.

WARNING!

Workers exposed to particles, fumes, mists, or solutions from beryllium-containing materials may develop beryllium sensitization or chronic beryllium disease, a potentially 

disabling or even fatal respiratory disease.

What Workers Should Do

NIOSH recommends that workers exposed to particles, 

fumes, mists, or solutions from beryllium-containing 

materials take the following steps to protect themselves:

 Understand the risks and follow all proper procedures for working with beryllium—including 

participation in safety training.

 Keep beryllium out of the lungs: 

— Make sure that beryllium dusts, fumes, mists, 

and beryllium-containing solutions and suspensions are controlled at their sources.

— Participate in respiratory protection programs 

when advised to do so. 

 Keep beryllium-containing dusts and solutions 

off the skin:

— Keep work surfaces and work areas clean.
Preventing Sensitization and Disease 

from Beryllium Exposure

— Participate in skin protection programs. These 

programs may include wearing gloves and 

company-issued clothing (with long sleeves 

and long pants) and showering at the end of 

the workday.

 Do not store or consume food, drinks, tobacco 

products, or cosmetics in beryllium work areas.

 Do not use cleaning methods that may cause 

dust to become resuspended in air (dry sweeping, compressed air, and other dust-generating 

methods, for example). Better methods include 

HEPA-filtered vacuums or wet cleaning methods 

that do not produce splash or spray.

 Prevent beryllium dusts and other contaminants from leaving beryllium work areas on your 

skin, clothing, shoes, and tools.

 Participate in workplace medical surveillance 

so that risks related to job tasks can be identified and prevented.

WARNING!

Workers exposed to particles, fumes, mists, or solutions from beryllium-containing materials may develop beryllium sensitization or chronic beryllium disease, a potentially 

disabling or even fatal respiratory disease.

What Workers Should Do

NIOSH recommends that workers exposed to particles, 

fumes, mists, or solutions from beryllium-containing 

materials take the following steps to protect themselves:

 Understand the risks and follow all proper procedures for working with beryllium—including 

participation in safety training.

 Keep beryllium out of the lungs: 

— Make sure that beryllium dusts, fumes, mists, 

and beryllium-containing solutions and suspensions are controlled at their sources.

— Participate in respiratory protection programs 

when advised to do so. 

 Keep beryllium-containing dusts and solutions 

off the skin:

— Keep work surfaces and work areas clean.

Prevención de la sensibilización y la

enfermedad por exposición al berilio

Lo que los trabajadores deben hacer

NIOSH recomienda que los trabajadores expuestos 

a las partículas, emisiones, vapores o soluciones 

de materiales que contienen berilio realicen los 

siguientes pasos para protegerse:

 Conozca los riesgos y siga todos los procedimientos adecuados para trabajar con berilio 

(como participar en cursos sobre seguridad).

 Evite que el berilio se introduzca en sus 

pulmones: 

— Asegúrese de que haya un control en las 

fuentes de polvo, emisiones, vapores, 

soluciones y suspensiones que contienen 

berilio.

— Participe en programas de protección 

respiratoria cuando se lo indiquen. 

 Evite el contacto de la piel con el polvo y las 

soluciones que contienen berilio:

¡ADVERTENCIA!

Los trabajadores expuestos a partículas, emisiones, vapores o soluciones de materiales 

que contienen berilio pueden presentar sensibilización al berilio o enfermedad crónica 

por berilio, que es una afección respiratoria potencialmente discapacitante o incluso 

mortal.

— Mantenga limpias las superficies y las 

áreas de trabajo.

— Participe en los programas de protección 

de la piel. Estos programas pueden incluir 

el uso de guantes y ropa proporcionados 

por la empresa (de mangas largas y con 

pantalones largos) y tener que ducharse al 

final de la jornada laboral. 

 No guarde ni consuma alimentos, bebidas, 

productos de tabaco o cosméticos en áreas 

donde se trabaja con berilio.

 No utilice métodos de limpieza que puedan 

causar que el polvo vuelva a suspenderse 

en el aire (por ejemplo, barrido en seco, aire 

comprimido y otros métodos que producen 

polvo). Los mejores métodos incluyen las 

aspiradoras con filtro HEPA o métodos de 

limpieza húmedos que no salpican ni rocían.

 Evite que el polvo de berilio y otros 

contaminantes salgan de las áreas donde se 
Prevención de la sensibilización y la

enfermedad por exposición al berilio

Lo que los trabajadores deben hacer

NIOSH recomienda que los trabajadores expuestos 

a las partículas, emisiones, vapores o soluciones 

de materiales que contienen berilio realicen los 

siguientes pasos para protegerse:

 Conozca los riesgos y siga todos los procedimientos adecuados para trabajar con berilio 

(como participar en cursos sobre seguridad).

 Evite que el berilio se introduzca en sus 

pulmones: 

— Asegúrese de que haya un control en las 

fuentes de polvo, emisiones, vapores, 

soluciones y suspensiones que contienen 

berilio.

— Participe en programas de protección 

respiratoria cuando se lo indiquen. 

 Evite el contacto de la piel con el polvo y las 

soluciones que contienen berilio:

¡ADVERTENCIA!

Los trabajadores expuestos a partículas, emisiones, vapores o soluciones de materiales 

que contienen berilio pueden presentar sensibilización al berilio o enfermedad crónica 

por berilio, que es una afección respiratoria potencialmente discapacitante o incluso 

mortal.

— Mantenga limpias las superficies y las 

áreas de trabajo.

— Participe en los programas de protección 

de la piel. Estos programas pueden incluir 

el uso de guantes y ropa proporcionados 

por la empresa (de mangas largas y con 

pantalones largos) y tener que ducharse al 

final de la jornada laboral. 

 No guarde ni consuma alimentos, bebidas, 

productos de tabaco o cosméticos en áreas 

donde se trabaja con berilio.

 No utilice métodos de limpieza que puedan 

causar que el polvo vuelva a suspenderse 

en el aire (por ejemplo, barrido en seco, aire 

comprimido y otros métodos que producen 

polvo). Los mejores métodos incluyen las 

aspiradoras con filtro HEPA o métodos de 

limpieza húmedos que no salpican ni rocían.

 Evite que el polvo de berilio y otros 

contaminantes salgan de las áreas donde se 
Prevención de la sensibilización y la

enfermedad por exposición al berilio

Lo que los trabajadores deben hacer

NIOSH recomienda que los trabajadores expuestos 

a las partículas, emisiones, vapores o soluciones 

de materiales que contienen berilio realicen los 

siguientes pasos para protegerse:

 Conozca los riesgos y siga todos los procedimientos adecuados para trabajar con berilio 

(como participar en cursos sobre seguridad).

 Evite que el berilio se introduzca en sus 

pulmones: 

— Asegúrese de que haya un control en las 

fuentes de polvo, emisiones, vapores, 

soluciones y suspensiones que contienen 

berilio.

— Participe en programas de protección 

respiratoria cuando se lo indiquen. 

 Evite el contacto de la piel con el polvo y las 

soluciones que contienen berilio:

¡ADVERTENCIA!

Los trabajadores expuestos a partículas, emisiones, vapores o soluciones de materiales 

que contienen berilio pueden presentar sensibilización al berilio o enfermedad crónica 

por berilio, que es una afección respiratoria potencialmente discapacitante o incluso 

mortal.

— Mantenga limpias las superficies y las 

áreas de trabajo.

— Participe en los programas de protección 

de la piel. Estos programas pueden incluir 

el uso de guantes y ropa proporcionados 

por la empresa (de mangas largas y con 

pantalones largos) y tener que ducharse al 

final de la jornada laboral. 

 No guarde ni consuma alimentos, bebidas, 

productos de tabaco o cosméticos en áreas 

donde se trabaja con berilio.

 No utilice métodos de limpieza que puedan 

causar que el polvo vuelva a suspenderse 

en el aire (por ejemplo, barrido en seco, aire 

comprimido y otros métodos que producen 

polvo). Los mejores métodos incluyen las 

aspiradoras con filtro HEPA o métodos de 

limpieza húmedos que no salpican ni rocían.

 Evite que el polvo de berilio y otros 

contaminantes salgan de las áreas donde se 

1

Preventing Sensitization and Disease from 

Beryllium Exposure 

BACKGROUND

Risks may be associated with all berylliumcontaining materials (including alloys of beryllium as well as beryllium metal and oxide 

materials) when these materials are heated 

or worked to create particles, fumes, or mists. 

Beryllium may be encountered as any of the 

following: 

 Compounds extracted from beryl and 

bertrandite minerals

 A refined metal with unique physical properties including high strength, lightness (low 

density), stiffness, dimensional stability, fidelity of vibration transmission, high thermal 

and electrical conductivity, neutron-moderating properties, and X-ray transparency

 A ceramic with electrical resistivity, a high 

melting point, and excellent thermal conductivity

WARNING!

Workers exposed to particles, fumes, mists, or solutions from 

beryllium-containing materials may develop beryllium sensitization 

or chronic beryllium disease, a potentially disabling or even fatal 

respiratory disease.

The National Institute for Occupational Safety and Health (NIOSH) requests assistance 

in preventing beryllium sensitization and 

chronic beryllium disease. Development of 

these conditions requires exposure to beryllium and is affected by both job tasks and 

genetic factors. Some jobs or tasks involve 

exposures that increase the risk of sensitization and disease. Some people have inherited genes that make them more likely to 

become sensitized or develop chronic beryllium disease when exposed.

NIOSH requests that the information in this 

Alert be brought to the attention of workers 

and employers by the following: trade associations, editors of trade journals, safety 

and health officials, labor organizations, 

members of the academic and public health 

communities, advocacy groups, workers’ 

compensation insurance companies, manufacturers and distributors of materials that 

contain beryllium, and the mass media.
2 Preventing Sensitization and Disease from Beryllium Exposure

 An alloy or mixture of metals having special properties including antigalling behavior, castability, corrosion resistance, 

electrical conductivity, durability, flexibility, 

nonsparking behavior, springiness (elasticity), and wear resistance* 

 A byproduct of recycling materials that 

contain beryllium, such as alloys

See the Appendix for examples of industries 

that use beryllium and products that may 

contain beryllium.

Material Safety Data Sheets (MSDSs) provide information about the beryllium content 

of products that contain more than 0.1% 

beryllium. At lower concentrations, employers and workers may not be aware of the 

presence of beryllium; but health risks may 

exist if the beryllium-containing material is 

dispersed as a dust, fume, or berylliumcontaining solution that can be inhaled or 

come into contact with unprotected skin. 

Cases of beryllium sensitization and chronic beryllium disease have been reported in 

which exposures were below the current Occupational Safety and Health Administration 

(OSHA) Permissible Exposure Limit (PEL) of 

2.0 micrograms per cubic meter (μg/m3) of 

air and the current NIOSH Recommended 

Exposure Limit (REL) of 0.5 μg/m3.

BERYLLIUM SENSITIZATION

A worker’s immune system determines 

whether he or she will develop health problems from working with beryllium. Some workers become sensitized to beryllium, which 

means that exposure to beryllium has triggered the immune system to recognize and 

*Copper-beryllium alloys are the most widely used 

form of beryllium.

respond to this metal as a foreign substance. 

The risk of sensitization is determined by beryllium exposure, but it may be increased by 

certain genes that have been inherited from 

either parent.

A blood test—the beryllium lymphocyte proliferation test (BeLPT)—can detect sensitization by measuring how blood cells react 

to beryllium. It has been used effectively in 

medical surveillance programs in both private industry and government organizations 

to identify sensitization among participating 

workers. However, as with all medical tests, 

the BeLPT is not perfect: false positive results (a nonsensitized person’s test result 

indicates sensitization) and false negative

results (a sensitized person’s test result indicates no sensitization) may occur. Results 

may also vary between clinical laboratories 

performing the BeLPT. Despite its limitations, the BeLPT is the best available tool 

to identify sensitization until a more reliable 

test is developed. 

No health symptoms are associated with beryllium sensitization. However, it is believed 

that a person must first be sensitized before 

beryllium in the lungs can cause the lung 

damage (called granulomas) of chronic beryllium disease [1].

Some individuals identified as sensitized 

with the BeLPT will already have chronic beryllium disease [2]. Those who are sensitized 

without chronic beryllium disease are at increased risk of developing it in the future. In 

one study following 55 sensitized individuals without chronic beryllium disease, about 

1/3 were diagnosed with the disease within 

a 41⁄2 year period of follow-up [3]. However, 

the overall proportion of all sensitized individuals who will eventually develop chronic 

beryllium disease is not known.
Preventing Sensitization and Disease from Beryllium Exposure 3

DISEASES

Chronic Beryllium Disease 

Chronic beryllium disease occurs when a 

sensitized worker’s lungs react with beryllium that has been inhaled, producing lung 

granulomas and scarring. 

To determine whether chronic beryllium 

disease is present, workers with abnormal BeLPT results must have further medical testing. A lung biopsy may be performed 

to remove small samples of lung tissue. In 

chronic beryllium disease, granulomas can 

be seen with a microscope in the biopsy 

samples. The biopsy test can detect disease 

before a worker has any symptoms. A lung 

lavage, where cells are “washed” from the 

lung, may also be performed and the lavage 

cells tested for sensitization. Other tests 

such as chest X-rays, computed axial tomography (CAT) scans of the chest, and pulmonary function tests can also help make the 

diagnosis of advanced disease.

Chronic beryllium disease has been observed 

among workers with a variety of exposure 

histories — long and short duration, high 

and low air concentrations of beryllium, 

and any form of beryllium. In many cases, 

chronic beryllium disease develops while 

workers are still being exposed to beryllium, 

occasionally within months of first exposure. 

In other instances, the disease may not be 

diagnosed until years after a person has 

stopped working in the beryllium industry.

Chronic beryllium disease usually has a slow 

onset of symptoms. It can be so mild at the 

time of diagnosis that the affected worker has 

no suspicion that he or she has a lung disease. 

However, when chronic beryllium disease progresses, the widespread granulomas and 

associated lung damage cause chronic chest 

symptoms such as coughing and shortness 

of breath on exertion. Other symptoms that 

may develop in some persons with chronic 

beryllium disease are unusual fatigue, night 

sweats, and weight loss. 

The symptoms and lung function abnormalities often respond to corticosteroid medication such as prednisone or other medications 

that suppress the immune system response 

to beryllium. However, these medications do 

not cure the disease; they have side effects 

and must usually be taken indefinitely to 

prevent progressive lung damage or slow 

the rate of clinical deterioration. Some people with chronic beryllium disease eventually require supplemental oxygen, become 

severely disabled, and even die because of 

respiratory failure or insufficiency.

Certain genes appear to cause some beryllium-exposed workers to be more susceptible to beryllium sensitization and chronic 

beryllium disease [2]. Continuing genetic 

research may contribute to a better understanding of why some are more susceptible. 

This research may also lead to prevention of 

sensitization and disease and the exploration of new treatments for sensitization and 

disease in affected workers. However, with 

our current knowledge, genetic testing is not 

useful in predicting who will develop chronic 

beryllium disease because (1) the genes 

linked to sensitization and disease are found 

in a large percentage of the general population, and (2) sensitization and chronic beryllium disease have developed in some people who do not have these genes. The future 

usefulness of genetic testing remains to be 

determined, but it may someday have a role 

in helping workers make informed decisions 

about working with beryllium.
4 Preventing Sensitization and Disease from Beryllium Exposure

Acute Beryllium Disease

Acute beryllium disease has been diagnosed 

in the past, but it is rare today. The disease 

typically has a quick onset with symptoms 

resembling those of pneumonia or bronchitis. It occurs after exposure to soluble beryllium salts, which are used in the making 

of beryllium metal. Acute beryllium disease 

usually resolves within months of stopping 

beryllium work, but some affected workers 

later develop chronic beryllium disease.

Cancer

Significantly elevated risks of lung cancer 

have been reported for workers exposed to 

beryllium; the National Toxicology Program 

lists it as a known carcinogen [4] and the International Agency for Research on Cancer 

reaffirmed its classification as carcinogenic 

to humans [5]. Controlling beryllium exposures to prevent chronic beryllium disease 

should also reduce the risk for lung cancer.

MEDICAL SURVEILLANCE

Medical surveillance of a workforce looks at 

medical test results over time in relation to 

information about jobs and processes. Medical surveillance of workers exposed to beryllium includes using the BeLPT to identify 

sentinel (new) cases of sensitization. Identification of sentinel cases may indicate that 

co-workers are at risk. Surveillance information is used to determine whether some jobs 

or processes are higher risk than others, to 

set priorities for making changes to protect 

workers, and to evaluate the success of efforts to prevent disease. Testing for beryllium sensitization is not a substitute for prevention of beryllium exposure and may not 

prevent chronic beryllium disease in sensitized individuals. 

WORKFORCE SURVEYS 

Since the late 1980s, beryllium-exposed workforces have been surveyed for sensitization 

to beryllium and chronic beryllium disease. 

Workers typically complete a questionnaire 

about their health and work history and submit blood samples that are tested for sensitization to beryllium. Sensitized workers are 

then further evaluated for chronic beryllium 

disease. Scientists look for jobs and work 

tasks in which sensitization and chronic beryllium disease are most common. They may 

also estimate workers’ beryllium exposure 

to determine whether risk increases as estimated exposure increases. 

Researchers have studied various beryllium 

workplaces, including those in the primary 

beryllium industry, nuclear weapons facilities, the ceramics industry, mining and ore 

milling facilities, precision machining plants, 

beryllium-contaminated buildings undergoing decontamination and decommissioning, 

workplaces with construction trades workers, 

and aluminum smelters [1, 6–19]. Workers in 

these studies were exposed to different forms 

of beryllium, such as beryllium oxide ceramic, 

pure beryllium metal, and beryllium alloys 

(primarily copper alloys); they may have been 

current or former workers. 

Workers who refine, prepare, and process 

beryllium and beryllium-containing materials are at the greatest risk for sensitization 

and chronic beryllium disease. Sensitization 

has been found in 1% to 15% of workers 

studied cross-sectionally, with chronic beryllium disease diagnosed in 10% to 100% of 

sensitized workers [2]. In one longitudinal 

study of a beryllium oxide ceramics worker 

cohort, the 11-year prevalences of sensitization and chronic beryllium disease were 

20% and 14%, respectively [15]. The risk for 
Preventing Sensitization and Disease from Beryllium Exposure 5

workers in other industries depends on their 

potential exposure to dust particles, fumes, 

mists, and beryllium-containing solutions 

and suspensions. 

Exposure-Related Risks

Some production jobs have higher rates of 

sensitization or chronic beryllium disease. 

Specific jobs or work processes that have been 

shown to carry a higher risk include machining of ceramics or beryllium metal, ceramics 

production, work with copper-beryllium rod 

and wire materials, and engineering, laboratory, and technical jobs [1, 7–10, 14, 17]. 

Risk is not limited to production workers. 

In many studies, additional cases of sensitization or chronic beryllium disease were 

identified among nonproduction workers or 

workers whose exposure appeared to be 

minimal, such as secretaries, other clerical 

workers, and security guards [1, 8–10, 17]. 

When estimates of beryllium exposure (based 

on mass concentration of airborne beryllium) were calculated for study participants, 

no consistent relationship was found between airborne exposure and risk of either 

sensitization or chronic beryllium disease. In 

other words, workers with the highest estimated beryllium exposures were not necessarily at the highest risk, and higher risk jobs 

or processes did not always have the highest 

beryllium exposure. Other exposure factors 

may also be important, including chemical 

form and particle size [20, Chapter 2]. However, control of airborne beryllium exposure is 

an important part of any workplace program to 

reduce the risk of sensitization and chronic 

beryllium disease.

Skin Exposure

Research suggests that sensitization may result from skin contact with beryllium dusts, 

fumes, and beryllium-containing solutions 

and suspensions. In the 1950s, patch testing led to skin sensitization [21]. More recently, researchers observed that tight control of airborne beryllium exposure alone did 

not prevent sensitization of new workers in 

the first year or two of their employment [7]. 

Laboratory researchers demonstrated that 

(1) mice could become sensitized to beryllium if beryllium was placed on their skin, 

and (2) tiny particles (dextran beads less 

than 1 micrometer (μm) in diameter) could 

penetrate intact human skin tissue samples 

when the skin was flexed, thereby allowing 

them to reach the layers of the skin where 

the immune system cells are located and 

where the sensitization process can begin 

[22]. Particles larger than 1 μm could penetrate only cuts or abrasions. Although research is continuing, NIOSH recommends 

that employers and workers prevent skin 

contact with beryllium particles or solutions 

containing beryllium, including protecting 

skin cuts and abrasions. 

Prevention

One study at a beryllium oxide ceramics plant 

has shown that a comprehensive preventive program can reduce the development of 

sensitization in new workers not previously 

exposed to beryllium [23]. The program placed 

special emphasis on preventing the migration of dust and fluids away from work processes and on protection of skin, in addition to engineering controls and respiratory 

protection [24]. The facility used medical 

surveillance with the BeLPT to monitor the 

effectiveness of the program in preventing 

sensitization. Nine percent of workers hired 

between 1993 and 1998, before the program started, became sensitized. Only 1% of 

workers hired between 2000 and 2004, after the program began, became sensitized. 

Air levels of beryllium were similar for the two 
6 Preventing Sensitization and Disease from Beryllium Exposure

time periods. Since these prevention results 

are from a single plant and cover a relatively 

short period of time, the results should be 

considered encouraging but preliminary. Additional follow-up over longer periods and at 

other beryllium workplaces remains to be 

performed.

CASE STUDIES

Case 1 

Two years after starting work at a berylliumusing facility, a secretary was moved to an 

area in which beryllium laboratory testing 

had been done years earlier. The following 

year, her work area was renovated, including 

opening the ventilation duct work. She developed skin problems, including itching and 

raised lesions, which she believed were due 

to the dust from renovation. Five months after renovation, she had her first abnormal 

BeLPT blood test which was confirmed the 

following month. She was then evaluated for 

chronic beryllium disease: no granulomas 

or other abnormalities were found in lung 

biopsy samples; her lung lymphocytes (obtained through lavage) were elevated (22%); 

and testing of her lung lavage cells did not 

indicate lung sensitization. She left work the 

following year. A second medical evaluation, 

16 months after the first, then found granulomas in the biopsy samples and further elevation of lung lavage lymphocytes (36%). 

At that time she was diagnosed with chronic 

beryllium disease.

Case 2

A beryllium worker took part in medical 

surveillance after spending more than 20 

years in different production jobs and as a 

foreman. He did not wear a respirator. He 

reported no cough, wheeze, or shortness of 

breath. His first blood samples were sent to 

two laboratories, and one BeLPT was abnormal. The following month, a second set of 

samples was sent to two laboratories, and 

both were abnormal, confirming that he was 

sensitized. His medical evaluation showed 

granulomas in his lung biopsy samples, elevated lung lavage lymphocytes (27%), and 

an abnormal lung lavage BeLPT, all of which 

supported the diagnosis of chronic beryllium 

disease. His participation in medical surveillance, along with other workers’, contributed 

to the development of a more comprehensive preventive program at his facility.

What do these cases illustrate? Case 1 shows 

us that sometimes those who don’t work directly with beryllium, but who are exposed 

to beryllium-containing dust, can develop 

chronic beryllium disease. It also shows that 

continued monitoring of the health of sensitized workers is important; this person’s 

chronic beryllium disease was not diagnosed 

until her second medical evaluation and after 

she left employment. Case 2 shows us the 

value of participating in workplace medical 

surveillance. This person had no symptoms 

and would not have known he had chronic 

beryllium disease if he had not participated 

in the medical surveillance that was offered 

to him. His participation helped to guide efforts to protect his fellow workers, as well as 

future workers.

CURRENT EXPOSURE LIMITS

Current beryllium exposure limits and action 

levels from various agencies and groups are 

provided below. 

NIOSH

In 1977, NIOSH suggested a REL of 0.5 μg/m3

to reduce the risk of beryllium-related lung 
Preventing Sensitization and Disease from Beryllium Exposure 7

cancer [25]. This REL does not prevent beryllium sensitization or chronic beryllium 

disease. Since a safe exposure limit for beryllium has not been determined, NIOSH recommends that employers keep airborne concentrations of beryllium as low as possible. 

OSHA 

The current OSHA PEL for beryllium is 2.0 

μg/m3 as an 8-hour time-weighted average 

(TWA) [26]. OSHA has stated that the current 

PEL may not adequately protect berylliumexposed workers from developing chronic 

beryllium disease [27, 28]. Other OSHA exposure limits for beryllium are a ceiling concentration of 5.0 μg/m3, and a maximum peak 

concentration of 25.0 μg/m3 for a maximum 

duration of 30 minutes [26].

DOE

The U.S. Department of Energy (DOE) requires various actions to limit exposures to 

beryllium (including engineering and administrative controls and the use of respiratory 

protection). The DOE also requires medical 

surveillance using the BeLPT to be offered 

when airborne concentrations of beryllium 

exceed an action level. In 1999, the DOE 

set a beryllium exposure action level (8-hour 

TWA) of 0.2 μg/m3 [26]. In addition, the DOE 

building-surface contamination level for beryllium in work areas during nonoperational 

periods is 3.0 μg/100 cm2 of surface area. 

The concentration of beryllium on items released to the public must not exceed 0.2 

μg/100 cm2 [26]. These surface contamination levels are based on technical feasibility 

rather than on documented risk for sensitization and disease. 

Other Limits

In 2009, the American Conference of Governmental Industrial Hygienists (ACGIH) adopted 

a new Threshold Limit Value (TLV®) for beryllium of 0.05 μg/m3 as an 8-hour TWA for 

inhalable particulate matter, and added notations for “sensitizer” and “skin”; no ShortTerm Exposure Limit (STEL) was included 

[29]. In 2007, the State of California adopted 

a new PEL of 0.2 μg/m3 8-hour TWA [30]. 

The Canadian province of Quebec has adopted a limit of 0.15 μg/m3 8-hour TWA [31]. In 

Europe, 8-hour TWA exposure limits range 

from 0.2 μg/m3 inhalable aerosol (Spain) to 

2.0 μg/m3 (e.g., United Kingdom) [32]. The 

Japanese occupational exposure limit is 2.0 

μg/m3 8-hour TWA [32]. China’s permissible 

concentration (8-hour TWA) is 0.5 μg/m3 [33].

OTHER RESOURCES

More information about beryllium is available through the following resources: 

NIOSH 

Respirators:

www.cdc.gov/niosh/topics/respirators/

Searchable database:

www2a.cdc.gov/nioshtic-2/default.asp

Pocket guide to chemical hazards:

www.cdc.gov/niosh/npg/pgintrod.html

International chemical safety cards:

www.cdc.gov/niosh/ipcs/icstart.html

Sampling/analytical methods:

www.cdc.gov/niosh/docs/2003-154/

OSHA

Hazard Information Bulletin: Preventing Adverse Health Effects from Exposure to Beryllium on the Job [28], www.osha.gov/dts/hib/

hib_data/hib19990902.html
8 Preventing Sensitization and Disease from Beryllium Exposure

Hazard Information Bulletin: Preventing Adverse Health Effects from Exposure to Beryllium in Dental Laboratories [34], www.osha.

gov/dts/hib/hib_data/hib020419.html

Safety and Health Topics: Beryllium, www.

osha.gov/SLTC/beryllium/index.html

Other

Brush Wellman Inc. Interactive Guide to Working 

Safely with Beryllium and Beryllium-Containing 

Materials, www.berylliumsafety.com† 

Committee on Beryllium Alloy Exposures, Committee on Toxicology, National Research Council. 

Health Effects of Beryllium Exposure: A Literature Review,www.nap.edu/catalog/12007.html†

Committee on Beryllium Alloy Exposures, Committee on Toxicology, National Research Council. 

Managing Health Effects of Beryllium Exposure

[20], www.nap.edu/catalog/12464.html†

Department of Energy: Title 10 CFR Part 

850 Chronic Beryllium Disease Prevention 

Program, www.hss.energy.gov/HealthSafety/

wshp/be/index.html†

Department of Labor: Energy Employees 

Occupational Illness Compensation Program, 

www.dol.gov/owcp/energy/†

National Jewish Health. Chronic Beryllium 

Disease: Overview, www.nationaljewish.org/

healthinfo/conditions/beryllium-disease/

index.aspx†

†By accessing this information, you will be directed to an 

external website that is not controlled by NIOSH or the 

U.S. Department of Health and Human Services. Links 

to websites outside of NIOSH are offered for your convenience in accessing related information, but do not 

constitute an endorsement of the website or its contents by NIOSH. NIOSH takes no responsibility for the 

accuracy, relevance, timeliness, or completeness of 

the information contained on non-NIOSH websites. 

CONCLUSIONS

Workers in various sectors of the beryllium 

industry are at risk of developing serious 

respiratory disease following exposure to beryllium. More action is needed to (1) identify workers exposed to beryllium who may 

not know that they are exposed, (2) improve 

protective measures for exposed workers, 

(3) reduce/minimize both overall exposures 

and, when possible, the number of exposed 

workers, (4) educate workers about the hazards of working with beryllium, (5) determine 

the characteristics of exposures (e.g., particle size, shape, surface area, and chemical form) that are associated with increased 

risk, and (6) identify industrial and occupational sectors that use beryllium and target 

them for prevention efforts.

RECOMMENDATIONS

NIOSH recommends that workers exposed 

to particles, fumes, mists, or solutions from 

beryllium-containing materials take the following steps to protect themselves: 

 Understand the risks and follow all proper 

procedures for working with beryllium—

including participation in safety training.

 Keep beryllium out of the lungs: 

— Make sure that beryllium dusts, fumes, 

mists, and beryllium-containing solutions and suspensions are controlled 

at their sources.

— Participate in respiratory protection 

programs when advised to do so.

 Keep beryllium-containing dusts and solutions off the skin:
Preventing Sensitization and Disease from Beryllium Exposure 9

— Keep work surfaces and work areas 

clean.

— Participate in skin protection programs. These programs may include 

wearing gloves and company-issued 

clothing (with long sleeves and long 

pants) and showering at the end of 

the workday.

 Do not store or consume food, drinks, 

tobacco products, or cosmetics in beryllium work areas.

 Do not use cleaning methods that may 

cause dust to become resuspended in air 

(dry sweeping, compressed air, and other 

dust-generating methods, for example). 

Better methods include HEPA-filtered vacuums or wet cleaning methods that do 

not produce splash or spray.

 Prevent beryllium dusts and other contaminants from leaving beryllium work areas on 

your skin, clothing, shoes, and tools.

 Participate in workplace medical surveillance so that risks related to job tasks 

can be identified and prevented.

 Seek medical attention for any chronic 

cough or shortness of breath, which may 

indicate chronic beryllium disease. 

 Seek medical attention for any rash or 

non-healing cut or wound.

NIOSH recommends that employers of workers exposed to particles, fumes, mists, or solutions from beryllium-containing materials 

take the following steps to protect workers, 

contractors, and visitors:

 Know the beryllium content of all materials in the workplace. The manufacturers or suppliers of materials containing 

greater than 0.1% beryllium are required 

to provide this information on Material 

Safety Data Sheets.

 Substitute less hazardous materials for 

those containing beryllium whenever 

feasible. 

 Minimize the number of workers exposed 

to beryllium dusts, fumes, mists, and 

beryllium-containing solutions and suspensions.

 Install, use, and maintain effective engineering controls for processes that create beryllium dusts, fumes, mists, and 

beryllium-containing solutions and suspensions.

 Keep airborne concentrations of beryllium as low as possible, since a safe exposure limit for beryllium has not been 

determined. 

 Monitor airborne beryllium concentrations to document the effectiveness of 

efforts to reduce airborne exposures.

 Inform workers about the risks of beryllium sensitization, chronic beryllium disease, and lung cancer, and the proper 

procedures for working with berylliumcontaining materials. 

 Keep beryllium dusts, fumes, mists, and 

beryllium-containing solutions and suspensions confined to the immediate work 

area. 

 Do not use cleaning methods that may 

cause dust to become resuspended in air 

(dry sweeping, compressed air, and other 

dust-generating methods, for example). 

Better methods include HEPA-filtered vacuums or wet cleaning methods that do not 

produce splash or spray.

 Prevent beryllium dusts and other contaminants from leaving beryllium work 

areas on workers’ skin, clothing, shoes, 

and tools.
10 Preventing Sensitization and Disease from Beryllium Exposure

 Identify and clean areas outside the beryllium work zone that may have become 

contaminated before these recommendations were implemented.

 Establish and maintain an appropriate respiratory protection program as needed.

 Establish and maintain a skin protection 

program to protect workers’ skin from 

contamination with beryllium dusts and 

solutions:

— Keep work surfaces and work areas 

clean. 

— Provide work gloves, long-sleeved shirts, 

long pants, and shoes that remain at the 

workplace.

— Provide showering and changing facilities. 

 Conduct medical surveillance for sensitization using the beryllium lymphocyte 

proliferation test for workers who come 

in contact with beryllium dusts, fumes, 

mists, and beryllium-containing solutions 

and suspensions:

— Identify higher-risk jobs and processes to prioritize prevention efforts and 

evaluate their effectiveness in decreasing the risk of sensitization.

— Ensure that sensitized workers identified through surveillance are referred 

for medical testing (1) to determine 

whether they have chronic beryllium 

disease, (2) to establish radiographic 

and lung function baselines for followup testing, and (3) receive counseling.

ACKNOWLEDGMENTS

Principal contributors to this Alert were 

Christine R. Schuler, Ph.D.; Gregory A. Day, Ph.D.; 

Paul K. Henneberger, Sc.D., M.P.H.; Ainsley 

Weston, Ph.D.; Mark D. Hoover, Ph.D.; and 

Kathleen Kreiss, M.D. John D. Piacentino, M.D., 

provided significant guidance and review. 

Marcia Stanton served as program coordinator. Susan Afanuh, Jane Weber, and 

Anne Hamilton provided editorial and production services. Vanessa B. Williams and 

Gino Fazio provided graphic design and production services. 

Please direct comments, questions, or requests for additional information to the following:

Director

Division of Respiratory Disease Studies

National Institute for Occupational Safety

 and Health

1095 Willowdale Road

Morgantown, WV 26505–2888

We greatly appreciate your assistance in protecting the health of U.S. workers.

John Howard, M.D.

Director

National Institute for Occupational

 Safety and Health

Centers for Disease Control and

 Prevention

REFERENCES

1) Kreiss K, Mroz MM, Zhen B, Martyny JW, 

Newman LS [1993]. Epidemiology of beryllium sensitization and disease in nuclear workers. Am Rev Respir Dis 148(4 Part 1):985–991.
Preventing Sensitization and Disease from Beryllium Exposure 11

2) Kreiss K, Day GA, Schuler CR [2007]. Beryllium: a modern industrial hazard. Annu 

Rev Public Health 28:259–277.

3) Newman LS, Mroz MM, Balkissoon R, 

Maier LA [2005]. Beryllium sensitization progresses to chronic beryllium disease: a longitudinal study of disease risk. Am J Respir Crit 

Care Med 171(1):54–60.

4) NTP [2002]. Beryllium (CAS No. 7440–

41–7) and beryllium compounds. Report on 

carcinogens. 11th ed. Washington, DC: U.S. 

Department of Health and Human Services, 

Public Health Service, National Toxicology 

Program [http://ntp.niehs.nih.gov/ntp/roc/

eleventh/profiles/s022bery.pdf].

5) IARC Monograph Working Group [2009]. 

Special report: policy: a review of human carcinogens—part C: metals, arsenic, dusts, and 

fibres. Lancet 10:453–454.

6) Deubner D, Kelsh M, Shum M, Maier L, 

Kent M, Lau E [2001]. Beryllium sensitization, 

chronic beryllium disease, and exposures at a 

beryllium mining and extraction facility. Appl 

Occup Environ Hyg 16(5):579–592.

7) Henneberger PK, Cumro D, Deubner D, 

Kent MS, McCawley M, Kreiss K [2001]. 

Beryllium sensitization and disease among 

long-term and short-term workers in a beryllium ceramics plant. Int Arch Occup Environ 

Health 74(3):167–176.

8) Kreiss K, Mroz MM, Newman LS, Martyny 

J, Zhen B [1996]. Machining risk of beryllium disease and sensitization with median 

exposures below 2 μg/m3. Am J Ind Med 

30(1):16–25.

9) Kreiss K, Mroz MM, Zhen B, Wiedemann 

H, Barna B [1997]. Risk of beryllium disease 

related to work processes at a metal, alloy, 

and oxide production plant. Occup Environ 

Med 54(8):605–612.

10) Kreiss K, Wasserman S, Mroz MM, Newman LS [1993]. Beryllium disease screening 

in the ceramics industry. Blood lymphocyte 

test performance and exposure-disease relations. J Occup Med 35(3):267–274.

11) Newman LS, Mroz MM, Maier LA, Daniloff EM, Balkissoon R [2001]. Efficacy of serial medical surveillance for chronic beryllium 

disease in a beryllium machining plant. J Occup Environ Med 43(3):231–237.

12) Rosenman K, Hertzberg V, Rice C, Reilly 

MJ, Aronchick J, Parker JE, Regovich J, Rossman M [2005]. Chronic beryllium disease and 

sensitization at a beryllium processing facility. 

Environ Health Perspect 113:1366–1372.

13) Sackett HM, Maier LA, Silveira LJ, Mroz 

MM, Ogden LG, Murphy JR, Newman LS 

[2004]. Beryllium medical surveillance at 

a former nuclear weapons facility during 

cleanup operations. J Occup Environ Med 

46(9):953–961.

14) Schuler CR, Kent MS, Deubner DC, Berakis MT, McCawley M, Henneberger PK, Rossman MD, Kreiss K [2005]. Process-related 

risk of beryllium sensitization and disease 

in a copper-beryllium alloy facility. Am J Ind 

Med 47:195–205.

15) Schuler CR, Kitt MM, Henneberger PK, 

Deubner DC, Kreiss K [2008]. Cumulative 

sensitization and disease in a beryllium oxide ceramics worker cohort. J Occup Environ 

Med 50:1343–1350.

16) Stange AW, Furman FJ, Hilmas DE [2004]. 

The beryllium lymphocyte proliferation test: 

relevant issues in beryllium health surveillance. Am J Ind Med 46(5):453–462.

17) Stange AW, Hilmas DE, Furman FJ, Gatliffe 

TR [2001]. Beryllium sensitization and chronic 

beryllium disease at a former nuclear weapons 

facility. Appl Occup Environ Hyg 16(3):405–417.
12 Preventing Sensitization and Disease from Beryllium Exposure

18) Taiwo OA, Slade MD, Cantley LF, Fiellin MG, Wesdock JC, Bayer FJ, Cullen MR 

[2008]. Beryllium sensitization in aluminum smelter workers. J Occup Environ Med 

50(2):157–162.

19) Welch L, Ringen K, Bingham E, Dement J, 

Takaro T, McGowan W, Chen A, Quinn P [2004]. 

Screening for beryllium disease among construction trade workers at Department of Energy nuclear sites. Am J Ind Med 46(3):207–218.

20) Committee on Beryllium Alloy Exposures, Committee on Toxicology, National 

Research Council [2008]. Managing health 

effects of beryllium exposure. Washington, 

DC: The National Academies Press. [www.

nap.edu/catalog/12464.html].

21) Curtis GH [1951]. Cutaneous hypersensitivity due to beryllium: a study of 

thirteen cases. AMA Arch Dermatol Syph

64(4):470–482.

22) Tinkle SS, Antonini JM, Rich BA, Roberts 

JR, Salmen R, DePree K, Adkins EJ [2003]. 

Skin as a route of exposure and sensitization 

in chronic beryllium disease. Environ Health 

Perspect 111(9):1202–1208.

23) Cummings KJ, Deubner DC, Day GA, 

Henneberger PK, Kitt MM, Kent M, Kreiss 

K, Schuler CR [2007]. Enhanced preventive programme at a beryllium oxide ceramics facility reduces beryllium sensitisation 

among new workers. Occup Environ Med 

64(2):134–140.

24) Deubner D, Kent M [2007]. Keeping 

beryllium workers safe: an enhanced preventive model (commentary). J Occup Environ Hyg 4:D23–D30.

25) NIOSH [1977]. Public hearing on the occupational standard for beryllium: statement 

of Edward J. Baier, NIOSH deputy director. 

U.S. Department of Labor, Occupational Safety and Health Administration, August 19.

26) CFR. Code of Federal regulations. Washington, DC: U.S. Government Printing Office, 

Office of the Federal Register. 

27) OSHA [1998]. Letter from Assistant 

Secretary Charles N. Jeffress to Peter Brush, 

Acting Assistant Secretary for Environment, 

Safety and Health, U.S. Department of Energy, 

August 27.

28) OSHA [1999]. Preventing adverse health 

effects from exposure to beryllium on the 

job. Washington, DC: U.S. Department of Labor, Occupational Safety and Health Administration, OSHA Hazard Information Bulletin 

99–09–02 [www.osha.gov/dts/hib/hib_data/

hib19990902.html].

29) ACGIH [2009]. TLVs® and BEIs®: based 

on the documentation of the threshold limit 

values for chemical substances and physical 

agents and biological exposure indices. Cincinnati, OH: American Conference of Governmental Industrial Hygienists. 

30) California Code of Regulations, Title 8, 

Section 5155, Table AC-1 [2007]. [http://

www.dir.ca.gov/title8/5155ac1Frame.html].

31) Gazette Officielle du Québec [2005]. 

Béryllium [7440-41-7]. Métal et composés 

(exprimée en Be) = 0,00015mg/m3. Gazette 

Officielle du Québec 137(31):4.

32) Institut für Arbeitsschutz der Deutschen Gesetzlichen Unfallversicherung [2010]. GESTIS 

International Limit Values for Chemical Agents: 

Occupational Exposure Limits (OELs) [http://

bgia-online.hvbg.de/LIMITVALUE/WebForm_

gw.aspx]. Date accessed: May 28, 2010.
Preventing Sensitization and Disease from Beryllium Exposure 13

33) Ministry of Health, People’s Republic of 

China [2007]. Occupational exposure limits 

for hazardous agents in the workplace, part 

1: chemical hazardous agents, GBZ 2.1-2007

[http://www.moh.gov.cn/publicfiles/business/

cmsresources/zwgkzt/cmsrsdocument/doc 

3277.pdf]. Date accessed: June 2, 2010.

34) OSHA [2002]. Preventing adverse health 

effects from exposure to beryllium in dental 

laboratories. Washington, DC: U.S. Department of Labor, Occupational Safety and Health 

Administration, OSHA Hazard Information 

Bulletin 02–04–19 [www.osha.gov/dts/

hib/hib_data/hib020419.html].

Preventing Sensitization and Disease from Beryllium Exposure 15

Appendix

Examples of Beryllium Industries

and Products

reactor components, oil field drilling and exploring devices, and relays and switches.

Fire prevention: Nonsparking tools and 

sprinkler system springs.

Instruments, equipment, and objects: Bellows, camera shutters, clock and watch gears 

and springs, commercial speaker domes, computer disk drives, musical instrument valve 

springs, pen clips, and commercial phonograph 

styluses.

Manufacturing: Injection molds for plastics, and bearings.

Other metals: Aluminum smelting and nonferrous metal foundries.

Sporting goods and jewelry items: Golf 

clubs, beryl and chrysoberyl gemstones (including aquamarine, emerald, and alexandrite), and manmade emerald and other 

gemstones with distinctive colors.

Scrap recovery and recycling: Various 

beryllium-containing products.

Telecommunications: Cellular telephone 

components, electromagnetic shields, electronic and electrical connectors, personal 

computer components, rotary telephone 

springs and connectors, undersea repeater 

housings, and transistor mountings (integrated circuit substrates).

Note: Health risks exist if beryllium-containing

materials are dispersed as a dust, fume, mist, 

or beryllium-containing solution or suspension 

that can be inhaled or come into contact with 

unprotected skin. 

Aerospace: Altimeters, braking systems, 

bushings and bearings for landing gear, 

electronic and electrical connectors, engines, gyroscopes, mirrors (e.g., space telescopes), precision tools, rockets, satellites, 

structural components, and missile guidance systems.

Automotive: Air-bag triggers, antilock brake 

system terminals, electronic and electrical connectors, steering wheel connecting 

springs, and valve seats for drag racer engines.

Biomedical: Dental bridges, partials, and 

other prostheses, medical laser and scanning electron microscope components, and 

X-ray windows.

Decommissioning and decontamination of 

worksites: Various beryllium-containing materials.

Defense: Heat shields, mast-mounted sights, 

missile guidance systems, nuclear weapon 

components, submarine hatch springs, and 

tank mirrors.

Energy and electrical: Heat exchanger tubes, 

microelectronics, microwave devices, nuclear 
NOTES
NOTES
DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226–1998

to For a monthly update on news at NIOSH, subscribe

E-mail: cdcinfo@cdc.govTTY: 1–888–232–63481–800–CDC–INFO (1–800–232–4636)

contact NIOSH atabout occupational safety and health topics,To receive NIOSH documents or more informationthrough research and preventionSafety and health at work for all peopleDelivering on the Nation’s promise:

NIOSH eNews by visiting www.cdc.gov/niosh/eNews.

SAFER 

DHHS (NIOSH) Publication No. 2011–107

• HEALTHIER • PEOPLE

TM

Official Business

Penalty for Private Use $300

or visit the NIOSH Web site at www.cdc.gov/niosh