DOE Beryllium Affected Workers Web Resources
1. What Is Beryllium?
Beryllium is a hard, lightweight metal that is very
strong and easy to shape. Beryllium and beryllium
compounds have many industrial uses. Beryllium copper
alloys and beryllium oxide ceramics are used in the
electronic, nuclear and aerospace industries.
Beryllium parts for nuclear weapons, experimental
reactors and physics experiments have been manufactured
and used at a number of Department of Energy (DOE)
facilities since the 1950s. Workers may have come
into contact with beryllium in a number of jobs there
over the years.
The DOE Chronic Beryllium Disease Prevention Program
regulation 10 CFR 850 defines beryllium as: elemental
beryllium and any insoluble beryllium compound or
alloy containing 0.1 percent beryllium or greater
that may be released as an airborne particulate.
Beryllium is found in mineral forms in nature and
very small amounts of beryllium are in the soil everywhere.
The beryllium that is known to cause disease is the
beryllium that is refined from its original mineral
form and is then used as beryllium metal, beryllium
alloys with other metals, and beryllium oxides.
2. How Does Someone Get Exposed
Exposure usually happens when a person breathes in
beryllium mists, dusts and fumes. Beryllium travels
to the lungs where it can cause damage. Beryllium-related
granulomas (noncancerous tumors or growths) can also
develop in other body tissues, but these do not usually
result in a loss of function.
Machinists, welders and operators may have been exposed
through direct handling of beryllium and beryllium
compounds. Other workers may have been exposed by
performing laboratory analyses on beryllium compounds,
coming into contact with contaminated equipment, or
by working near a beryllium operation.
It is important for you to try to remember any
jobs or processes that might have brought you into
contact with beryllium and beryllium compounds. Explain
these carefully to any health provider who asks you
about your work history.
3. What Are The Major Health
Problems Beryllium Can Cause?
Beryllium disease is caused primarily by breathing
air containing beryllium mists, dusts, and fumes.
Both acute (abrupt, short-term) and chronic (long-term)
health problems can occur.
The acute disease starts soon after exposure and
resembles pneumonia or bronchitis. It requires relatively
high levels of exposure to the more soluble forms
of beryllium and is now quite rare because protective
measures to reduce exposure are usually in place.
The chronic form - Chronic Beryllium Disease (CBD)
- takes a long time to develop, usually several years
or even decades. It can occur at much lower levels
of exposure than the acute form. In CBD, inflammation
and scarring of the lungs make it more difficult for
the lungs to get oxygen to the bloodstream and body.
A special type of scarring called granuloma is very
typical of this disease. These non-cancerous growths
look like scars or tumors present in another disease
called sarcoidosis. The inflammation leads to a build-up
of abnormal tissue called granulomas and if the inflammation
persists scar tissue that permanently damages the
lung. CBD is similar to another disease called sarcoidosis.
A work history and additional tests will help to make
the correct diagnosis. Figure 1 shows changes that
can be found in the chest x-ray of a CBD patient.
Figure 1 Bilateral hilar adenopathy and fine nodular
upper lobe infiltrates in CBD
Courtesy: Milton D Rossman, MD Professor
of Medicine University of Pennsylvania Medical Center
Pulmonary Allergy & Critical Care Division
Most people exposed to beryllium will NOT get the
disease. With the amount of beryllium in dusts we
know were present in the workplace, fewer than three
percent will probably develop disease.
CBD can be mild or severe. For some, it can be a
relatively minor condition, while for others it can
become a very serious, disabling disease. As with
many workplace hazards, higher exposures (doses) to
beryllium cause more people to get sick and can result
in more severe symptoms. In a few people, even very
small amounts of beryllium can pose a problem. This
is because even small amounts of beryllium can cause
some people to become sensitive (called sensitization
or sensitivity) to the metal. CBD cannot be cured
but it can be treated with medications that reduce
inflammation and the build-up of scar tissue.
Beryllium is identified by the International Agency
for Research on Cancer as a cancer causing substance
based on convincing evidence in laboratory animals
and suggestive evidence in humans. Among beryllium
production plant workers, studies found a small but
significant increase in the amount of lung cancers.
However, other researchers have pointed out flaws
in that study.
The Department of Health and Human Services has also
determined that beryllium and certain beryllium compounds
may reasonably be anticipated to be carcinogens. This
determination is based on animal studies and studies
in workers. "However, the dose that is sufficient
to cause these adverse health effects remains unknown."
4. What is the Beryllium Blood
Test - Beryllium Lymphocyte Proliferation Test (Be-LPT)?
The Lymphocyte Proliferation Test (LPT) is a laboratory
blood test that examines how a type of disease-fighting
blood cells that are normally found in the body, called
lymphocytes, reacts to beryllium. In general terms,
the Be-LPT is performed by culturing lymphocytes from
peripheral blood. Beryllium and other substances needed
for the test are then added to small groups of these
lymphocytes. The laboratories call a test "abnormal"
if lymphocytes react strongly, “normal” if lymphocytes
do not react, "borderline" if the response is weak
or indeterminate, and "uninterpretable" if the blood
sample was damaged in shipment or there was another
technical problem with the test.
Experts believe that the Be-LPT shows abnormal results
in individuals who have become "sensitized" to beryllium
and that sensitization is the first step to getting
CBD. Studies have shown that practically all individuals
with CBD also are sensitized. On the other hand, many
individuals that are sensitized to beryllium do not
have CBD. Sensitization means that the person was
exposed to beryllium and that his or her body has
become hypersensitive . It means that an individual
is more likely than others to get CBD but the individual
may never get CBD or may get a mild case of CBD especially
if the individual's exposure was low.
As with any other screening test, the Be-LPT sometimes
provides inaccurate or uninterpretable results. The
test results may appear abnormal when a person is
not sensitized or normal when a person is actually
sensitized. If you have uninterpretable results, you
may be asked to provide another blood sample so the
test can be repeated. A repeat test also may be offered
to confirm an abnormal test result or because the
test was borderline. If your Be-LPT is "abnormal,"
future testing may be covered by the Department of
Labor Energy Employees Occupational Illness Compensation
Program Act of 2000 (DOL EEOICPA). If you have two
"abnormal" tests in a row, you may want to consider
further medical tests to confirm or rule out CBD.
Concerns have been expressed  over shortcomings
of the blood BeLPT but DOE continues to consider that
test to be a reliable tool for screening individuals
for beryllium sensitization. A published evaluation
 of the commonly used BeLPT method used for 12,194
current and former workers at 18 DOE sites found the
test to positively identify a case of beryllium sensitization
at a rate comparable to other widely accepted medical
tests and therefore is determined effective in medical
surveillance of beryllium-exposed workers. If you
want to read the studies, they are:
 Borak J, Woolf SH, Fields CA, Use of beryllium
lymphocyte Proliferation Testing for Screening of
Asymptomatic Individuals: An Evidence-based Assessment,
J Occup Environ Med. 2006; 48:937-947.
 Stange AW, Furman FJ, Hilmas DE, The beryllium
lymphocyte proliferation test: Relevant issues in
Beryllium Health Surveillance, Am J Ind Med. 2004
The National Academy of Sciences' recently published
a study for the US Air Force which concluded that
while some issues surround the accuracy of the test,
it is an adequate test for use in a surveillance program.
The report is published as: National Research Council
of the National Academies, Managing Health Effects
of Beryllium Exposure, ISBN: 0-309-12533-2, The
National Academies Press, Washington, DC (2008).
Remember that you may refuse further tests at
this point or at any point during your medical evaluations.
5. How Often Should I Have the
Medical experts recommend that persons who worked
with beryllium and may have breathed it into their
lungs may want to have the Be-LPT blood test every
year while still working with beryllium. If symptoms
of CBD develop, Be-LPT testing along with a rigorous
medical evaluation should be done as soon as possible
to establish a diagnosis. You may be eligible to receive
retesting through the appropriate DOE medical screening
program. The DOE, through its Office of Health, Safety
and Security, has sponsored free beryllium screening
for former workers from many sites http://www.hss.energy.gov/HealthSafety/FWSP/formerworkermed/index.html.
6. When Can I Stop Being Tested?
Experts believe that after people who are no longer
working with beryllium and have had 2-3 normal Be-LPTs
at three year intervals are most likely normal. Experts
also believe that those individuals who have been
sensitized will have been identified by then and should
get regular follow-up evaluations to watch for symptoms
that may need treatment. If you develop symptoms that
might be related to CBD or concerns about having CBD
symptoms or a respiratory condition that your physician
cannot diagnose, your physician may have you take
a Be-LPT test.
7. Could an Abnormal Be-LPT
Affect My Work with Beryllium in the Future?
If you are found to have a consistently abnormal
Be-LPT or if you have CBD, it is advisable to stay
away from environments where beryllium may be present.
Some employers may restrict your work to areas where
there is no beryllium above the background levels
or not hire you for jobs that involve potential exposure
to refined forms of beryllium.
8. What Are The Symptoms Of
Chronic Beryllium Disease?
Symptoms of CBD include:
- Shortness of Breath, especially with activity
- Chest Pain
- Weight Loss
- Loss of Appetite
It is important to note that NOT all individuals
with these symptoms will have CBD. These can be symptoms
of other conditions which may require medical attention
as well. Also, not all people with CBD have all these
9. What Will Happen If I am
Diagnosed as Having Chronic Beryllium Disease?
Most people with chronic beryllium disease are able
to control the symptoms with prescription drugs and
regular medical treatment so that they can live full
and productive lives.
Because of the considerable reserves built into the
human pulmonary system and because humans only use
about one-third of their lung capacity when at rest,
sedentary people may be diagnosed with the disease
but have no symptoms. If you do not have any symptoms,
you probably will not require treatment and chronic
beryllium disease will probably have little effect
on your life. Even so, you should avoid future exposure
to beryllium dust and see a doctor regularly to monitor
the disease. Figure 2 shows changes that can be found
in the chest CT scan of a CBD patient. These changes
need to be monitored regularly by a physician.
Figure 2 Chest CT: Diffuse fine nodular disease and adenopathy
Courtesy: Milton D Rossman, MD Professor
University of Pennsylvania Medical Center
Pulmonary, Allergy & Critical Care Division
Treatment with a group of drugs called corticosteroids
("steroids"), such as prednisone, may be advised for
those with symptoms of chronic beryllium disease.
These "steroids" are not the same as the ones you
hear about athletes using. The steroids provided for
CBD patients provide more good than harm when used
appropriately. These steroids reduce inflammation
and are believed to help keep the condition from progressing.
Complete cure is not possible, but steroids may be
effective in controlling the disease. Any decision
to use drugs should be made after discussing possible
side effects with your doctor.
Any person with a lung condition, including chronic
beryllium disease, may benefit from pneumonia and
flu vaccinations and early treatment of respiratory
If you smoke cigarettes, try to STOP or seek professional
help. This is especially important for those with
lung disease. Exposure to beryllium may increase a
person's chances of getting lung cancer. It is important
to eliminate major additional cancer risks such as
If your preliminary Be-LPT results are abnormal and
your current DOE job exposes you to elevated levels
of beryllium in the air, you are encouraged to consider
accepting removal from the job as outlined in the
DOE Regulation 10 CFR 850.35 Medical Removal. Moving
to a job without beryllium exposures until a final
diagnosis can be made is a sensible precaution.
10. How Can I and My Family
Cope with the Emotional Effects That May Occur After
Being Diagnosed as Having CBD?
Individuals with concerns regarding their physical
health frequently experience the physical and psychological
effects of stress. This may include workers who have
been advised of a positive beryllium sensitivity blood
test and particularly those advised of the diagnosis
of CBD. DOE employees with a CBD diagnosis and their
family may want to learn more about how to recognize
and manage these complications. DOE provides emotional
and other support for current workers through the
Employee Assistance Programs (EAP) at the sites. EAPs
provide a myriad of services such as counseling for
emotional, family, medical, financial, legal, and
work-related problems. Services are confidential.
Some EAP services are offered on the sites and some
offsite. Family members may contact the EAP services
for assistance. Usually EAP services are free for
a specified number of visits. If the EAP counselors
determine that a condition warrants additional treatment,
individuals may be referred to appropriate resources
for continued counseling.
Current workers who would like to talk about the
emotional and other effects of CBD should contact
their site occupational medicine clinic, or the human
resources department, or go directly to the EAP. A
list of the DOE site occupational medicine clinics
is at: http://www.hss.doe.gov/cmo/directory.html.
The clinic staff will provide you information on how
to contact the local EAP.
Former workers may want to contact the occupational
medicine clinic at their previous DOE worksite to
determine if they are covered under the EAP.
Other resources which might be helpful include:
These facts were prepared for your use and are
NOT meant as a substitute for consulting with your
own doctor! However, because chronic beryllium disease
is rare, most family doctors and internists have not
had the opportunity to treat individuals with chronic
beryllium disease. For this reason, you may also wish
to consult a lung specialist that your doctor recommends.
If you do not have a personal physician, you can request
a list of board certified pulmonary doctors from the
local medical society, or look for a pulmonary doctor
in the yellow pages.
U.S. Department of Labor
11. How Do I Apply for Workers'
Compensation Benefits Through the Department of Labor?
Financial Compensation and Medical Care for DOE
Workers and Certain DOE Vendors with Chronic Beryllium
U.S. Department of Labor Energy Employees Occupational
Illness Compensation Program (DOL EEOICP): http://www.dol.gov/esa/owcp/energy/regs/compliance/main.htm
The mission of the DOL EEOICP program is to provide
lump-sum compensation and health benefits to eligible
DOE nuclear weapons workers and workers at certain
DOE vendors (including employees, former employees,
contractors and subcontractors) and lump-sum compensation
to certain survivors if the worker is deceased (read
more). Beryllium workers are among those eligible
for compensation through the DOL EEOICP. When you
apply for benefits, DOL will collect medical, employment,
and other information from you and make a decision
about whether or not you qualify for compensation
and benefits. If you qualify for benefits you may
receive reimbursement or payment for doctor's office
visits, medical treatments, hospital visits, and consultations;
inpatient and outpatient hospital charges, including
emergency room visits for the accepted conditions,
diagnostic laboratory testing, and chest x-rays; drugs
prescribed by a doctor, both brand name and generic;
ambulance services; and travel to the doctor, hospital,
clinic, other medical facility, or pharmacy. To learn
more read the DOL Medical Qualifications Brochure
DOL District Offices: http://www.dol.gov/owcp/energy/regs/compliance/law/jurisdictionmap.htm
To learn more about the DOL EEOICP benefits program,
click on the links below.
View basic information about the DOL EEOICP
View/download brochures and fact sheets
Benefits: Part B and Part E
Asked Questions (FAQs)
Information for Atomic Weapons Industry Workers and
Benefits: Questions and Answers about the Energy Employees
Occupational Illness Compensation Program
Diseases and the EEOICPA
Do I Qualify for an Impairment Award under Part E
of the EEOICPA
Loss Benefits under Part E of the EEOICPA
a Tort Action Affects your Right to EEOICPA Benefits
a list of covered facilities
help filing a claim
Contact your Claims Examiner at the District Office or the DOL Resource Centers to get an update on your claim
the status of my dose reconstruction (NIOSH)
about Special Exposure Cohorts
help with medical bills
as a medical provider
Significant EEOICPA Decisions
about program law and regulations
more program information
other related links
the latest program news
DOL Toll-Free Help: 1-866-888-3322
8:00 am to 4:30 pm Eastern Time (Mon - Fri)
12. Department of Labor's Resource
The Department of Labor's Resource Centers
are available around the U.S. to assist workers with
applying for claims under EEOICP. View a map of locations
and the regions they serve: http://www.dol.gov/esa/owcp/energy/regs/compliance/ResourceMeetings/ResourceCenters.htm
Twelve (12) resource centers help employees and families
file for benefits under the EEOICPA. A list of resource
centers can be located at the U.S. Department of Labor's
web site at http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/main.htm
or you may contact a center by dialing a number provided
- Anchorage, Alaska (888) 654-0014
- Livermore, California (866) 606-6302
- Westminster, Colorado (866) 540-4977
- Idaho Falls, Idaho (800) 861-8608
- Paducah, Kentucky (866) 534-0599
- Las Vegas, Nevada (866) 697-0841
- Espanola, New Mexico (866) 272-3622
- Amherst, New York (800) 941-3943
- Portsmouth, Ohio (866) 363-6993
- North Augusta, South Carolina (866) 666-4606
- Oak Ridge, Tennessee (866) 481-0411
- Richland, Washington (888) 654-0014
U.S. DEPARTMENT OF LABOR Energy Employees Occupational
Illness Compensation Program Act (EEOICPA).
Benefits are available under two parts of the EEOICPA.
Explanations of the two separate benefits are below.
|Part B of the EEOICPA
(enacted July 31, 2001) provides benefits to eligible
current or former employees of the Department
of Energy (DOE), and certain of its vendors, contractors
and subcontractors, and to certain survivors of
such individuals as provided in the Act. To be
eligible, an employee must have sustained a radiogenic
cancer, chronic silicosis, beryllium sensitivity,
or chronic beryllium disease while in the
performance of duty at a covered DOE facility,
atomic weapons employer facility or a beryllium
vendor facility during a specified period of time.
Part B provides benefits in the amount of $150,000
and covers medical expenses related to the accepted
condition. Part B also provides for payment of
a smaller lump-sum of $50,000 to individuals (who
also receive medical benefits) or their eligible
survivors, who were determined to be eligible
for compensation under section 5 of RECA.
||Part E of the EEOICPA
(enacted October 28, 2004) provides compensation
and medical benefits to DOE contractor and subcontractor
employees and to certain uranium workers who developed
a covered illness as a result of exposure to any
toxic substance (including the three covered
by Part B) at a DOE facility or RECA Section 5
facility, as appropriate. It grants covered employees
a federal payment based on the level of impairment
and/or years of qualifying wage-loss if they developed
a covered illness as a result of exposure to toxic
substances. Certain survivors of deceased workers
are also eligible to receive compensation, if
the covered illness caused, aggravated or contributed
to the employee's death. The maximum compensation
under Part E is $250,000 for all claims relating
to any individual.
Department of Energy Sponsored
13. Former Worker Program:
In 1993, the U.S. Congress enacted Public Law 102-484,
Section 3162. This law directed DOE to establish a
program to evaluate the health of former DOE workers
who may have been exposed to hazardous substances
at work. The DOE Former Worker Program was established
to offer medical screening to former DOE workers who
may be at risk for development of health effects because
of exposures to hazards during their employment at
DOE. Former workers are encouraged to participate
in the screening program and may learn more about
how to apply for the screenings by contacting Mary
Fields at DOE HQ.
More detailed information for
former workers is available on HQ DOE websites
Office of Worker Screening and Compensation Support:
Former Worker Screening Program Brochure:
Former Worker Medical Screening Website - Related
Former Beryllium Vendor Worker Screening Website:
The diagram below shows how persons who participate
in the DOE's FWP beryllium screening program and are
found to have an abnormal Be-LPT blood test and/or
diagnosis of CBD, may move into the Department of
Labor's EEOICP workers' compensation program.
Worker Program: Beryllium Affected Workers-
Diagram explaining how Former Workers apply for Department
of Labor Benefits
14. Current DOE Beryllium Workers
The DOE Beryllium Regulation
to protect current beryllium workers: Contact
The DOE Beryllium Rule -10 CFR 850 Chronic Beryllium
Disease Prevention Program - establishes a chronic
beryllium disease prevention program (CBDPP) to reduce
the number of workers currently exposed to beryllium
in the course of their work at DOE facilities managed
by DOE or its contractors, minimize the levels of,
and potential for, exposure to beryllium, and establish
medical surveillance requirements to ensure early
detection of the disease. To learn more about this
regulation go to CBDPP Regulation 10 CFR 850
The Beryllium Registry:
The Beryllium Rule became effective January 7, 2000.
The Rule established the health and safety standards
for conducting beryllium work at DOE. Among the standards
in this regulation is the requirement to maintain
a registry of all known current beryllium workers.
The goal of the registry is to determine the incidence
and prevalence of beryllium sensitization and chronic
beryllium disease (CBD). The data will be analyzed
to better understand CBD and to identify those at
risk. Another goal is to monitor and evaluate the
effectiveness of DOE's Chronic Beryllium Disease Prevention
Program. The Beryllium Registry is supported at DOE
HQ by the Office of Illness and Injury Prevention
Programs maintained by the Oak Ridge Institute for
Science and Education. To learn more about the Registry
go to: http://www.hss.energy.gov/HealthSafety/IIPP/hservices/bery_wr.html
Beryllium Safety Awareness Bulletin
DOE's HQ EEOICP: Contact
DOE HQ EEOICP website: http://www.hss.energy.gov/HealthSafety/FWSP/Advocacy/
DOE HQ Human Subjects Protection
Program website http://humansubjects.energy.gov/worker-studies/cbd.htm
DOE HQ Guidance for Informed Choice:
15. Additional DOE Websites
Providing Information for Current and Former DOE Workers
Who are Currently Working With or Who Have Worked
with Beryllium or Who Have Chronic Beryllium Disease
The DOE Beryllium Health and Safety Committee's webpage
hosted by Sandia National Laboratory: http://www.sandia.gov/BHSC/index.htm
Oak Ridge Institute for Science and Education: http://orise.orau.gov/oews/be-studies-testing.htm
Oak Ridge Institute for Science and Education, Institutional
Review Board: http://orise.orau.gov/worker-health-studies/capabilities/protecting-human-subjects/orsirb.aspx
This board reviews and approves all studies that are
undertaken through DOE to understand beryllium exposure
risks and health outcomes such as chronic beryllium
Oak Ridge National Laboratory - the Beryllium LPT
test - a technical explanation
Ames Laboratory Beryllium Fact Sheet
Argonne National Laboratory
Argonne National Laboratory Human Health Fact Sheet
Brookhaven National Laboratory Beryllium Web Site
Fermi National Laboratory (FermiLab) Beryllium Hazard
FermiLab Beryllium Handling Training Powerpoint Presentation
Hanford Beryllium Awareness Group
Hanford Beryllium Questions and Answers
Kansas City Plant Former Worker Fact Sheet
Lawrence Berkeley National Laboratory
NNSA Investigation of Beryllium Exposure Cases at
N. Las Vegas Facility
16. Other U.S. Federal Agency's
Beryllium Web Pages and Information Resources
The Department of Labor Occupational Safety and Health
Administration's (OSHA) Beryllium Standard
OSHA Additional Information on Beryllium
OSHA Safety and Health Topic on Beryllium
The Centers for Disease Control and Prevention's
Beryllium Fact Sheet for Construction Workers
National Institute for Occupational Safety and Health
NIOSH International Chemical Safety Card on Beryllium
Agency for Toxic Substances and Disease Registry
ATSDR ToxFAQs on Beryllium
Environmental Protection Agency
National Institute for Environmental Health Sciences
U.S. Geological Survey Beryllium Statistics and Information
U.S. Army Center for Health Promotion and Preventive
U.S. Navy Medical Matrix on Beryllium
Department of Defense Office of Installations and
U.S. Department of Commerce National Oceanic and
Department of the Interior - Bureau of Reclamation
EPA's National Emission Standard for Beryllium
National Library of Medicine Article on diagnosis
and management of CBD
National Institute of Standards and Technology Basic
Atomic Data on Beryllium