Assessment of beryllium disease
risk in pre-selected BC industries
January 2015
Principal Investigator/Applicant
Dr. Tim Takaro
RS2010-OG11
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
Assessment of beryllium disease risk in pre-selected BC industries
Principal Investigator
Dr. Tim Takaro
1
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
Assessment of beryllium disease risk in pre-selected BC industries
Tim Takaro1, Yu Uchida1, Mike Van Dyke2, Lisa Maier2, Mieke Keohoorn3,4,5
1.
2.
3.
4.
5.
Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
Division of Environmental and Occupational Health Sciences, Department of Medicine,
National Jewish Health, Denver, USA
School of Population and Public Health, University of British Columbia, Vnacouver,
Canada
Centre for Health Services and Policy Research, University of British Columbia,
Vancouver, Canada
School of Environmental Health, University of British Columbia, Vancouver, Canada
Correspondence to: Tim K. Takaro, MD, MPH, MS.
Associate Professor
Faculty of Health Sciences
Simon Fraser University
8888 University Dr. Blusson Hall 11518
Burnaby, BC V5A 1S6
Phone: 778-782-7186
Fax:
778-782-5927
ttakaro@sfu.ca
Final Report to WorkSafeBC
2
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
Table of Contents
MAIN RESEARCH FINDINGS FROM THE STUDY ............................................................ 4
EXECUTIVE SUMMARY .......................................................................................................... 5
1
RESEARCH CONTEXT ..................................................................................................... 7
1.1
1.2
1.3
1.4
2
Beryllium .................................................................................................................................... 7
Chronic Beryllium Disease ....................................................................................................... 7
Pilot Study in BC ....................................................................................................................... 8
Objectives ................................................................................................................................... 8
RESEARCH DESIGN AND METHODOLOGY .............................................................. 9
2.1
2.2
2.3
2.4
2.5
2.6
Recruitment of workers ............................................................................................................ 9
Worksite Evaluations ................................................................................................................ 9
Risk Communication ............................................................................................................... 10
Medical Surveillance ............................................................................................................... 10
Procedures for Clinic Patients ................................................................................................ 11
Exposure Assessment and Blood Test Reports ..................................................................... 11
3
RESULTS ............................................................................................................................ 12
3.1
Worksite Evaluations .............................................................................................................. 12
3.1.1 Power Production and Distribution ....................................................................................... 12
3.1.2 Pulp and Paper Mills ............................................................................................................. 14
3.1.3 Air Transportation Maintenance ........................................................................................... 16
3.1.4 Dental Technicians ................................................................................................................ 17
3.1.5 Welders, Machinists and Electricians ................................................................................... 18
3.2
Medical Surveillance and Survey Results.............................................................................. 19
3.2.1 Air Transportation Maintenance ........................................................................................... 20
3.2.2 Dental Technicians ................................................................................................................ 20
3.2.3 Clinic Patients ....................................................................................................................... 20
4
DISCUSSION ...................................................................................................................... 21
5
ACKNOWLEDGEMENTS ............................................................................................... 25
6
REFERENCES.................................................................................................................... 26
7
APPENDICIES ................................................................................................................... 28
7.1
7.2
Report of Wipe Sample Analysis for BC Hydro Facilities ................................................... 28
Report of Wipe Sample Analysis for VCC Dental Technology Program ........................... 39
3
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
MAIN RESEARCH FINDINGS FROM THE STUDY
Power Production and Distribution
Beryllium concentrations in forty-one surface dust wipe samples collected in four different
facilities of a power production and distribution company in BC ranged from below the detection
limit of 0.0021 μg/100 cm2 to 0.23 μg/100 cm2. The highest concentration was found on a
grinding machine in a machining shop in one of the facilities.
A sample collected near an uncovered stator of a hydraulic power generator contained beryllium
of 0.092 μg/100 cm2, while another sample taken at approximately one meter from the same
stator was 0.0067 μg/100 cm2. The results suggest that, if the stator was the source of beryllium
exposure, the beryllium dust from the stator remained in close proximity without traveling to the
outside area.
Pulp and Paper Mills
There was no evidence of beryllium use in a pulp and paper mill we visited. Why the industry
has its sarcoidosis rate above the average is unclear, and we could not determine the association
between the rates and beryllium.
Air Transportation Maintenance
According to BC aerospace companies we contacted, they no longer operate heavy maintenance
operation in BC that may involve alternation of beryllium-containing parts. However, we learned
from aerospace workers that beryllium exposure is still possible during replacement of old brake
assemblies and electronic transistors and transmitters, fitting of bushing sleeves, and use of antiseize compounds that contains beryllium.
Dental Technicians
Beryllium-containing dental alloys were used for crown and bridges in 1970s and 1980s but less
common in the recent years. Dust samples collected from two manual casting machines in
current use in a dental technology training program contained 0.10 and 0.11µg/100 cm2 of
beryllium. However, the program’s staff members were not aware of any beryllium use during
their career in the program for over ten years.
Electronics Waste Recycling
Historical exposure monitoring data obtained from an electronics waste recycling facility showed
that beryllium was found in several dust samples collected in 2004, but not in later years. The
report states that the findings were possibly because e-waste processed in 2004 contained the
highest concentration of circuit boards in the waste.
Recruitment of study subjects for interviews and the beryllium lymphocyte proliferation test was
carried out in three populations: dental technicians; welders, machinists and electricians; and
clinic patients with sarcoidosis. Forty-one subjects consented to participate in the study, and 34
of them took the beryllium lymphocyte proliferation test. Results of the blood test were normal
for 33 subjects and uninterpretable for one subject.
4
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
EXECUTIVE SUMMARY
Introduction
Exposure to beryllium causes chronic beryllium disease (CBD) in susceptible individuals.
Despite the existence of several industries with possible beryllium operations, no cases of CBD
have been diagnosed in British Columbia. CBD is often misdiagnosed as sarcoidosis, another
lung condition that is more common and clinically and histopathologically indistinguishable
from CBD. In our pilot study, we observed elevated rates of sarcoidosis in some industries and
suspected that there are hidden CBD cases resulted from exposure to beryllium in those
industries. The purpose of this study was to identify workplaces in BC with beryllium exposure
risk, raise awareness of beryllium hazard, and screen workers and sarcoidosis patients for
beryllium sensitization.
Methods
Based on the results of the pilot study, the following five industries and occupations in BC were
targeted: 1) power production and distribution; 2) air transportation maintenance; 3) pulp and
paper mills; 4) dental technicians; and 5) welders, machinists and electricians. With assistance
from WorkSafeBC and cooperating unions we approached the targeted industries to propose a
worksite exposure assessment, risk communication where appropriate and screening of interested
workers for beryllium sensitization using the beryllium lymphocyte proliferation test (BeLPT).
The exposure assessment included consultation with company representatives and workers,
walk-through exposure surveys, and surface dust wipe sampling. In addition to the five target
populations, sarcoidosis patients from the two largest sarcoidosis referral centres in BC with
beryllium-related occupational history were also recruited for the study, including BeLPT.
Results
The findings from our dust sample analysis, historical monitoring records, and interviews with
workers suggested that beryllium exposure is likely in aircraft maintenance workers, dental
technicians, and e-waste recycling workers in BC. However, most of the companies in these
target industries that we approached refused to participate and restricted our access to their
facilities. With this limitation, we were unable to be comprehensive in our investigation and
identify specific sites and sources of beryllium exposure. This was the primary reason we did not
exhaust all the funds budgeted for this project. Although recruitment of workers through the
beryllium-flagged industries was unsuccessful, we obtained consent from 10 aircraft
maintenance workers, 18 dental technicians, and 13 sarcoidosis patients to participate in the
study. Thirty-four of the consenting subjects received the BeLPT; all of the test results were
normal except one that was not interpretable.
Implications
Convincing companies to participate was challenging and access to their workers was often
restricted, while recruitment of workers through unions was more successful. We could not reach
a conclusion about beryllium risk in BC. Either there is negligible risk for beryllium disease in
the Province or we were unable to detect it with our limited access to workers at risk. Additional
exposure information and risk communication are required to better understand the long-term
benefit of investigating beryllium disease risk in BC. In particular past practices leaving residual
or legacy exposure risk need to be examined to eliminate future risks from this latent disease.
5
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
WorkSafeBC has now implemented a new policy reducing the Occupational Exposure Limit
(OEL) for beryllium to 0.05 ug/m3. This will be a further incentive to continue investigation.
Supporting the lower OEL will require employers to know their product sources and production
hazards for beryllium dust and fume.We suggest improving workers’ accessibility to appropriate
information and medical services for beryllium disease detection, to complement the anticipated
need for increased in exposure assessment.
6
2011s0207 Final Report – Revised Final 15Jan15
1
RESEARCH CONTEXT
1.1
Beryllium Takaro et al.
Beryllium (Be), a strong light-weight metal with excellent thermal properties, has historically
been used for the production of fluorescent lights, high-tech military equipment, nuclear reactors,
and nuclear weapons. Recently its use has expanded in the manufacturing of a wide range of
diverse products such as, neon signs, personal computers, mobile telephones, golf clubs, and
jewelry (1). Primary beryllium industries include the mining, refining and production of
beryllium, beryllium alloys, beryllium ceramics, and other limited number of products containing
beryllium. Secondary downstream industries – where beryllium products are used – have
received less attention and include - dental laboratories, specialty foundries, and parts
manufacturing for electronics and specialized tools and switch applications.
1.2
Chronic Beryllium Disease Beryllium is highly toxic for susceptible individuals. Exposure to beryllium, even at a low level
from secondary sources, can cause a progressive, debilitating lung condition known as Chronic
Beryllium Disease (CBD) or berylliosis. Symptoms of CBD are breathing difficulties, coughing,
chest pain, and general weakness. Signs include enlargement of the liver, spleen and right heart,
and kidney stones. The course of chronic beryllium disease varies. Some affected people may
have few or no symptoms at all for many years, followed by eventual deterioration of lung and
possibly other organ function (2). This disease process is mediated by the immune response in
the lungs in which individuals’ progress from sensitization to developing granulomas in the lung
– the histological hallmark of the disease – pulmonary fibrosis and increasing hypoxia. The
body’s immune system reacts to beryllium by forming fibrous granulomas that are typically
found in the lungs, but have also been reported to occur in the skin, liver, spleen, kidney, bone,
nervous system, skeletal muscles, lymph glands and the wall of the heart (2).
The current occupational standard for beryllium, 2 µg/ m3 of the air on average for an 8-hour
work shift, is clearly not protective and safe levels are more likely two orders of magnitude
lower. In 2009, American Conference of Governmental Industrial Hygienists (ACGIH) adopted
a new Threshold Limit Value (TLV) for beryllium of 0.05 µg/ m3 (3). Beryllium exposure is a
health risk not only for workers who work directly with it, but also those who may have
incidental or by-stander exposure e.g. maintenance works or security guards, spouses of workers
or other community members who may be indirectly exposed and develop sensitization and
disease(2,4–8). Following exposure to beryllium, “beryllium sensitization” can develop after a
few months, or can also take many years after exposure to develop.
Sensitization is usually diagnosed by the beryllium lymphocyte proliferation test (BeLPT), an in
vitro assay of the proliferation of lymphocytes after stimulation with beryllium salts. This
immunologic assay is used to identify and assist in the diagnosis of CBD and for screening and
surveillance of populations at risk (9). Individuals with beryllium sensitization are at very high
risk for progression to chronic beryllium disease. Longitudinal research has established that
individuals with beryllium sensitization progress to CBD at a rate of 6% – 8% per year (10) but
follow-up has not been long enough to determine if all individuals with beryllium sensitization
will eventually progress to CBD. Finally, though data is limited, several studies and
7
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
environmental disease logic suggest that sensitized workers who are removed from exposure
have a lower risk for progression to CBD (11,12).
CBD has been recognized in various industries across the U.S. since the 1930s. This debilitating
lung disease presents with cough and shortness of breath often years after first exposures.
Estimates of U.S workers exposed range from 135,000 current workers to 800,000 current and
former workers (1,13). It was not until the 1990s that CBD was first recognized in Canada with
the first workers diagnosed ten years ago in Quebec in exotic metal and recycling foundries and
the aerospace industry. There have been no cases yet diagnosed in BC, and we suspected this
may be due to diagnostic confusion with sarcoidosis, another granulomatous lung condition that
is more common and clinically and histopathologically indistinguishable from CBD. Sarcoidosis
is an idiopathic, debilitating chronic lung condition with a prevalence of 3-10/100,000 in the U.S.
among people of European decent and about 10 fold higher in African Americans. No data is
available for prevalence in Canada, but Northern Europeans have prevalence between the two
(11,14). CBD resembles sarcoidosis both pathologically and clinically, but because it is directly
linked to exposure to beryllium, CBD is a preventable disease.
1.3
Pilot Study in BC
Our previously funded WorkSafeBC project (Beryllium Disease in BC Workers: A pilot
surveillance project using linked administrative data), established the feasibility of using BC
medical services outpatient and hospitalization inpatient health records to link regional cases of
sarcoidosis to industry of employment, to estimate workplace environmental exposures to
beryllium at the population-level. By examining the overlap between BC industries with
beryllium hazard and cases of sarcoidosis, we have generated estimates that several thousand BC
workers are at risk for beryllium exposure, particularly within the following North American
Industrial Classifications (NAIC) designations: Electric Power Generation, Transmission and
Distribution, Boiler, Tank and Shipping Container Manufacturing, Support Activities for Air
Transportation, Communications Equipment Manufacturing, Machining, and Pulp and Paper,
representing over 12,600 BC workers (15). Sarcoidosis may also be misdiagnosed as other lung
diseases such as hypersensitivity pneumonitis. Knowing the correct diagnosis is a public health
imperative as this knowledge determines what may be effective preventive strategies. More
research is needed to further determine whether/how many of the 104 cases of sarcoidosis
occurring in these BC industries between 1991 and 2006 actually represent chronic beryllium
disease.
1.4
Objectives
This study addressed WorksafeBC’s 2010 research and disease prevention priorities for
Occupational disease, injury and health services and corresponded to the 2010 research priority
on emerging occupational diseases related to sensitizing agents. By targeting BC industries with
potential beryllium, we aimed to identify workplaces at risk for CBD, educate workers about
beryllium hazard, and screen workers at risk using the BeLPT. Based on the pilot project, we
targeted the following five industries and occupations in BC for this study: 1) power production
and distribution including electrical contractors; 2) air transportation maintenance; 3) pulp and
paper mills; 4) dental technicians; and 5) welders, machinists and electricians. In addition to the
five target populations, we included clinic patients in BC who have sarcoidosis or other
pulmonary diseases and occupational history with potential beryllium exposure.
8
2011s0207 Final Report – Revised Final 15Jan15
2
RESEARCH DESIGN AND METHODOLOGY
2.1
Recruitment of workers
Takaro et al.
With assistance from WorkSafeBC and cooperating unions we prepared a list of BC companies
in each of the targeted industries identified in the pilot study. We contacted the company
representatives such as health and safety officers, operation managers, or facility managers by
phone and/or emails to introduce this study and ask for their participation. During this
recruitment process, we provided the representatives beryllium material information and
discussed with them about their current and past use of beryllium and potential exposure. In
addition to the direct communication with companies, in-person meetings were held with
members from BC Federation of Labour, BC Building Trades, International Brotherhood of
Electrical Workers, International Association of Machinists and Aerospace Workers, and College
of the Rockies. The purpose of the meetings was to investigate the risk of beryllium exposure in
welders, machinists and electricians not only in the targeted industries but also in other fields
with possible beryllium use and disease risk.
We used different approach to recruit dental technicians because many of the dental technicians
in BC are self-employed. We presented our study to them at town hall meetings and conventions
that were organized by the Dental Technicians Association of BC (DTABC). We handed out our
study information and solicit for participation at the events. The College of Dental Technicians
of BC (CDTBC) included our study information in their newsletter and distributed to all
registered dental technicians in BC. The CDTBC also sent an email announcement about the
study to the registered dental technicians. In November 2013, we set up our booth at the
DTABC’s annual convention to directly recruit dental technicians and provide the BeLPT during
the event.
2.2
Worksite Evaluations
After the initial groundwork of recruiting facilities from the targeted populations, we conducted
worksite evaluations, assisted by our experienced beryllium exposure assessment team from
National Jewish Health (NJH) in Denver, Colorado, the leading beryllium research institution in
the world. Once participating worksites have provided consent, on-site beryllium exposure
assessment was performed at each facility.

We held a facility stake-holder meeting or conference call that involved management,
environmental health and safety, and labour representatives, when possible. The purpose
of the meeting was to interview the facility representatives about use of berylliumcontaining materials at the facility, specific operations involving beryllium, and the
potential number of employees involved in these operations. Facility representatives were
asked to survey whether their operations involve beryllium-containing materials.

On-site visits were scheduled with assurances from management that we were able to
perform an accompanied walk-through the entire facility and have the opportunity to
speak with employees involved in operations with potential beryllium exposure.
9
2011s0207 Final Report – Revised Final 15Jan15
2.3
Takaro et al.

Facility walk-through surveys were performed by the SFU Research Assistant Yu Uchida
and Dr. Mike Van Dyke, our industrial hygiene consultant and beryllium expert from
NJH, utilizing previously deployed protocols. Special attention was given to non-routine
processes such as maintenance and facility shut-down or start-up operations.

We verified the exposure potential of suspected operations using wipe samples collected
in accordance with ASTM D6966 with analysis for beryllium by ICP-AES. Samples were
collected from surfaces at varying heights to assess the potential for current and past
airborne exposure to beryllium. Beryllium levels greater than 0.2 µg/100 cm2 were
considered evidence of past beryllium exposure. Samples between 0.05 and 0.2 µg/100
cm2 were compared against to control samples from non-beryllium areas due to the
potential for contamination by naturally-occurring beryllium from wind-blown dust.
Risk Communication
Along with the recruitment of companies and study subjects, the BC investigator team conducted
risk communication with company representatives, individual workers, and clinic patients.
Contents of the communication were based-upon previous such efforts conducted by the NJH
consultants for the U.S. Agency for Toxic Substances and Disease Registry (ATSDR) as part of
their Case Studies in Environmental Medicine series18 tailored to the targeted industrial sectors.
Topics discussed included: history of beryllium disease, occupational and community beryllium
exposure, the BeLPT and its use in clinical and medical surveillance settings, epidemiology,
diagnosis and treatment of BeS and CBD, and future directions in primary prevention.
The risk communication was done in several ways; we held in-person meetings with company
representatives when possible, provided the information and explained the need of further
investigation by phone and emails as we recruit companies, and had oral and poster presentations
in conferences and town hall meetings. Recruited study subjects received the information when
they had individual interview with an investigator. We also posted the information and study
participation procedures on the SFU research study website.
As part of this study and in conjunction with her MSc. Thesis the SFU Research Assistant, Yu
Uchida conducted a risk communication project and launched an online education and survey
system for dental technicians. Recruitment emails with a link to the webpage were sent by the
College of Dental Technicians of BC (CDTBC) to all registered BC dental technicians whose
email accounts were in the CDTBC’s file. The online system provided education materials about
CBD and the BeLPT and asked dental technicians to contact us if they were interested in
participating in the study and taking the BeLPT blood test.
2.4
Medical Surveillance
Following the risk communication, we asked those individuals who were 19 years old or older
and had potential beryllium exposure to sign consent to participate in medical surveillance.
All individuals who agreed to medical surveillance completed our “Employee Exposure
Questionnaire” and “Employee Health Questionnaire” (American Thoracic Society derived
symptom questionnaire) to evaluate beryllium exposure and other exposures that may be
important in granulomatous lung disease as well as clinical status. The researchers kept the
information that we collected securely in identifiable form for a period of five years at which
10
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
time they are destroyed. Only the BC investigator team had an access to the results of the
questionnaire and other identifiable information during the five-year period.
Phlebotomy for the BeLPT was scheduled at the worksites, off-site locations that were arranged
by unions, or Vancouver General Hospital. We hired a licensed person to draw blood from the
individuals with informed consent. The phlebotomist collected a 30-millilitre blood sample from
a vein in individual’s arm. The blood samples were coded and sent directly to the Respiratory
Laboratory at NJH in Denver, Colorado. Disease-fighting blood cells that are normally found in
the body (lymphocytes) were separated from other blood cells and examined in the laboratory.
Beryllium solutions at varying concentrations were added to a small number of these
lymphocytes. If the lymphocytes react to the beryllium, the test results are “abnormal,”
indicating that the individual is sensitized to beryllium. If the lymphocytes do not react to
beryllium, the test is “normal.” The coded blood samples are kept for two years in the laboratory
and then discarded according to the rules and regulations of Simon Fraser University.
2.5
Procedures for Clinic Patients
To enrich the study population, recruitment posters were placed in the Lung Centre in Vancouver
General Hospital that sought interest in the study and highlighted the ‘at risk’ industries (see
Table 1 in Appendix A). This expanded list was based upon all BC industries suspected of
potential beryllium exposure from the work of UBC student Karen McCaig (Co-I Demers
supervisor, funded by WorkSafeBC)22 (16)and includes industries too small to be included in the
“Who works where” database used to link sarcoidosis cases to NAIC coded industries.16,23 With
assistance from cooperating physicians in the Lung Centre in Vancouver General Hospital
(VGH) and Division of Respiratory Medicine in St. Paul’s Hospital (SPH), we recruited patients
with sarcoidosis or similar pulmonary diseases who have occupational history with potential
beryllium exposure.
Upon receiving permission to contact the patients who met the criteria, we mailed a recruitment
letter and a consent form to the VGH patients and called the SPH patients for recruitment. We
arranged an interview with each consenting patient, determined the patient’s risk of beryllium
exposure, and provide the BeLPT if applicable. We did not perform worksite evaluation for these
individual cases, but some of the patients have worked in the targeted industries where exposure
assessment was done or additional beryllium information was obtained.
2.6
Exposure Assessment and Blood Test Reports
Participating companies received the results of worksite evaluations regarding the beryllium
exposure risk at their workplaces. We linked back the codes to individuals when the results of
BeLPT came back from the laboratory, and sent the results and explanation to individuals.
Individuals with abnormal BeLPT result and/or respiratory symptoms were referred to the
Occupational Medicine Clinic at Vancouver General hospital for appropriate further medical
examination. Although the information of the individuals’ participation and their BeLPT test
results were not released to their employers, if we had found any BeS case, we intended to report
the existence of beryllium-sensitized workers in their facility for exposure and disease prevention
purposes. We provided additional prevention recommendation to the companies where beryllium
exposure and/or cases of beryllium sensitization and CBD were found.
11
2011s0207 Final Report – Revised Final 15Jan15
3
RESULTS
3.1
Worksite Evaluations
3.1.1
Power Production and Distribution
Takaro et al.
Power production and distribution had the highest sarcoidosis rate of 30.3 in 10,000 in BC based
on the pilot study (15). We approached BC Hydro, the main electricity distributer in BC, and had
informal meeting with the Senior Safety Advisor. He suspected beryllium use in stators, a part
made of copper wires surrounding the rotor of many large generators in BC Hydro facilities.
After a discussion the possibility with BC Hydro and the International Brotherhood of
Electricians and Welders (IBEW) Local 258, we conducted exposure assessments using the wipe
sample method in BC Hydro’s mechanical shop and coil shop in Surrey and the hydroelectric
power stations in Buntzen Lake and Ruskin Dam. The original report of the sample collection
and results is included in Appendix 7.1.
Seven wipe samples were collected in the mechanical shop (Table 1). The detection limit for
beryllium was 0.0021 μg/100 cm2. All of the seven wipe sample results were below 0.05 μg/100
cm2, suggesting the minimal risk of beryllium exposure in this site.
Table 1.
Results of wipe samples collected in the mechanical shop in Surrey
Sample ID
Sample area description
S01
S02
S03
S04
S05
S06
S07
Top of press brake
Arm of exhaust ventilation 1
Arm of exhaust ventilation 2
Top of parts cabinet
Top of mill
Top of storage lockers
arm of exhaust ventilation 3
* LOD: 0.0021 μg/100 cm2
Beryllium conc.*
(µg/100 cm2)
0.026
0.021
0.035
0.045
0.013
0.0071
0.022
Of the six wipe samples we collected in the coil shop in Surrey, results of the sample S10 and
S11 showed beryllium concentrations between 0.063 μg/100 cm2 and 0.096 μg/100 cm2 (Table
2). They are indication of probable beryllium exposure, but we were unable to confirm the
possibility due to the lack of control sample analysis for differentiating beryllium residues
caused by work operation from naturally-occurring beryllium.
12
2011s0207 Final Report – Revised Final 15Jan15
Table 2.
Takaro et al.
Results of wipe samples collected in the coil shop in Surrey
Sample ID
Sample area description
S08
S09
S10
S11
S12
S13
Top of electrical cabinet 1
Top of electrical cabinet 2
Top of electrical junction box
Top of electrical chase
Top of shut-off box
Top of electrical cabinet 3
* LOD: 0.0021 μg/100 cm2
Beryllium conc.*
(µg/100 cm2)
0.042
0.013
0.096
0.063
0.0078
0.017
Following the visits to the Surrey facility, we collected 11 wipe samples from the Buntzen Lake
Powerhouse. The powerhouse was under maintenance at the time or our visit. The stator was
covered, and we did not have direct access to stator for sample collection. Two samples had
beryllium above 0.05 μg/100 cm2, but no control was available to compare with (Table 3). The
results showed no elevated level of beryllium concentration in areas close to the stator, which
raised a question of whether stators were appropriate target as a beryllium exposure source.
Table 3.
Results of wipe samples collected in the Buntzen Lake Powerhouse.
Sample ID
Sample area description
B14
B15
B16
B17
B18
B19
B20
B21
B22
B23
B24
Top of electrical chase
Top of electrical box in stator area
Top of concrete wall directly below stator
Top of concrete wall directly below stator (2nd sample)
Top of crane rail in generator room
Pipe holder in level below generator enclosure
Electrical box level below generator enclosure
Window ledge outside control room
Top of stator cover directly outside control room
Electrical chase behind grinder in maintenance shop
Electrical chase behind work bench in maintenance shop
* LOD: 0.0021 μg/100 cm2
Beryllium conc.*
(µg/100 cm2)
0.027
0.0067
< 0.0021
0.0081
0.0047
0.0069
0.0065
0.054
0.0059
0.066
0.012
The Ruskin Dam Powerhouse was also under maintenance at the time of the sample collection,
and the researcher had access to a space approximately 30 centimeter from a stator where dust
from the stator’s wear could accumulate. Among the 17 wipe samples collected in the Ruskin
Dam Powerhouse, we found beryllium concentration of 0.23 μg/100 cm2 in the sample R08, a
grinder in machining shop (Table 4). Two other samples collected in the same area contained
0.093 μg/100 cm2 (R07) and 0.094 μg/100 cm2 (R09) beryllium. Dr. Van Dyke suspected that the
grinder wheel might be the source of the beryllium contamination of the area.
While the results of the Buntzen Lake’s sample analysis did not find evidence of beryllium
exposure from stators, the sample R12 taken near a uncovered stator in Ruskin Dam contained
beryllium of 0.092 μg/100 cm2 (Table 4). However, beryllium concentration in the sample taken
13
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
at approximately one meter from the same stator was 0.0067 μg/100 cm2 (R03), which is well
below the level of concern. This difference suggests that, if the stator was the source of beryllium
exposure, the beryllium dust from the stator remained in close proximity without traveling to the
outside area.
Table 4.
Results of wipe samples collected in the Ruskin Dam Powerhouse.
Sample ID
Sample area description
R01
R02
R03
R04
R05
R06
R07
R08
R09
R10
R11
R12
R13
R14
R15
R16
R17
Top of metal frame in a circular space in Generator 1,
above turbine, below rotor and stator
Top of metal pipe, opposite to Sample R01
Top of louver by stator in Generator 1
Top of metal cover of stator in Generator 1
Top rotor, surrounded by stator in Generator 1
Wall under the spider frames, space above turbine
Top of a lathe in machining shop
Top of a grinder in machining shop
Top of a safety kit box above the grinder
Top of a refrigerator in welding space
Floor of the path around stator
Beside stator in Generator 1
Beside stator in Generator 1 (different spot from R12)
Floor of communications room
Top of storage shelves in electricians shop
Top of work bench in electricians shop
Top of file cabinet in office space
* LOD: 0.0021 μg/100 cm2
Beryllium conc.*
(µg/100 cm2)
0.029
0.0082
0.0067
0.0057
0.0059
0.0045
0.093
0.23
0.094
0.038
0.011
0.092
0.040
<0.0021
0.0053
< 0.0021
< 0.0021
We sent the results of the wipe sample analysis to the company’s health and safety committee
members and requested to arrange a meeting to discuss about the results. However, the company
representatives stopped responding to our enquiries, we did not have further communication.
3.1.2 Pulp and Paper Mills
Pulp and paper mills had an elevated sarcoidosis rate of 19.3 in 10,000 male workers in BC
based on the pilot study (15). Although no formal report is available to public, WorkSafeBC
provided us a collection of airborne beryllium exposure data from various industries, which
contained some measurements in pulp, paper, and paper board mills in BC in 1980s. Three
samples that referred to the job category of “welders and related machine operators” in the
industry contained beryllium concentrations above 0.05 µg/m3 and below 2 µg/m3. We targeted
three pulp and paper mill companies in BC and explored the possibility of beryllium exposure in
this industry, but no evidence of beryllium use was found.
14
2011s0207 Final Report – Revised Final 15Jan15

Takaro et al.
Kruger:
We arranged a meeting with the Safety and Occupational Health Supervisor at Kruger
and other key personnel and performed a walkthrough survey in the facility in New
Westminster, BC. A piece of ceramic layer from a pulpstone, supplied by Norton, was
sampled and analyzed, but there was no detectable level of beryllium found. No evidence
of beryllium content in their pulpstones and refiner plates was found by web-searching
and consulting the suppliers.
Golder Associates performed air quality tests in Kruger’s paint area, collecting a total
particulate sample and a respirable particulate sample each in three job positions: one
painter, one painter’s assistant, and one welder. The samples collected from the painter
and painter’s assistant were short term samples of approximately two hours, and the
welder’s samples were collected over the majority of the work shift in accordance with
NIOSH methods 0500 and 0600. None of the samples, which were analyzed with ICPMS using a modified version of NIOSH Method 7300, contained beryllium at the
detection limit of 0.2 µg/m3 (L. Clements, personal communication, July 7, 2011). The
Senior Health and Safety Specialist at Golder Associates, Dr. Robert Lockhart has been
working with pulp and paper industries for many years, but he has never encountered any
beryllium use and exposure issues in the field (R. Lockhart, personal communication
June, 2011).
The painters were using a Sponge Jet product to remove old paint from various pieces of
equipment prior to being repainted. Beryllium is not reported to be present in the Sponge
Jet product used according to the MSDS. The welder carried out a variety of work tasks
over the course of the day including welding (arc, metal inert gas and tungsten inert gas
methods), cutting (plasma and oxy-acetylene methods), torching, and grinding. He
worked on mild steel, carbon steel, stainless steel and aluminum. Beryllium was not
reported to be present in any of the rods, wire feeds, or electrodes according to the MSDS
provided.

Company E:
We contacted the Safety Supervisor, but we did not receive response and were unable to
follow-up despite our several attempts of phone and email communication.

Company F:
The Technical Specialist did not know of any beryllium use in their equipment. He
speculated possible use in pulpstones that were used in groundwood mechanical pulp
technology up until 2006, and in steel discs used in thermo-mechanical pulp technology.
The company’s pulpstone supplier told us that they do not add beryllium to pulpstones.
Beryllium concentration in pulpstones is well below 0.1 percent by weight if any, and the
only possibility of beryllium contamination is a trace amount of naturally occurring
beryllium in raw material. Refiner plates and discs used in Company F are from a
supplier that uses recycled materials from other manufacturers. According to one of the
manufacturers’ metallurgists, their low and high consistency segments are made in
Sweden and Finland, and none of the segments contain beryllium. Another supplier
company also confirmed that they do not add any beryllium to their refiner plates. While
15
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
we did not find any evidence of beryllium use, the study information was brought to the
health and safety committee for discussion. However, Company F declined to participate
in further investigation because the subject was not one of its top priorities.
3.1.3
Air Transportation Maintenance
Aircraft maintenance is one of the known occupations for beryllium exposure risks and had the
second highest sarcoidosis rate of 26.4 in 10,000 (15). Seventeen aerospace companies in BC
were contacted by phone and/or email, but none of them agreed to participate in the study. The
followings describe our communication with each company and their responses.

Company A:
We contacted the Vice President, Operations and the Senior Employee Relations
Specialist. They agreed to share the study information with other personnel and to
discuss whether they would participate. One company’s representative shared his
suspicion of beryllium use in some bushings in the past, but the company refused to
participate in the study after consulting its safety committee. The reason for the refusal
was simply because this was not one of their top priorities.

Company B:
Company B was a private aircraft maintenance company contracted by Air Canada since
2004 for its aircraft maintenance activities. Since our several attempts to reach the
company’s representatives failed, we contacted Trustee and Conductor/Sentinel of the
International Association of Machinists and Aerospace Workers (IAM) Canadian
Airways Lodge 764 who worked closely with the company. The Trustee told us that the
company used and manufactured beryllium-containing bushings on their aircraft in the
Vancouver facility, and helped us contact the health and safety committee. However, the
Corporate Industrial Hygienist and Health and Safety Manager found that the Vancouver
facility no longer operated the manufacturing and maintenance of the beryllium parts and
argued that there was little or no beryllium exposure risk currently. According to a
machinist who had worked for the company for over twenty years, the Vancouver facility
stopped the manufacturing and maintenance operation over ten years ago and they have
done only shipping and installation of the parts since then. Although we explained them
the potential risk of exposure during disassembling and installation of the berylliumcontaining materials and particularly from legacy exposures in the past when beryllium
was used, the company made a decision not to participate in this study.

Company C (Educational Institution):
The Associate Dean, Aerospace was aware of the health risks of beryllium and told us
that beryllium is in the bifilar vibration dampers in the S 76 rotor that has been displayed
statically for viewing only (G. Turner, personal communication, November 1, 2010).
Beryllium exposure from this source is minimal and there is no other beryllium on the
campus, while he advised instructors to exercise appropriate caution. No further
communication has been made with the department.
16
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.

Company D:
The Director of Maintenance showed interest in the Beryllium Study, although he was
not aware of any beryllium use in his facility. He contacted a contracting company in the
U.S.A. where Company E send its aircraft for heavy maintenance, and found that
beryllium-copper could be used in bushings on horizontal stabilizers and landing gears.
However, Company E does not perform any direct maintenance work on the parts
suspected to be beryllium-containing. He was advised of the potential of exposure and
sensitization from past exposures, but thought that the amount of beryllium exposure is
minimal if any and was reluctant to continue the investigation that required further
involvement with its suppliers and contracting companies.

Other Companies:
We introduced the Beryllium Study information to the other companies’ representatives
by phone and emails and requested their participation in the Beryllium Study. Some of
them did not respond to our enquiries at all, while some refused to participate in the
Beryllium Study either because they were not aware of any beryllium use or simply
because they were not interested in the study. We withdrew one company because it does
not have a maintenance facility in BC.
In summary, we could not convince the companies of the importance of investigating their
potential beryllium exposure, even legacy exposures from past practices with known berylliumalloyed materials. The unsuccessful recruitment of the aerospace companies was related to lack
of evidence of their current beryllium use and lack of recognition about their risk of developing
CBD from legacy exposure. Many of the aerospace companies did not seem willing to open
themselves for discussion, and communication with their employees was restricted.
3.1.4
Dental Technicians
The pilot study did not find elevated sarcoidosis rate in dental technicians in BC. It is possible
that the rate was underestimated because many dental technicians are self-employed or work in
small laboratories whereas the sarcoidosis rates were calculated based on employer-paid health
premiums codes of the Medical Services Plan registry (14). We decided to include this
population since there are well-known exposure risks when they melt and cast beryllium alloys
and sandblast, de-burr and polish the casted frames. WorkSafeBC’s unofficial beryllium
exposure data included results from several dental laboratories in BC between 1982 and 1992 (G.
Clark, personal communication, June 25, 2012). The results of 20 samples ranged from 0.1 to
111 µg/m3 of beryllium; 12 of them were at or above the current OEL of 2 µg/m3.
We conducted an exposure assessment in the Dental Technology Program in Vancouver
Community College (VCC) in BC by collecting surface wipe samples from five areas of the
laboratories. The original report of the sample collection and results is included in Appendix 7.2.
The analysis of the samples revealed that 0.10 and 0.11µg/100 cm2 of beryllium were found in
the samples taken from two manual casting machines, while the other three samples did not have
any detectable level of beryllium (Table 5).
17
2011s0207 Final Report – Revised Final 15Jan15
Table 5.
Takaro et al.
Results of wipe samples collected in VCC Dental Technology Laboratories
Sample ID
Sample area description
Beryllium conc.
(µg/100 cm2)
VCC-01
VCC-02
VCC-03
VCC-04
VCC-05
manual casting machine 1
manual casting machine 2
Vacuum filter bag under a metal grinding desk
Top of a lighting fixture above the grinding desks
Top shelf of an old storage room
0.11
0.10
< 0.002
< 0.002
< 0.002
According to the program’s staff and faculty members, the laboratories were closed in 1997 for a
major renovation and reopened in 1999. The two casting machines were brought in new after the
renovation. The oldest member of the program has worked in the program since right after the
reopening of the laboratories, but neither he nor other staff members were aware of any
beryllium use in the laboratories. Having no detectable level of beryllium in the other three
samples suggests that the beryllium found in the casting machines resulted from use of
beryllium-containing materials in the area, and not from naturally occurring beryllium. We
reported the results to the program staff members and advised that they should keep the area
clean and make sure no additional exposure of beryllium will occur.
3.1.5
Welders, Machinists and Electricians
We held meetings, organized by BC Federation of Labour, with workers union representatives
from BC Building Trades, College of the Rockies, IBEW Local 213, and IAM Local 250 to
discuss the possibility of beryllium use and exposure in welders, machinists and electricians in a
wide variety of industries. Besides recruiting individual aerospace workers with help from the
IAM representative (described later in section 3.2.1), the discussion leaded us to investigate two
other companies in BC.

Company G
Company G is a contractor in BC for various electrical construction and maintenance
work. The company undertakes contract work in BC Hydro’s substations, including
cutting and welding of bus bars that involves a lot of dust and fume exposure. Although
specific beryllium exposure source was not identified, we explored some options to
survey the operations and collect dust samples. However, we could not carry out the site
visit and sample collection without official permission from the company and BC Hydro.

Company H
Company H has an electronics waste recycling facility in Trail, BC. The industrial
hygienist expressed his interest in investigating the beryllium exposure risk and shared
internal report of beryllium exposure assessment conducted as part of the company’s
monitoring program. The records show that beryllium was found in several dust samples
collected in 2004, but not in samples taken in later years. The report states that the
findings were possibly because e-waste processed in 2004 contained the highest
concentration of circuit boards in the waste. The report also includes air sample data that
there was no detectable level of beryllium in the sample collected from 2004 to 2010.
However, the detection limits of these analyses were much higher than the recommended
18
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
LOD of 0.05 to 0.2 μg/m3. Therefore, we offered to conduct more sensitive exposure
assessment and communicated with the industrial hygienist and the health and safety
manager to arrange a visit. The representatives were very supportive towards the plan at
first but stopped responding when we tried to plan the actual visit.
3.2
Medical Surveillance and Survey Results
A total of 41 subjects consented to participate in the study, which breaks down to 10 aerospace
workers, 18 dental technicians, and 13 clinic patients as described in Figure 1.
Figure 1.
A flow chart of the recruitment and BeLPT results
Of the 41 consenting subjects, 34 subjects received BeLPT tests; four subjects did not follow-up
to take the test; two subjects were unable to have their blood samples tested due to sample
delivery errors; and one subject’s blood sample did not have enough count of lymphocytes
required for the BeLPT analysis. The BeLPT results were normal in 33 subjects and one
uninterpretable, likely due to a technical error in the laboratory. We offered the subject with an
uninterpretable result another blood test, but the subject was unable to follow-up.
19
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
Table 6. Study population characteristics based on the survey results and interviews
Aerospace Workers Dental Technicians Clinic Patients
Total survey #
10
16
10
Gender - male:female
10:0
12:4
10:0
Age average in yrs (range) 60.0 (48 – 71)
47.5 (33 – 63)
51.0 (29 – 77)
Average yrs in the
28.5 (15 – 37)
24.8 (10 – 41)
20 (2 – 36)*
occupation (range)
Beryllium work awareness 10:0
10:6
2:8
(aware:unaware)
* The numbers are based on the years of work experience in occupations with possible beryllium exposure. See
Table X for the list of beryllium-related occupations that the clinic patients have had.
Table 6 shows demographic and occupational characteristics of the study population based on
the survey results and in-person interviews with individual subjects. A total of 36 subjects
completed the survey, and majority of them were male. Details of the BeLPT and survey results
for each population category are described in the following sections.
3.2.1
Air Transportation Maintenance
While recruitment of aerospace companies was unsuccessful, we obtained consent from 10
individual workers in the industry by circulating emails through BC Federation of Labour and
posting the study information on the IAM Canadian Airways Lodge 764 online bulletin. Nine of
the consenting subjects were current or former workers of the Air Canada group, including
Canadian Western Air Lines, Pacific Western Airlines, and Aveos, located in the aircraft
maintenance facilities adjacent to the Vancouver International Airport in Richmond. All 10
subjects were aware that they have been involved in beryllium-related operations during their
career in several work stations allocated for maintenance of flight controls, landing gear, engines,
and electronic components. Examples of their beryllium operations include replacement of old
brake assemblies that contain beryllium, adjusting the size of beryllium bushing sleeves,
replacing beryllium oxide ceramic pieces used in electronic transistors and transmitters, use of
anti-seize compounds contained beryllium. Despite the findings about their exposure to
beryllium, results of their BeLPTs were all normal.
3.2.2
Dental Technicians
As a result of our recruitment effort, 18 dental technicians consented after receiving our study
information at the dental technicians events and newsletter or through the online risk
communication study. Of those, 14 subjects took the BeLPT. The blood test results were normal
for all of the 14 subjects. Ten of the 16 subjects who completed the surveys were aware of their
use of beryllium-containing dental alloys in the past, including some dental technicians who told
us that beryllium alloys were used in the VCC Dental Technology Program in 1970s and 1980s,
and possibly in 1990s. None of the subjects reported current use of beryllium.
3.2.3
Clinic Patients
After consulting with physicians in the Lung Centre in Vancouver General Hospital, we found
30 patients who have sarcoidosis or similar pulmonary diseases and have worked in occupations
with potential risk of exposure to beryllium. When we mailed our recruitment letter and study
20
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
information to the 30 patients, 10 subjects consented to participate in the study, five letters were
returned to us due to invalid addresses, three subjects have deceased, and one subject had normal
BeLPT result before and did not consent to repeat the test in this study. Besides the recruitment
method by mail, we recruited two additional patients of the Lung Centre who were referred
directly by their physicians.
In the Division of Respiratory Medicine in St. Paul’s Hospital, six sarcoidosis patients were
identified with possible occupational beryllium exposure. Four of the patients gave us permission
to contact them for the recruitment purpose; only one of them consented. As a result, the total of
13 clinic patients from VGH and SPH consented to participate in the study. However, three of
the 13 subjects did not respond to our follow-up communication to schedule interview and blood
draw meetings. Occupations with possible beryllium involvement that the 10 subjects had are
listed in Table 7. Two subjects, an aircraft maintenance worker and a toolmaker, were aware of
their beryllium use at work.
Table 7.
Current and past occupations of the ten participating subjects
Aircraft maintenance
Residential construction
Automotive repair
Security installation
Boiler making
Ship construction and repair
Electronics repair
Rail construction and repair
Mining and metal manufacture
Truck/taxi driver
Pulp and paper
Tool making
Of the 10 subjects who took the BeLPT, nine received normal BeLPT results, and one subject’s
result was uninterpretable, which was likely due to a technical error according to the laboratory
manager. We offer the patient another test, but the patient was unable to follow-up.
4
DISCUSSION
This was the first study in BC that investigated beryllium exposure risks in BC industries and
screened workers for beryllium sensitization. While recruitment of target companies and their
workers was challenging, we were able to inform sub-sets of workers about their possible
beryllium exposure and disease risks, learn about their work operations, and conduct walk
through survey and surface dust sample collection in two industries, BC Hydro facilities and in
the dental training laboratory at Vancouver Community College. We were also able to recruit a
small number of sarcoidosis patients for Respirology clinics who had a work history suggestive
of possible beryllium exposure. In all 41 workers completed our questionnaire and 34 had the
BeLPT test for sensitization. This was well below our target and lower than would be adequate
to ascertain a sensitization risk level in the population studied. Based upon previous studies in
moderate risk populations such as construction workers in the U.S. Dept of Energy workers (20)
We expected approximately 2% prevalence of Be sensitization. Therefore to have a 95% chance
of detecting a single case we would need to test 50 individuals. The low number of BELPTs
21
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
performed and this statistical reality leaves us with two possible conclusions: 1) there is no
beryllium risk in the BC industries were able to examine, or 2) we could not detect sensitization
or significant exposure because we did not test enough individuals at risk and we did not sample
in the right locations or timeframe to detect presence of beryllium. There was no dust sample that
beryllium concentration exceeded the level of concern at 0.2 µg/100 cm3 (our highest wipe
sample level was 0.096 µg/100 cm3), and we did not find any strong evidence of beryllium
exposure in the facilities. Given current information we cannot exclude either possibility.
For example, the initial speculation about stator as a source of beryllium exposure in BC Hydro
was not confirmed but the possibility has yet to be excluded. Samples taken from an area closed
to uncovered stator (R12 and R13) had higher beryllium concentrations than the samples taken
from the surrounding areas of the same stator (R01-05) as shown in Table 4. Assuming that the
stator is a source of beryllium exposure, this finding suggests that beryllium dust from the stator
tend to remain in the area. This was also supported by the low beryllium concentrations found in
the areas near a covered stator (B14-17, Table 3).
While beryllium exposure risk in power production and distribution is also still uncertain, we
could not identify any beryllium exposure source in pulp and paper industry. One possible
scenario of beryllium exposure is the burning of coal and fuel oil that contain naturally occurring
beryllium (17). However, we were unable to study the possibility, and further investigation is
required to determine the reason behind the elevated sarcoidosis rates observed in the industries.
If beryllium is unrelated to the sarcoidosis rates, we suspect that high moisture and possibly
biologic contaminants in their operations may be associated with granulomatous disease, e.g.
hypersensitivity pneumonitis, but this is only a hypothesis. The etiology of sarcoidosis itself
remains an active area of research (18), and therefore other exposures in the industry may
explain the high prevalence of this condition.
The exposure assessment in VCC Dental Technology laboratories revealed that hundreds of
current and former students in the program might have been at risk as we found non-negligible
levels of beryllium in samples collected from casting machines. Even though the program staff
members were not aware of beryllium-containing dental alloys in the laboratories, the findings
indicated that beryllium had been used in the casting operation. While all 14 BeLPT tests done
for dental technicians were normal, continuing education about beryllium hazard and screening
of workers is recommended as we learned that beryllium alloys were very common in 70s and
80s and also used in the major dental technician training program in BC for a long period of
time.
It is our opinion informed by previous literature and a recent review and position statement by
the American Thoracic Society (21) that of the two possible realities described at the beginning
of the Discussion, it is most likely that beryllium risk does exist in BC and we were unable to
detect it for the reasons outlined.
Future opportunities for worker protection
In August 2013, WorkSafeBC proposed lowering the current OEL for beryllium from 2 µg/m3 to
0.05 µg/m3, and asked stakeholders for their comments (19). We anticipated having the new
22
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
OEL in place at the beginning of this study in 2010, and recruitment of companies could have
been more successful if we had the policy implementation. The delay of the OEL change made it
more difficult for us to convince companies of the importance and benefit of investigating their
risk of beryllium exposure as part of this research study and letting us have access to their
workers. Therefore, we could recruit only the workers who learned about this study through their
unions and came forward to participate individually, not by their employers’ provision or
support. Comparing to 250 blood tests we initially budgeted for, 34 subjects received the BeLPT
in this study, and any unspent research funds were returned to WorkSafeBC.
The unofficial data of airborne beryllium measurements taken in several industries and
occupations from 1981 to 2003 show that 67 out of 176 samples had beryllium concentrations
that are greater than of 0.05 µg/m3. Of those, 13 samples exceeded the current OEL of 2 µg/m3,
including the 12 samples from dental laboratories as described in the section 3.1.4. Deciding
what companies and workplaces to target could have been easier for us if the WorkSafeBC’s
data also included sample locations, but the information was not available. WorSafeBC could
request beryllium-flagged companies to disclose beryllium-related information such as material
inventories and exposure monitoring data and to conduct further beryllium exposure assessment
if necessary.
Tracking beryllium-containing materials from manufactures to down-stream users will be very
helpful in identifying workplaces with beryllium in BC. At the beginning and the end of this
study we requested Materion Corporation, the only beryllium and beryllium alloy manufacture in
North America, a list of BC-based purchasers of its beryllium products, but the request was
denied.
Along with the assessment, continuing risk communication is necessary to raise awareness of the
beryllium hazard, educate employers and workers about their possible risk not only from current
operations but from legacy exposure, and encourage transparency at work. We also found that
occupational history recorded in clinic charts is often insufficient such that some charts of
sarcoidosis patients we reviewed in this study included no occupational information and some
had only the current occupations. Because BeS and CBD can occur long after the initial
exposure, health professionals should be informed of the importance of exploring the patient’s
thorough occupational history when searching for the association between respiratory illnesses
and beryllium.
In the hope that the OEL change and the follow-up investigation will result in finding workers at
risk and encouraging the screening test, we point out that accessibility to the BeLPT is limited in
some areas of BC. There is no laboratory for BeLPT in the west coast, while blood samples need
to be delivered to a laboratory within 24 hours in order to recover live lymphocytes for the
analysis. The beryllium laboratory in National Jewish Health in Denver, CO was used for the
BeLPT in this study, but the overnight delivery to the laboratory is not available from areas
outside of the Lower Mainland or Vancouver Island. A few subjects from outside of the Lower
Mainland were unable to take the BeLPT due to the difficulty of travelling to within range of 24hour parcel service. Additionally, the Medical Services Plan does not pay for BeLPT testing
(~$200 USD) leaving a profound disincentive for physicians and patients.
23
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
Though we could not fully achieve the goals of identifying beryllium workplaces and exposure
sources and screen workers at risk to find BeS and CBD cases, we did make progress in
informing several sectors about the risk of beryllium-related operations through the
communication with various stakeholders. We were able to educate individuals both within and
outside organizations, which may serve to reduce risk in the future. We hope this will encourage
them to take their own initiative for prevention, while WorkSafeBC will continue the
investigation of beryllium exposure and disease risks in BC.
24
2011s0207 Final Report – Revised Final 15Jan15
5
Takaro et al.
ACKNOWLEDGEMENTS
We thank the following people for their support and help in conducting this study.
Prevention and Occupational Disease Initiatives, Worker and Employer Services, WorkSafeBC
Geoffrey Clark
Colin Murray
Vancouver General Hospital
Dr. Chris Carlsten
St. Paul’s Hospital
Dr. Don Sin
Fran Schooley
International Brotherhood of Electricians and Welders, Local 258
Nicole Biernaczyk
BC Federation of Labour, Vancouver, BC
Nina Hansen
The College of Dental Technicians of BC
Ronald Revell
Dental Technicians Association of BC
Renata Cecconi
25
2011s0207 Final Report – Revised Final 15Jan15
6
Takaro et al.
REFERENCES
1. Henneberger P, Goe S, Miller W, Doney B, Groce D. Industries in the United States with
Airborne Beryllium Exposure and Estimates of the Number of Current Workers Potentially
Exposed. J Occup Environ Hyg. 2004 Oct;1(10):648–59.
2. Stange AW, Furman FJ, Hilmas DE. Rocky Flats Beryllium Health Surveillance. Environ
Health Perspect. 1996 Oct;104 Suppl 5:981–6.
3. American Conference of Governmental Industrial Hygienists. Beryllium and Compounds.
ACGIH; 2009.
4. Kreiss K, Mroz MM, Zhen B, Martyny JW, Newman LS. Epidemiology of beryllium
sensitization and disease in nuclear workers. Am Rev Respir Dis. 1993 Oct;148(4 Pt 1):985–
91.
5. Kreiss K, Mroz MM, Zhen B, Wiedemann H, Barna B. Risks of beryllium disease related to
work processes at a metal, alloy, and oxide production plant. Br Med J. 1997;54(8):605.
6. Kreiss K, Wasserman S, Mroz MM, Newman LS. Beryllium disease screening in the
ceramics industry. Blood lymphocyte test performance and exposure-disease relations. J
Occup Med Off Publ Ind Med Assoc. 1993 Mar;35(3):267–74.
7. Kreiss K, Mroz MM, Newman LS, Martyny J, Zhen B. Machining risk of beryllium disease
and sensitization with median exposures below 2 micrograms/m3. Am J Ind Med. 1996
Jul;30(1):16–25.
8. Balkissoon RC, Newman LS. Beryllium copper alloy (2%) causes chronic beryllium disease.
J Occup Environ Med Am Coll Occup Environ Med. 1999 Apr;41(4):304–8.
9. Newman LS, Mroz MM, Maier LA, Daniloff EM, Balkissoon R. Efficacy of serial medical
surveillance for chronic beryllium disease in a beryllium machining plant. J Occup Environ
Med Am Coll Occup Environ Med. 2001 Mar;43(3):231–7.
10. Newman LS. Beryllium Sensitization Progresses to Chronic Beryllium Disease: A
Longitudinal Study of Disease Risk. Am J Respir Crit Care Med. 2004 Sep;171(1):54–60.
11. Viet SM, Torma-Krajewski J, Rogers J. Chronic beryllium disease and beryllium
sensitization at Rocky Flats: a case-control study. AIHAJ J Sci Occup Environ Health Saf.
2000 Apr;61(2):244–54.
12. Rutstein DD, Mullan RJ, Frazier TM, Halperin WE, Melius JM, Sestito JP. Sentinel Health
Events (occupational): a basis for physician recognition and public health surveillance. Am J
Public Health. 1983 Sep;73(9):1054–62.
13. NIOSH. National occupational hazard survey - Vol. III: Survey analysis and supplemental
tables. National Institute for Occupational Safety and Health; 1987.
26
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
14. Sood A, Beckett WS, Cullen MR. Variable response to long-term corticosteroid therapy in
chronic beryllium disease. CHEST J. 2004;126(6):2000–7.
15. Takaro T, McLeod C, Xu F, Koehoorn M, Demers P. Beryllium Disease in BC Workers: A
Pilot Surveillance Project Using Linked Administrative Data. 2009.
16. McCaig K. Estimation of industries and occupations with potential exposure to Beryllium in
British Columbia. MSc. Thesis: School of Occupational and Environmental Hygiene,
University of British Columbia; 2006.
17. ATSDR. Toxicological profile for beryllium. 2002.
18. Newman KL, Newman LS. Occupational causes of sarcoidosis: Curr Opin Allergy Clin
Immunol. 2012 Apr;12(2):145–50.
19. WorkSafeBC. Proposed Changes to the B.C. Occupational Exposure Limits Based on the
2012 New or Revised ACGIH TLVs and TLVs for Other Substances from Prior Years
[Internet]. [cited 2014 Apr 24]. Available from:
http://www.worksafebc.com/regulation_and_policy/policy_consultation/law_40_10_1060
.asp
20. Welch L, Ringen K, Bingham E. Dement J, Takaro TK, McGowan W, Chen A, Quinn P.
Screening for beryllium disease among construction trade workers at department of
energy nuclear sites. Am. J. Ind. Med. 46:207-218, 2004.
21. Balmes JR, Abraham JL, Dweik RA, Fireman E, Fontenot AP, Maier LA, Muller-Quernheim
J, Ostiguy G, Pepper LD, Saltini C, Schuler CR, Takaro TK, Wambach PF. An Official
ATS Statement on the Diagnosis and Management of Beryllium Sensitivity and Chronic
Beryllium Disease: An Executive Summary. Am. J. Resp. Crit. Care Med. 190: e34-59.
2014.
27
2011s0207 Final Report – Revised Final 15Jan15
7
APPENDICIES
7.1
Report of Wipe Sample Analysis for BC Hydro Facilities
Takaro et al.
Prepared by Mike Van Dyke, National Jewish Health
Introduction
Sampling was conducted at two of the BC Hydro shops and generators to assess the potential for
past beryllium exposure from work on electrical components including hydroelectric stators.
Sampling consisted exclusively of wipe samples collected from areas of the facility that were
unlikely to have been recently cleaned and represent settled particulate over many years of
operation. This type of sampling strategy is helpful to determine the potential for past airborne
beryllium exposure and to identify operations that should be evaluated further. Sampling was
conducted by Mike Van Dyke, Ph.D., CIH from National Jewish Health in Denver, Colorado and
Yu Uchida from Simon Fraser University on August 15, 2012 at the Coil and Mechanical shops,
on August 16, 2012 at the Buntzen Generating Station, and on October 30, 2012 at the Ruskin
Generating Station (Ms. Uchida only). At the generating facility, samples were focused around
the area of the stator due to previous reports that the stator consisted of components fabricated
from copper beryllium alloy.
Methods
Wipe samples were collected from 100 cm2 areas using Ghost Wipes® (commercially available
premoistened wipes) and 100 cm2 paper templates. Samples were submitted to an AIHA
accredited laboratory for analysis using NIOSH 7300. A detailed list of sample locations with
photographs is presented in the attached table.
Evaluation Criteria
There are no risk-based criteria for evaluating beryllium surface loading. The U.S. Department of
Energy has established a public release criteria of 0.2 μg/100 cm2 for equipment that has been
used in beryllium areas. This means that contaminated equipment must be cleaned to levels
below 0.2 μg/100 cm2 before it can be released to the public. While this criteria is clearly not
risk-based, in practice, this appears to be a reasonable cut-off that identifies work areas where
there has been even a small volume of beryllium fabrication activities. When evaluating wipe
sample results, it is important to remember that beryllium is a naturally-occurring element that
can be identified at levels approaching 0.2 μg/100 cm2 if enough dust is collected on the wipe
sample. At this time, there are no widely available methods to differentiate naturally-occurring
beryllium from refined beryllium metal.
Results
Only a single wipe sample result was above the public release limit of 0.2 μg/100 cm2 that has
been established by the U.S. Department of Energy. This wipe sample (R08, 0.21 μg/100 cm2)
was collected from the top of a grinder in the Ruskin machine shop. While there have been
reports of grinding wheels that contain low-levels of beryllium, it is unknown whether this
slightly elevated surface beryllium level resulted from grinding a beryllium alloy or from the
grinding wheel itself. However, the lack of other significant levels in the machine shop may
suggest the grinding wheel itself is the source. All other results from shops and generating
facilities were well below 0.2 μg/100 cm2. There seemed to be a general pattern that samples
28
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
collected from very dirty areas were in the hundredths of a microgram range and those collected
from cleaner areas were in the thousandths of a microgram range. This pattern suggests the
beryllium that is being detected may be naturally occurring beryllium rather than beryllium from
fabrication or maintenance activities. Overall, these results provide little evidence to suggest that
there is significant beryllium exposure in hydroelectric maintenance or fabrication activities.
29
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
30
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
31
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
32
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
33
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
34
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
35
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
36
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
37
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
38
2011s0207 Final Report – Revised Final 15Jan15
7.2
Takaro et al.
Report of Wipe Sample Analysis for VCC Dental Technology Program
Vancouver Community College (VCC) – Dental Technology Department
Wipe Sample Collection Data
Sampling Date: March 28, 2012, 9:15 – 9:50 am PDT
(Samples were collected in the beginning of the day before the labs were used for classes)
Collected by Yu Uchida
Sample ID
Area Description
VCC-01
manual casting
machine 1 (Fig. 1)
manual casting
machine 2 (Fig. 2)
Vacuum filter bag
under a dental tech
student’s desk
(Fig. 3)
VCC-02
VCC-03
VCC-04
VCC-05
Top of a lighting
fixture above the
grinding desks (Fig.
4)
Top shelf of an old
storage room (Fig. 5)
Sample Surface Note
Material
Result
(µg/100
cm2)
0.11
Metal
The casting machine is used
frequently, at least a few times a week
0.10
Metal
This casting machine is used less
frequently.
< 0.002 Fabric
This desk is mainly used for grinding
metals. Each desk has a suction
vacuum attached (Fig. 3 – right) and
dust is collected by a filter under the
desk. Filters are replaced every year.
< 0.002 Metal
< 0.002
Metal
This room is used to store some old
equipment and supplies that they don’t
use anymore.
The labs were closed in 1997 for a major renovation and reopened in 1999. All equipment was
brought in new after the renovation. A few dental technicians in BC told us that they have used
beryllium-containing dental alloys at VCC in the 80s and probably in the 90s, but none of the
current lab staff know of any beryllium use (They came after the renovation).
Students clean the labs on a daily basis, and major cleaning is done every semester.
Comments by Mike Van Dyke, National Jewish Health:
We identified very low levels of beryllium in the casting machine suggesting that a low
percentage beryllium alloy had been processed at some time. This low level suggests that
processing of beryllium-containing alloy likely occurred only a few times or alternatively that
the casting machine had been very well cleaned since the beryllium-containing alloy was used.
The levels identified in the casting machines were well below surface levels of concern (> 0.2
µg/100 cm2) as identified by the U.S. Department of Energy. The other samples from the
laboratory were negative for beryllium which supports the hypothesis that past airborne
beryllium exposures in this new laboratory are unlikely.
39
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
Pictures of the sample areas are shown below.
Figure 1. VCC-01
Figure 2. VCC-02
Figure 3. VCC-03
40
2011s0207 Final Report – Revised Final 15Jan15
Takaro et al.
Figure 4. VCC-04
Figure 5. VCC-05
41
All rights reserved. WorkSafeBC encourages the copying, reproduction, and
distribution of this document to promote health and safety in the workplace,
provided that WorkSafeBC is acknowledged. However, no part of this
publication may be copied, reproduced, or distributed for profit or other
commercial enterprise or may be incorporated into any other publication without
written permission of WorkSafeBC.
Additional copies of this publication may be obtained by contacting:
Research Services
6951 Westminster Highway
Richmond, B.C. V7C 1C6
Phone (604) 244-6300 / Fax (604) 244-6295
email: resquery@worksafebc.com