Contribution of incidental exposure pathways to total beryllium exposures

Beryllium manufacturing processes are associated with the immune-mediated chronic beryllium disease (CBO). Recent workplace epidemiological studies have been relatively unsuccessful in correlating disease with workplace air concentrations of beryllium, thereby failing to support the hypothesis that dose by the respiratory route determines the risk of disease. This has led to consideration of the hypotheses that dermal or oral exposures to beryllium can influence disease risk, either as a cause of sensitization or to induced tolerance to beryllium. If so, the control of dermal and/or ingestion exposure to beryllium, which has heretofore been widely disregarded in the United States, would be of practical importance. Most of the literature of the past 50 years indicates that ingestion and dermal uptake of beryllium are unimportant routes of exposures. The toxicology data generally support this position. However, research is under way to determine whether sensitization to beryllium may occur following exposure via routes other than inhalation, raising the question of whether this sensitization from other routes of exposure makes the lungs more susceptible to inflammation when inhaled doses are encountered. Using published data on other metals, this article describes the likely range of doses that a worker might incur in the workplace due to incidental exposure pathways (i.e., exposures not directly related to inhalation of workplace air), such as hand-to-mouth exposure, dermal contact, and resuspension following deposition of beryllium onto clothing. This analysis indicates that these incidental routes of exposure could contribute to total absorbed doses of beryllium that exceed simple airborne inhalation exposures. Because the doses presented by these alternative exposure pathways could be appreciable compared with the airborne inhaled dose, and could continue even when respirators are worn, these pathways may represent the primary routes of entry of beryllium into the body. We believe that the potential for exposure from these incidental exposure pathways merits additional study.