Prevalence of beryllium sensitization among aluminium smelter workers.

BACKGROUND: Beryllium exposure occurs in aluminium smelters from natural contamination of bauxite, the principal source of aluminium. AIMS: To characterize beryllium exposure in aluminium smelters and determine the prevalence rate of beryllium sensitization (BeS) among aluminium smelter workers. METHODS: A population of 3185 workers from nine aluminium smelters owned by four different aluminium-producing companies were determined to have significant beryllium exposure. Of these, 1932 workers participated in medical surveillance programmes that included the serum beryllium lymphocyte proliferation test (BeLPT), confirmation of sensitization by at least two abnormal BeLPT test results and further evaluation for chronic beryllium disease in workers with BeS. RESULTS: Personal beryllium samples obtained from the nine aluminium smelters showed a range of <0.01-13.00 µg/m(3) time-weighted average with an arithmetic mean of 0.25 µg/m(3) and geometric mean of 0.06 µg/m(3). Nine workers were diagnosed with BeS (prevalence rate of 0.47%, 95% confidence interval = 0.21-0.88%). CONCLUSIONS: BeS can occur in aluminium smelter workers through natural beryllium contamination of the bauxite and further concentration during the refining and smelting processes. Exposure levels to beryllium observed in aluminium smelters are similar to those seen in other industries that utilize beryllium. However, compared with beryllium-exposed workers in other industries, the rate of BeS among aluminium smelter workers appears lower. This lower observed rate may be related to a more soluble form of beryllium found in the aluminium smelting work environment as well as the consistent use of respiratory protection.

Medical surveillance in work-site safety and health programs.

Businesses frequently call on family physicians to provide employee health services at the work site or in the clinician's office. These services include medical screening (detection of dysfunction or disease before an employee would ordinarily seek medical care) and medical surveillance (analysis of health information to identify workplace problems that require targeted prevention). Such services can transform acute care and routine screening activities into opportunities for primary prevention when they are integrated into the broader framework of work-site safety and health programs. Components of these programs include management commitment, employee participation, hazard identification and control, employee training and program evaluation. For optimal program success, family physicians must communicate with frontline safety officers and have first-hand knowledge of the workplace and its hazards. Professional and technical resources are available to guide the family physician in the role of medical surveillance program coordinator.