Estimates of the number of workers in the United States occupationally exposed to beryllium were published in the 1970s and 1980s and ranged from 21,200 to 800,000. We obtained information from several sources to identify specific industries with beryllium exposure and to estimate the number of current workers potentially exposed to beryllium. We spoke with representatives from the primary beryllium industry and government agencies about the number of exposed workers in their facilities. To identify industries in the private sector but outside the primary industry, we used data from the Integrated Management Information System (IMIS), which is managed by the Occupational Safety and Health Administration, and the Health Hazard Evaluation program of the National Institute for Occupational Safety and Health. We used IMIS data from OSHA inspections with a previously developed algorithm to estimate the number of potentially exposed workers in nonprimary industries. Workers potentially exposed to beryllium included 1500 current employees in the primary beryllium industry and 26,500 individuals currently working for the Department of Energy or the Department of Defense. We identified 108 four-digit Standard Industrial Classification (SIC) categories in which at least one measurement of airborne beryllium was ≥ 0.1 μ g/m³. Based on the subset of 94 SIC categories with beryllium ≥ 0.1 μ g/m³, we estimated 26,400 to 106,000 workers may be exposed in the private sector (outside the primary industry). In total, there are as many as 134,000 current workers in government and private industry potentially exposed to beryllium in the United States. We recommend that the results of this study be used to target at-risk audiences for hazard communications intended to prevent beryllium sensitization and chronic beryllium disease.

Background and Aims:Work related asthma (WRA) is one of the most frequently reported occupational lung diseases in a number of industrialised countries. A better understanding of work aggravated asthma (WAA), as well as work related new onset asthma (NOA), is needed to aid in prevention efforts.Methods:WAA and NOA in the United States were compared using cases reported to the National Institute for Occupational Safety and Health (NIOSH) from four state Sentinel Event Notification Systems for Occupational Risks (SENSOR) surveillance programmes for 1993–95.Results:A total of 210 WAA cases and 891 NOA cases were reported. WAA cases reported mineral and inorganic dusts as the most common exposure agent, as opposed to NOA cases, in which diisocyanates were reported most frequently. A similar percentage of WAA and NOA cases still experienced breathing problems at the time of the interview or had visited a hospital or emergency room for work related breathing problems. NOA cases were twice as likely to have applied for workers’ compensation compared with WAA cases. However, among those who had applied for worker compensation, approximately three-fourths of both WAA and NOA cases had received awards. The services and manufacturing industrial categories together accounted for the majority of both WAA (62%) and NOA (75%) cases. The risk of WAA, measured by average annual rate, was clearly the highest in the public administration (14.2 cases/10⁵) industrial category, while the risk of NOA was increased in both the manufacturing (3.2 cases/10⁵) and public administration (2.9 cases/10⁵) categories.Conclusions:WAA cases reported many of the same adverse consequences as NOA cases. Certain industries were identified as potential targets for prevention efforts based on either the number of cases or the risk of WAA and NOA.

The goal of this study was to identify occupational risk factors for severe exacerbation of asthma and estimate the extent to which occupation contributes to these events.The 966 participants were working adults with current asthma who participated in the follow-up phase of the European Community Respiratory Health Survey. Severe exacerbation of asthma was defined as self-reported unplanned care for asthma in the past 12 months. Occupations held in the same period were combined with a general population job-exposure matrix to assess occupational exposures.74 participants reported having had at least one severe exacerbation event, for a 1-yr cumulative incidence of 7.7%. From regression models that controlled for confounders, the relative risk (RR) was statistically significant for low (RR 1.7, 95% CI 1.1–2.6) and high (RR 3.6, 95% CI 2.2–5.8) biological dust exposure, high mineral dust exposure (RR 1.8, 95% CI 1.02–3.2), and high gas and fumes exposure (RR 2.5, 95% CI 1.2–5.5). The summary category of high dust, gas, or fumes exposure had RR 3.1 (95% CI 1.9–5.1). Based on this RR, the population attributable risk was 14.7% among workers with current asthma.These results suggest occupation contributes to approximately one in seven cases of severe exacerbation of asthma in a working population, and various agents play a role.

To summarize recent findings on work-exacerbated asthma, based on medical literature published during 2005 and the first 10 months of 2006. Although prevalence estimates varied considerably among six recent epidemiologic studies, collectively they contribute to the conclusion that work-exacerbated asthma is common. Median work-exacerbated asthma prevalence estimates were 18% of adults with asthma, 25% of working adults with asthma and 45% of all work-related asthma cases. Work-exacerbated asthma can result from a variety of occupational triggers, including physical factors (e.g. extreme temperatures, exercise), behavioral states (e.g. strong emotions, stress), odors (e.g. perfume), general irritants and dust, and second-hand cigarette smoke. Work-exacerbated asthma cases have many of the same demographic and clinical traits as other adults with asthma and occupational asthma cases, although some differences have been reported. Recent review articles have offered some recommendations on the management of work-exacerbated asthma, but more comprehensive advice is anticipated from a professional medical society in the next few years. Epidemiologic studies indicate that work-exacerbated asthma is common. Researchers have started to pay attention to work-exacerbated asthma, but more studies are needed on all aspects of this condition in order to improve diagnosis, management and prevention.