The BeLPT: algorithms and implications.

BACKGROUND The beryllium lymphocyte proliferation test (BeLPT) is used to identify persons with beryllium sensitization. The variability of laboratory results and lack of a "gold standard" have led to questions about the test's performance. Fortunately, a recently published study has credibly estimated standard epidemiologic parameters for the BeLPT. METHODS Information from this recent study was used to assess the performance of two common algorithms for BeLPT testing. Standard epidemiologic parameters were determined for two common algorithms and then compared. RESULTS One of the two algorithms was more sensitive than the other (86% vs. 66%). The specificity of both algorithms (99.8% or greater) was high. At an estimated 2% prevalence, the positive predictive value of both algorithms for beryllium sensitization remained high (90% or higher). CONCLUSIONS A priori characterization of the testing algorithm under consideration can enhance public health decision-making.

[1]  John W Martyny,et al.  Beryllium workers' health risks. , 2005, Journal of occupational and environmental hygiene.

[2]  D. Hilmas,et al.  The beryllium lymphocyte proliferation test: Relevant issues in beryllium health surveillance. , 2004, American journal of industrial medicine.

[3]  William E Miller,et al.  Industries in the United States with Airborne Beryllium Exposure and Estimates of the Number of Current Workers Potentially Exposed , 2004, Journal of Occupational and Environmental Hygiene.

[4]  L. Welch,et al.  Screening for beryllium disease among construction trade workers at Department of Energy nuclear sites. , 2004, American journal of industrial medicine.

[5]  Y. Lerman,et al.  Misdiagnosis of sarcoidosis in patients with chronic beryllium disease. , 2003, Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG.

[6]  L. Maier.  Clinical Approach to Chronic Beryllium Disease and Other Nonpneumoconiotic Interstitial Lung Diseases , 2002, Journal of thoracic imaging.

[7]  D. Deubner,et al.  Variability, predictive value, and uses of the beryllium blood lymphocyte proliferation test (BLPT): preliminary analysis of the ongoing workforce survey. , 2001, Applied occupational and environmental hygiene.

[8]  L. Newman.  Immunologic mechanisms in granulomatous lung disease. , 2000, Immunopharmacology.

[9]  L. Newman,et al.  Identification of pathogenic T cells in patients with beryllium-induced lung disease. , 1999, Journal of immunology.

[10]  D. Middleton,et al.  Chronic beryllium disease: uncommon disease, less common diagnosis. , 1998, Environmental health perspectives.

[11]  H. Wiedemann,et al.  Risks of beryllium disease related to work processes at a metal, alloy, and oxide production plant. , 1997, Occupational and environmental medicine.

[12]  L. Newman,et al.  Significance of the blood beryllium lymphocyte proliferation test. , 1996, Environmental health perspectives.

[13]  L S Newman,et al.  The natural history of beryllium sensitization and chronic beryllium disease. , 1996, Environmental health perspectives.

[14]  K. Kreiss,et al.  Screening blood test identifies subclinical beryllium disease. , 1989, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[15]  K. Kreiss,et al.  Pathologic and immunologic alterations in early stages of beryllium disease. Re-examination of disease definition and natural history. , 1989, The American review of respiratory disease.

[16]  J. Buring,et al.  Epidemiology in Medicine , 1987 .

[17]  M. Eisenbud,et al.  Epidemiological aspects of beryllium-induced nonmalignant lung disease: a 30-year update. , 1983, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[18]  M. Eisenbud,et al.  Origins of the standards for control of beryllium disease (1947-1949). , 1982, Environmental research.

[19]  W. Grove.  Statistical Methods for Rates and Proportions, 2nd ed , 1981 .

[20]  H. Toutenburg.  Fleiss, J. L.: Statistical Methods for Rates and Proportions. John Wiley & Sons, New York‐London‐Sydney‐Toronto 1973. XIII, 233 S. , 1974 .