In a study in mid-2003, E Fireman and colleagues1 found that 6% of patients labelled as having sarcoidosis actually had chronic beryllium disease. This result highlights an ongoing problem in industry and medical practice. The proliferation of industrial uses of beryllium is resulting in an unrecognised epidemic of chronic beryllium disease, as evidenced by many epidemiological studies over the past decade. 2-8

Occupational exposure to beryllium occurs in aerospace, nuclear, military, automotive, electronics, and telecommunications industries, in operations in metal machine shops, and in alloy applications, such as tubing for oil and gas drilling, tools and dies, jewellery, bicycle frames, and dental appliances. Beryllium is most often used as an alloy with copper, aluminum, magnesium, or nickel; the beryllium content and its attendant hazards may not be obvious to workers generating dust and fumes. Recycling of electronics, computers, and scrap alloy to recover copper also results in beryllium exposure and disease to an unknown number of workers, many of whom are unaware of the risks. Contemporary cases of chronic beryllium disease have been reported from the USA, Britain, Canada, France, Germany, Sweden, Israel, Japan, and Russia. Estimates of the number of