From Big Medical Encyclopedia

BERYLLIUM (Beryllium, Glucinium; Be) — chemical element II of group of a periodic system of elements of D. I. Mendeleyev; possesses toxic action. At. number 4, at. weight 9,0122. From six radioisotopes practical application is found 7 Be with half-life 54 days and 10 Be with half-life 2,5•10 6 years. B. — solid brittle metal of light gray color. On air becomes covered by the oxide film giving it an opaque shade and protecting from further oxidation. Density 1,85 — 1,86, t ° pl 1280 °, t ° kip 2471 — 2970 °. It is opened by Voklen (L. N. Vauquelin) in 1798. B.'s maintenance in crust 4•10 - 4 weight. %. The main mineral — beryl [Be 3 Al 2 (SiO 3 ) 6 ], versions to-rogo are gemstones an emerald and aquamarine. Traces 7 Be and 10 Be are found in a rain water, snow, sea deposits, in the atmosphere where B. is formed as a result of the nuclear reactions proceeding under the influence of space beams.

B. in chemical connections dvukhvalenten. Does not interact with water. It is dissolved in acids and solutions of alkalis with formation of beryllates (Be+2NaOH = Na 2 BeO 2 + H 2 ). An oxide of beryllium — BeO and hydrate of an oxide — Be(OH) 2 — white powders, water-insoluble, having amphoteric properties.

Metal B. has high-permeability for X-ray owing to what it is applied to the device of «windows» in X-ray equipments. In atomic reactors B. it is used as the decelerator and a reflector of neutrons, is a source of neutrons which lets out under the influence of alpha particles, gamma-rays. B. the hl is widely applied in instrument making, in the aircraft and space equipment. obr. in the form of alloys with other metals (copper, magnesium, aluminum).

B. and its connections are very poisonous. Salts B. already in concentration of 10-6 mol/l specifically inhibit an alkaline phosphatase. B. oppresses also an adenozintrifosfataza and formation of phosphorus and ammonia at disintegration of nucleic acids. Pilot studies and clinical observations demonstrate that on an organism the change of protein metabolism leading to disturbance of activity of separate enzymes and development of autoimmune process is the cornerstone of the mechanism of action of B. It is undoubted also that an essential role in a pathogeny of a disease is played also by a sensitization of an organism

the maximum allowable concentrations compounds B. of beryllium and its connections (in terms of B.) in air of a working zone makes 0,001 mg/mg.

B.'s definition is carried out by a luminescent or spectrographic method.

Professional harm

High toxicity of B. and its connections causes a possibility of cases of poisoning with it or its salts, e.g., at B.'s extraction from ores, during the receiving alloys, stonewares, at production of X-ray tubes, fluorescent and neon lamps etc.

The picture of poisoning of B. and its connections depends on degree of their dispersion: vapors and smokes are more poisonous and lead to defeats of deep departments of respiratory tracts. According to some researchers, connections B. break permeability of cells, causing hypostasis of the last. Then the necrosis of cells with the subsequent growth of connective tissue elements develops.

The main way of penetration of B. and its connections is a respiratory organs; B. in bones, lungs, limf, nodes, a liver, a cardiac muscle, etc. is deposited. B.'s allocation comes from an organism through intestines, to a lesser extent through kidneys.

Acute forms of poisoning with beryllium are observed at inhalation of BeCl 2 , BeF 2 , BeS0 4 , Be (NO 3 ) 2 , oxyfluorides of beryllium.

In some cases acute intoxication is shown in the form of a disease of type foundry fever (see), in other cases — in the form of sharp irritation of mucous membranes of respiratory tracts, a conjunctiva of eyes. At patients laryngitis, tracheitis are observed, and also bronkhobronkhiolit which proceed with high temperature and respiratory insufficiency. Quite often acute bronkhobronkhiolit is followed by a bronchospasm.

Clinical symptoms of poisoning abate in 2 — 3 weeks (sometimes 2 — 3 months). Weight of a clinical current at poisoning with beryllium fluoride (BeF 2 ) explain with defeat not only a mucous membrane of bronchial tubes and bronchioles, but also all bronchial wall with the accompanying defeat of peribronchial fabric. At repeated intoxication the disease proceeds in more severe form. The most frequent complication is pneumonia.

The remote effects of acute poisoning are development hron, toxic bronchitis, a pneumosclerosis and bronchiectasias.

A berylliosis — the occupational disease caused by toxic action of B. and its slightly soluble connections — Be, BeO, Be(OH) 2 , it can be shown several months of a pla later even years after stoppage with connections B. The stage of latency is shorter, the current of a berylliosis is heavier and mortality of patients is higher.

The death of the patients suffering from a berylliosis most often comes from pneumonia or heart failure. Most often the berylliosis develops at workers at B.'s melting, by production of alloys and fluorescent lamps etc. Accelerate development or associated diseases, surgical interventions, pregnancy, etc. cause an exacerbation of a disease. The general weakness, a lose of weight, an asthma, cough (in the beginning dry, in the subsequent wet), thorax pains is observed. Already in initial stages of a berylliosis disturbances of cordial activity are observed, the pulmonary heart develops, there is dystrophy of a myocardium etc. Radiological two main forms of a berylliosis come to light: 1) intersticial — is characterized by easier course and relatively less expressed progressing of pathological process; 2) granulematozny — is characterized by heavier clinical symptomatology and more bystry progressing. In initial phases of development multiple cellular granulomas in lungs have the small sizes; they come to light only on initially increased roentgenograms. In the expressed cases larger shadows and clearly the revealed perinodulyarny emphysema appear. In process of progressing of process against the background of these changes there are rough cirrhotic fields alternating with krupnobullezny emphysema. On roentgenograms pleural unions are found, in roots of lungs quite often come to light giperplazirovanny limf. nodes.

According to the existing working classification the berylliosis is divided into three stages: I, II and III. Along with characteristic X-ray-morphological manifestations are the basis for the specified division preferential this all-clinical trials (see. Pneumoconiosis ).

Fig. 4. A beryllium granuloma in a lung with big polymorphism of cellular elements and existence of colossal cells (coloring hematoxylin-eosine; x 100).] Fig. 4. A beryllium granuloma in a lung with big polymorphism of cellular elements and existence of colossal cells (coloring hematoxylin-eosine; x 100).
Fig. 5. Development of fibrous fabric on site granulomas (coloring according to Van-Gizona; x 100).
Fig. 6. A conchoidal little body among the field of a sclerosis, from below at the left — a necrosis (coloring hematoxylin-eosine; x 100).
Fig. 7. A conchoidal little body (coloring on iron on Perlsa; x 400).
Fig. 8. A diffusion pneumosclerosis between two granulomas (coloring hematoxylin - eosine; x 100).
Fig. 9. Desquamative bronchitis with bronchiectasias (coloring according to Van-Gizona; x 200).

At a berylliosis morphological changes are characterized by diffusion damage of both lungs and pleurae, a widespread granulomatosis and hron, the interstitial proliferative process which is localized in partitions of alveoluses under a pleura, peribronkhialno, perivaskulyarno. Granulomas — grayish-white color, a dense consistence, from 0,2 to 1,5 cm in size. The granuloma consists generally of histiocytes, epithelial cells with impurity (hl. obr. on the periphery) lymphoid, plasmatic and colossal cells like cells of foreign bodys (tsvetn. fig. 4 — 9). Colossal cells contain crystal educations. Further there is a maturing of cells of a granuloma with the advent of fibroblasts in it. Fibroblasts begin to produce collagenic fibers, and process comes to the end with development on site of a granuloma of a connective tissue small knot which quite often is exposed to a hyalinosis. In granulomas find conchoidal (rakovinoobrazny) little bodies with a diameter from 2,5 to 10 microns, typical for B., which can form accumulations with a diameter up to 190 microns. Sometimes they are located in multinucleate colossal cells. Conchoidal little bodies are painted by hematoxylin in blue, blue-violet color, sometimes give positive reaction to iron, have an appearance of fluorescent bluish grains during the lighting by ultraviolet rays. Along with a granulomatosis in interalveolar partitions diffusion proliferative process with existence of histiocytes, lymphoid, plasmocytes, fibroblasts, coming to an end with a diffusion pneumosclerosis is observed. Bronchitis is observed, development of bronchiectasias is possible. Sites of an atelectasis and emphysema meet. In blood vessels the endarteritis, an endophlebitis, fibrinferments can take place. The described changes in lungs usually lead to development of a pulmonary heart.

Granulomas were found also in a liver, a spleen, nights, skeletal muscles, a myocardium, pleura, limf, nodes, primary bronchi and marrow. Development of granulomas in skin and hypodermic cellulose at B.'s penetration through the damaged cover is possible.

Treatment patients at acute intoxication by soluble compounds of B. are carried out by the general principles of professional poisonings: etiological, pathogenetic and symptomatic. First of all perhaps more bystry termination of further contact with the pathogenic agent is necessary: delete the victim from the gas-polluted room, take off the contaminated clothes, delete toxicant from integuments. At easily expressed intoxications which development is caused by direct irritant action of soluble compounds of beryllium (chloride, sulfate, fluoric, etc.) mucous membranes, a conjunctiva, respiratory tracts, purpose of an aerosoltherapy in the form of alkaline inhalations (2% solution of sodium bicarbonate) daily within 10 — 15 days, washing of conjunctivas of 2% solution of sodium bicarbonate with the subsequent instillation in eyes of 10% of solution of a sulfacetamide of sodium is reasonable; symptomatic therapy (antibechics, spasmolysants). At acute intoxications of average and heavy degree (a capillary bronchitis, a bronchiolitis) inhalations of Carbogenum are recommended; prescription of medicines of broncholitic and antiinflammatory action (Euphyllinum, Aminophyllinum, Synthophyllinum), antibacterial agents (antibiotics and streptocides), antihistaminic drugs. In cases of inefficiency of various bronkho-spazmolitlok at the expressed phenomena of a bronchospasm use of the means operating on an inflammatory component of pathological process is recommended. The best drugs are corticosteroids (30 — 40 mg of Prednisolonum a day in the form of short courses for 15 — 20 days with gradual decrease to the minimum doses).

In all cases of acute intoxication treatment shall be complex, it is necessary to use strictly individually in each separate case a combination of these or those medicines. Also individually it is necessary to resolve an issue and of a dosage of drugs and a method of their introduction. On elimination of symptoms of intoxication the dignity is recommended. - hens. treatment (midland of the Union. Southern coast of the Crimea).

Corticosteroids are widely applied to treatment of a granulematozny form of a berylliosis, as well as to treatment of diffusion diseases of connecting fabric. Treatment is recommended to be carried out by courses. Duration of one course 30 — 60 days. Two courses a year are usually conducted. Average therapeutic doses are appointed (20 — 30 mg with gradual decrease in doses to minimum). Along with corticosteroids it is possible to apply also cytostatic immunodepressants (azotionrin, etc.).

Prevention it has to be directed first of all to sealing of productions, the correct organization of system of ventilation of production rooms and cleaning of ventilating emissions, use of individual protection equipment (overalls, respirators, etc.), preliminary surveys of the persons going to work, and periodic medical examinations of workers.

During the diagnosing of a berylliosis irrespective of disease severity the further contact with B. shall be immediately stopped (the decision of questions of examination of working capacity is passed differentially taking into account features of reaction of an organism and a dignity. - a gigabyte. working condition).

The positive skin test with salts B. indicating a sensitization of an organism of B. is also a contraindication to continuation of contact with it. The further contact with B. and its connections after the postponed acute intoxication by these substances even is not recommended at an absolute recovery since the sensitization to the specified substances is possible.

Beryllium in the medicolegal relation matters at investigation of hl. obr. production poisonings; expert value has a feverish syndrome, similar to the phenomena of foundry fever. At necropsy in lungs observe dense nodules, emphysema, expansion and a hypertrophy of the right heart, in a liver — swelling, a necrosis and fatty regeneration. In the easy dead find up to 78 mkg, in regional glands, a liver, nights, edges — to 138 mkg of B. on 100 g of fabric. At court. - a chemical research detection and B.'s definition in bodies spectral or chemical is made by methods. The chemical research is made after extraction with berillony II.

Bibliography: Voynar A. I. A biological role of microelements in an organism of animals and the person, M., 1960; Darwin J. and Badderi Dzh. Beryllium, the lane with English, M., 1962, bibliogr.; Rosenberg P. A. Quantitative definition of beryllium in biological environments, Labo-rat. business, No. 4, page 11, 1963; Whyte D. and Burke J. Beryllium, the lane with English, M., 1960, bibliogr.; Schubert Dzh. Some new data in chemistry and biochemistry of beryllium, Usp. chemical, t. 30, century 4, page 550, 1961; Everest D. A. Himiya of beryllium, the lane with English, M., 1968, bibliogr.

Professional harm — Akopov I. A. and d river. Safety of work during the work with beryllium and its alloys, M., 1964; Alekseeva O. G. Experimental studying of influence of a sensitization nucleoproteids of lungs on expressiveness of the skin test of Kurtis at a berylliosis, the Gigabyte. work and the prof. having got sick., jSft 9, page 29, 1967; The Berylliosis, under the editorship of K. P. Molokano-va, etc., M., 1972, bibliogr.; Vasilyeva E. V. Immunological assessment of model of an experimental berylliosis, Bulle, Eksperim, biol, and medical, t. 67, ΛΓ\» 3, page 74, 1969; Gelfon I. A. and Orlova A. A. Some kliniko-biochemical parallels at a berylliosis, Klin, medical, t. 47, No. 6, page 73, 1969; P. P's Cursors. Pneumoconiosis, M., 1965; Izraelsom 3. And., Mogilev O. Ya. and Suvorov S. V. Questions of occupational health and professional pathology during the work with rare metals, page 78, M., 1973; Orlova A. A. Current state of a question of treatment of a berylliosis, in the same place, t. 48, L» 3, page 140, 1970; Orlova A. A. and Rosenberg of P. A. Sostoyaniye of oxidizing processes at the expressed forms of a berylliosis, the Gigabyte. work and the prof. having got sick., No. 4, page 22, 1969; Andrews J.M., To a z e-sh i H. and. H and of d at H. L. Patterns of lung dysfunction in chronic beryllium disease, Amer. Rev. resp. Dis., v. 100, p. 791, 1969; Chiappino G., Cirla A. Vigliani E. C. Delayed-type hypersensitivity reactions to beryllium compounds, Arch. Path., v. 87, p. 131, 1969; Lie ben J. Williams R. R. Respiratory disease associated with beryllium refining and alloy fabrication, J. occup. Med., v. 11, p. 480, 1969.

A.A. Orlova, M.C. Tolgskaya, A.A. Chumakov; A.N.Krylova (court.), E.A. Maksimyuk (chemical).