Beryllium Biobank 3: considerations for improving chronic beryllium disease screening.

OBJECTIVE: To optimize beryllium worker screening.

METHODS: Beryllium-exposed persons are classified as beryllium-exposed, beryllium-sensitized (BeS), or chronic beryllium disease. Implications of defining BeS by two or more positive lymphocyte proliferation tests (LPTs) were investigated with a simple binomial model. The potential effect of adjusting the interval for repeated intensive testing to detect chronic beryllium disease among persons with BeS was assessed with a Markov model.

RESULTS: Accuracy of properly identifying BeS is reduced as the number of repeated tests increases. Markov simulation illustrates that adjusting second-stage screening intervals on the basis of personal risk may significantly affect cost-effectiveness.

CONCLUSIONS: The criteria for classification as BeS should be adjusted depending on the number of LPTs performed. Modifying the interval for repeated intensive testing on the basis of each worker's data can improve cost-effectiveness.