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Use of Beryllium Lymphocyte Proliferation Testing for Screening of Asymptomatic Individuals: An Evidence-Based Assessment

Borak, Jonathan MD, DABT; Woolf, Steven H. MD, MPH; Fields, Cheryl A. MPH

Journal of Occupational and Environmental Medicine: September 2006 - Volume 48 - Issue 9 - p 937-947
doi: 10.1097/01.jom.0000232548.03207.9f
Original Articles

Objective: We reviewed published data describing use of beryllium lymphocyte proliferation testing (BeLPT) to determine the appropriateness of BeLPT for screening asymptomatic individuals.

Methods: Published studies were identified by computerized literature searches and hand searches of relevant bibliographies and cited references. Critical assessment of evidence focused on five elements essential to judging effectiveness of preventive services: 1) burden of suffering, 2) accuracy and reliability of screening tests, 3) effectiveness of early detection, 4) harms of screening, and 5) benefits outweighing harms.

Results: Important gaps and deficiencies in the evidence were found. The prevalence of beryllium sensitization and chronic beryllium disease in asymptomatic individuals are unknown. The accuracy and reliability of BeLPT are uncertain. Marked intra- and interlaboratory variability has been reported. The clinical benefits of early intervention have not been confirmed or quantified in asymptomatic individuals.

Conclusions: There is currently insufficient scientific evidence to support the use of BeLPT for routine screening of asymptomatic individuals.

From the Departments of Medicine and Epidemiology & Public Health (Dr Borak), Yale School of Medicine, New Haven, Connecticut, Jonathan Borak & Company, New Haven, Connecticut; the Departments of Family Medicine, Epidemiology and Community Health (Dr Woolf), Virginia Commonwealth University, Richmond, Virginia; and the Department of Epidemiology & Public Health (Ms Fields), Yale School of Medicine, New Haven, Connecticut, Jonathan Borak & Company, New Haven, Connecticut.

Address correspondence to: Jonathan Borak, MD, DABT, 234 Church Street (#1100), New Haven, CT 06510; E-mail:

©2006The American College of Occupational and Environmental Medicine