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The beryllium lymphocyte proliferation test: Relevant issues in beryllium health surveillance
Author(s) -
Stange Arthur W.,
Joseph Furman F.,
Hilmas Duane E.
Publication year - 2004
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.20082
Subject(s) - beryllium , medicine , medical surveillance , false positive paradox , lymphocyte , sensitization , immunology , repeatability , pathology , statistics , chemistry , chromatography , mathematics , organic chemistry
Background The beryllium lymphocyte proliferation test (Be‐LPT) measures beryllium‐specific cellular immune response, and is useful in medical surveillance of beryllium sensitivity and chronic beryllium disease (CBD). Methods Current and former employees (n = 12,194) of 18 United States Department of Energy (DOE) sites were tested for beryllium sensitization at four laboratories with Be‐LPT expertise. Beryllium sensitized individuals were offered evaluations for CBD. The sensitivity, specificity, and positive predictive value (PPV) of the Be‐LPT were determined, as was inter‐ and intra‐laboratory agreement. Results False positives were calculated to be 1.09%, with a laboratory range of 0.00–3.35% for the 10‐year investigation. Be‐LPTs performed on inter‐laboratory split blood specimens from sensitized individuals showed a false negative rate of 31.7%. The intra‐laboratory repeatability of abnormal Be‐LPT results ranged from 80.4–91.9%. The sensitivity of the Be‐LPT was determined to be 0.683, with a specificity of 0.969. The PPV of one abnormal Be‐LPT was 0.253. Conclusions The Be‐LPT is efficacious in medical surveillance of beryllium‐exposed individuals. The PPV of the Be‐LPT is comparable to other widely accepted medical tests. Confirmation of an abnormal result is recommended to assure appropriate referral for CBD medical evaluation. Am. J. Ind. Med. 46:453–462, 2004. Published 2004 Wiley‐Liss, Inc.