Hsie AW (1978) Quantitative mammalian cell genetic toxicology.
Environ Sci Res. 15; 291-315.
Huang H, Meyer KC, Kubai L, and Auerbach R. (1992) An immune model
of beryllium-induced pulmonary granulomata in mice: Histopathology,
immune reactivity, and flow-cytometric analysis of bronchoalveolar
lavage-derived cells. Lab Invest 67:138-146.
Huang W, Fernandez D, Rudd A, Johnson WP, Deubner D, Sabey P, Storrs
J, Larsen R. (2011) Dissolution and nanoparticle generation behavior
of Be-associated materials in synthetic lung fluid using inductively
coupled plasma mass spectroscopy and flow field-flow fractionation.
J Chromatogr A 1218 (27) 4149-4159.
[IARC] International Agency for Research on Cancer. (1993).
Beryllium, cadmium, mercury and exposures in the glass manufacturing
industry. Monogr Eval Carcinog Risk Hum 58:41-117.
[IARC] International Agency for Research on Cancer. (2009). Special
Report: Policy A review of human carcinogens--Part C: metals,
arsenic, dusts, and fibres. The Lancet/Oncology. Vol 10 May 2009.
[IARC] International Agency for Research on Cancer. (2012) A review
of the human carcinogens: arsenic, metals, fibres, and dusts.
[ICRP] International Commission on Radiological Protection. (1960)
Report of ICRP Committee II on Permissible Dose for Internal
Radiation. Health physics, 3:154-155.
[ICRP] International Commission on Radiological Protection. (1994).
ICRP Publication 66: Human Respiratory Tract Model for Radiological
Protection (No. 66). ICRP (Ed.). Elsevier Health Sciences.
[ICSC] International Chemical Safety Card 0226 (beryllium metal).
http://www.ilo.org/dyn/icsc/showcard.display?p_lang=en&p_card_id=0226.
[ICSC] International Chemical Safety Card 1325 (beryllium oxide)
http://www.inchem.org/documents/icsc/icsc/eics1325.htm.
[ICSC] International Chemical Safety Card 1351 (beryllium sulfate)
http://www.inchem.org/documents/icsc/icsc/eics1351.htm.
[ICSC] International Chemical Safety Card 1352 (beryllium nitrate)
http://www.inchem.org/documents/icsc/icsc/eics1352.htm.
[ICSC] International Chemical Safety Card 1353 (beryllium carbonate)
http://www.inchem.org/documents/icsc/icsc/eics1353.htm.
[ICSC] International Chemical Safety Card 1354 (beryllium chloride)
http://www.ilo.org/dyn/icsc/showcard.display?p_lang=en&p_card_id=1354.
[ICSC] International Chemical Safety Card 1355 (beryllium fluoride)
http://www.inchem.org/documents/icsc/icsc/eics1355.htm.
Infante P, Wagoner J, Sprince N. (1980) Mortality patterns from lung
cancer and nonneoplastic respiratory disease among white males in
the Beryllium Case Registry. Environ Res 21:35-43.
Invanokov AT, Popov BA, Parfenova IM (1982) Resorption of soluble
beryllium compounds through the injured skin. Gig Tr Prof Zabol 9:
50-52.

Irwin, R.S., F.J. Curley, and C.L. French, 1990. ``Chronic cough:
the spectrum and frequency of causes, key components of the
diagnostic evaluation, and outcome of specific therapy,'' Am Rev
Respir Dis 1990; 141: 640-7.
Jackson L, Evers BM. (2006) Chronic inflammation and pathogenesis of
GI and pancreatic cancers. Cancer Treat Res. 130:39-65.
Johnson JS, Foote K, McClean M, Cogbill G. (2001) Beryllium exposure
control program at Cardiff Atomic Weapons Establishment in the
United Kingdom. Appl Occup Environ Hyg. May;16(5):619-30.
Johnston CJ, Driscoll KE, Finkelstein JN, Baggs R, O'Reilly MA,
Carter J, Gelein R, Oberd[ouml]rster G. (2000) Pulmonary chemokine
and mutagenic responses in rats after subchronic inhalation of
amorphous and crystalline silica. Toxicol Sci. 2000 Aug;56(2):405-
13.
Joseph, P., T. Muchnok, and T. Ong. (2001) Gene expression profile
in BALB/c-3T3 cells transformed with beryllium sulfate. Mol.
Carcinog. 32(1):28-35.
Kada T. (1980) Mutagenicity of selected chemicals in the rec-assay
in bacillus subtilis. Cmpoarative Chemical Mutagenesis, pp 19-22.
KanematsuN, Hara M, Kada T. (1980) Rec assay and mutagenicity
studies on metal compounds. Mutat Res. Feb;77(2):109-16.
Kang KY, Bice D, Hoffman E, D'Amato R, Ziskind M, Salviggio. (1977)
Experimental studies of sensitization to beryllium, zirconium, and
aluminum compounds in the rabbit. J. Allergy Clin Immunol.
Jun;59(6):425-36.
Keizer TS, Sauer NN, McClesky TM. (2005) Beryllium binding at
neutral pH: the importance of the Be-O-Be motif. J Inorg Biochem;
99(5): 1174-1181.
Kelleher PC, Martyny JW, Mroz MM, Maier LA, Ruttenber AJ, Young DA,
et al. (2001) Beryllium particulate exposure and disease relations
in a beryllium machining plant. J Occup Environ Med 43: 238-249.
Kent MS, Robins TG, Madl AK. (2001) Is total mass or mass of
alveolar -deposited airborne particles of beryllium a better
predictor of the prevalence of disease? A preliminary study of a
beryllium processing facility. Appl Occup Environ Hyg. 16 (5): 539-
558.
Keshava, N, Zhou G, Spruill M, Ensell M, Ong TM. (2001) Carcinogenic
potential and genomic instability of beryllium sulphate in BALB/c-
3T3 cells. Mol. Cell. Biochem. 222(1-2):69-76.
Kimber I, Basketter, DA, Gerberick GF, Ryan CA, Dearman RJ. 2011.
Chemical Allergy: Transplating Biology into Hazard Characterization.
Toxicol. Sci. 120 (S1): S238-S268.
Kittle LA, Sawyer RT, Fadok VA, Maier LA, Newman LS. (2002)
Beryllium induces apoptosis in human lung macrophages. Sarcoidsis
Vasc Diffuse Lung Dis; 19(2): 101-113.
Klemperer FW, Martin AP, Van Riper J. (1951) Beryllium excretion in
humans. A M A Arch Ind Hyg Occup Med. Sep; 4(3):251-6.
Knaapen AM, Borm PJ, Albrecht C, Schins RP. (2004) Inhaled particles
and cancer. Part A: Mechanisms. Int J Cancer. May 10;109(6):799-809.
Kniesner, T.J., W.K. Viscusi, and J.P. Ziliak, 2010. ``Policy
relevant heterogeneity in the value of statistical life: New
evidence from panel data quantile regression,'' Journal of Risk and
Uncertainty, 40, pp. 15-31.
Kniesner, T.J., W.K. Viscusi, C. Woock, and J.P. Ziliak, 2012. ``The
Value of a Statistical Life: Evidence from Panel Data,'' Review of
Economics and Statistics, 94(1), pp. 74-87.
Kolanz, M., 2001. Brush Wellman Customer Data Summary. OSHA
Presentation, July 2, 2001. Washington, DC.
Kreiss K, Newman LS, Mroz MM, Campbell PA. (1989) Screening blood
test identifies subclinical beryllium diease. J Occup Med. 31 (7):
603-608.
Kreiss K, Mroz MM, Zhen B, Martyny JW, Newman LS. (1993a)
Epidemiology of beryllium sensitization and disease in nuclear
workers. Am Rev Respir Dis 148:985-991.
Kreiss K, Wasserman S, Mroz MM, Newman LS. (1993b) Beryllium disease
screening in the ceramics industry. Blood lymphocyte test
performance and exposure-disease relations. J Occup Med 35:267-274.
Kreiss K, Mroz MM, Newman LS, Martyny J, Zhen B. (1996) Machining
Risk of Beryllium Disease and Sensitization With Median Exposures
Below 2 micrograms/m\3\. Am J Ind Med. 30(1):16-25.
Kreiss K, Mroz MM, Zhen B, Wiedemann H, Barna B. (1997) Risks of
beryllium disease related processes at a metal, alloy, and oxide
production plant. Occup Environ Med. 54 (8): 605-612.
Kreiss K, Day GA, Schuler CR. (2007) Beryllium: a modern industrial
hazard. Annu Rev Public Health. 28:259-77.
Kriebel D, Sprince N, Eisen E, Greaves I. (1988a) Pulmonary function
in beryllium workers: assessment of exposure. Br J Ind Med 45:83-92.
Kriebel D, Sprince NL, Eisen EA, et al. (1988b) Beryllium exposure
and pulmonary function: A cross sectional study of beryllium
workers. Br J Ind Med 45:167-173.
Krivanek, Reeves. (1972) The effects of chemical forms of beryllium
on the production of the immunological response. Am Ind Hyg Assoc J.
Jan; 33(1):45-52.
Kuroda K, Endo G, Okamoto A, Yoo YS, Horiguchi S. (1991)
Genotoxicity of beryllium, gallium and antimony in short-term
assays. Mutat Res. Dec;264(4):163-70.
Lang L. (1994) Beryllium: a chronic problem. Environ Health Perspect
102:526-531.
Langhammer A, Forsmo S, Syversen U. (2009). Long-term therapy in
COPD: any evidence of adverse effect on bone? Int J Chron Obstruct
Pulmon Dis. 4:365-80.
Lansdown ABG (1995) Physiological and toxicological changes in the
skin resulting from the action and interaction of metal ions.
Critical reviews in toxicology, 25(5):397-462.
Larramendy ML, Popescu NC, DiPaolo JA. (1981) Induction by inorganic
metal salts of sister chromatid exchanges and chromosome aberrations
in human and Syrian hamster cell strains. Environ Mutagen. 3 (6):
597-606.
Lederer H and J Savage. (1954) Beryllium Granuloma of the Skin. Br J
Ind Med. Jan; 11(1):45-8.
Lee KP, Trochimowicz HJ, Reinhardt CF. (1985) Pulmonary response of
rats exposed to titanium dioxide (TiO2) by inhalation for two years.
Toxicol Appl Pharmacol. Jun 30;79(2):179-92.
Leek RD, Harris AL. (2002) Tumor-associated macrophages in breast
cancer. J Mammary Gland Biol Neoplasia 2002, 7:177-189.
LeFevre ME, Joel DD. (1986) Distribution of label after intragastric
administration of 7Be-labeled carbon to weanling and aged mice. Proc
Soc Exp Biol Med 182:112-119.
Lehouck A, Boonen S, Decramer M, Janssens W. (2011). COPD, bone
metabolism, and osteoporosis. Chest. Mar;139(3):648-57.
Leonard A, Lauwerys R. (1987) Mutagenicity, carcinogenicity and
teratogenicity of beryllium. Mutat Res 186:35-42.
Levy PS, Roth HD, Hwang PMT, Powers TE. (2002) Beryllium and lung
cancer: A reanalysis of a NIOSH cohort mortality study. Inhal
Toxicol. 14 (10): 1003-1015.
Levy, P.S., H.D. Roth, P.M.T. Hwang, and T.E. Powers, 2002.
``Beryllium and Lung Cancer: A Reanalysis of a NIOSH Cohort
Mortality Study,'' Inhalation Toxicology, 14:1003-1015.
Levy PS, Roth HD, Deubner DC. (2007) Exposure to beryllium and
occurrence of lung cancer: A reexamination of findings from a nested
case-control study. J Occup Environ Med. 49 (1): 96-101.
Lieben J, Metzner,F. (1959) Epidemiological findings associated with
beryllium extraction. Am IndHyg Assoc J 20(6):152.
Lieben J, Williams RR. (1969) Respiratory Disease Associated With
Beryllium Refining And Alloy Fabrication. 1968 Follow-up. J Occup
Med. 11(9):480-5.
Lind, R.C. (Ed.), 1982. Discounting for Time and Risk in Energy
Policy, Washington, DC: Resources for the Future.
Lionakis MS and Kontoyiannis DP. (2003). Glucocorticoids and ivasive
fungal infections. Lancet. Nov 29:362(9398):1828-38.
Lipworth BJ. (1999). Systemic adverse effects of inhaled
corticosteroid therapy: A systematic review and meta-analysis. Arch
Intern Med. May 10: 159(9): 941-955.
Machle W, Beyer E, Gregorious F. (1948). Berylliosis; acute
pneumonitis and pulmonary granulomatosis of beryllium workers. Occup
Med (Chic Ill). Jun;5(6):671-83.
Mack DG, Lanham AK, Palmer PE, Maier LA, Watts TH, Fontenot AP.
(2008) 4-4BB enhances proliferation of beryllium-specific T cells in
the lung of subjects with chronic beryllium disease. J Immunol. Sep
15;181(6):4381-8.
MacMahon B. (1994) The epidemiological evidence on the
carcinogenicity of beryllium in humans. J Occup Med 36:15-24.

Madl AK, Unice K, Brown JL, Kolanz ME, Kent MS. (2007) Exposure-
response analysis for beryllium sensitization and chronic beryllium
disease among workers in a beryllium metal machining plant. J Occup
Environ Hyg. Jun;4(6):448-66.
Magat W., W. Viscusi, and J. Huber, 1996. ``A Reference Lottery
Metric for Valuing Health,'' Management Science, (42: 8), pp. 1118-
1130.
Maier LA. (2001) Beryllium health effects in the era of the
beryllium lymphocyte proliferation test. Appl Occup Environ Hyg
16(5):514-520.
Maier LA, Reynolds MV, Young DA, et al. (1999) Angiotensin-1
converting enzyme polymorphisms in chronic beryllium disease. Am J
Respir Crit Care Med 159(4 Pt 1):1342-1350.
Maier LA, Tinkle SS, Kittie LA, et al. (2001) IL-4 fails to regulate
in vitro beryllium-induced cytokines in berylliosis. Eur Resp J
17:403-415.
Maier LA. (2001) Beryllium health effects in the era of the
beryllium lymphocyte proliferation test. Appl Occup Environ Hyg. 16
(5): 514-520.
Maier LA, McGrath DS, Sato H, Lympany P, Welsh K, Du Bois R,
Silveira L, Fontenot AP, Sawyer RT, Wilcox E, Newman LS. (2003)
Influence of MHC class II in susceptibility to beryllium
sensitization and chronic beryllium disease. J Immunol 171(12):
6910-6918.
Maier LA, Martyny JW, Liang J, Rossman MD. (2008) Recent Chronic
Beryllium Disease in Residents Surrounding a Beryllium Facility. Am
J Respir Crit Care Med. 1;177(9):1012-7.
Maier LA, Barkes BQ, Mroz M, Rossman MD, Barnard J, Gillespie M,
Martin A, Mack DG, Silveira L, Sawyer RT, Newman LS, Fontenot AP.
(2012) Infliximab therapy modulates an antigen-specific immune
response in chronic beryllium disease. Respir Med; 106 (12): 1810-
1813.
Mancuso TF, El-Attar AA. (1969) Epidemiological study of the
beryllium industry. Cohort methodology and mortality studies. J
Occup Med. Aug;11(8):422-34.
Mancuso TF. (1970) Relation of duration of employment and prior
respiratory illness to respiratory cancer among beryllium workers.
Environ. Research 3: 251-275.
Mancuso TF. (1979) Occupational lung cancer among beryllium workers.
Dusts and Diseases, R. Lemen and JM Dement eds. Park Forest South,
Il: Pathotox Publishers. Pp 463-471.
Mancuso T. (1980) Mortality study of beryllium industry workers'
occupational lung cancer. Environ Res 21:48-55.
Mandervelt C, Clottens FL, Demedts M, Nemery B. (1997) Assessment of
the sensitization potential of five metals in the murine local nymph
node assay. Toxicology. Jun 6;120(1):65-73.
Marchand-Adam S, El Khatib A, Guillon F, Brauner MW, Lamberto C,
Lepage V, Naccache JM, Valeyre D. (2008) Short- and long-term
response to corticosteroid therapy in chronic beryllium disease. Eur
Respir J; 32 (3): 683-693.
Martin AK, mack DG, Falta MT, Mroz MM, Newman LS, Maier LA, Fontenot
AP. (2011) Beryllium-specific CD4+ T cells in blood as a biomarker
of disease progression. J Allergy Clin Immunol; 128(5): 1100-1106.
Martyny J, Hoover M, Mroz M, Ellis K, Maier L, Sheff K, Newman L.
(2000) Aerosols generated during beryllium machining. J Occup
Environ Med 42:8-18.
Marx JJ and R Burrell. (1973) Delayed hypersensitivity to beryllium
compounds. J Immunol.l Aug;111(2):590-8.
Materion and USW (2012). Industry and Labor Joint Submission to OSHA
of a Recommended Standard for Beryllium. February, 2012.
Materion Information Meeting, 2012. Personal communication during
meeting between Materion Corporation and the U.S. Occupational
Safety and Health Administration. Elmore, Ohio. May 8-9.
Materion (2004). [previously Brush Wellman, 2004]. Brush Wellman's
1999 Baseline Full-Shift Personal Breathing Zone (Lapel-Type)
Exposure Results for its Elmore, Ohio, Primary Beryllium Production
Facility. Brush Wellman, Inc., Cleveland, Ohio. Data provided to
Eastern Research Group, Inc. August 23. [Unpublished].
McCanlies EC, Ensey JS, Schuler CR, Kreiss K, Weston A. (2004) The
association between HLA-DPB1Glu69 and chronic beryllium disease and
beryllium sensitization. Am J Ind Med. 46 (2): 95-103.
McCanlies EC, Schuler CR, Kreiss K, Frye BL, Ensey JS, Weston A.
(2007) TNF-alpha polymorphism in chronic beryllium disease and
beryllium sensitization. J Occup Environ Med. 49(4): 446-452.
McCanlies EC, YUCesoy B, Mnatsakanova A, Slaven JE, Andrew M, Frye
BL, Schuler CR, Kreiss K, Weston A. (2010) Association between IL-1A
single nucleotide polymorphisms and chronic beryllium disease and
beryllium sensitization. JOEM 52 (7): 680-684.
McCawley MA, Kent MS, Berakis MT. (2001) Ultrafine beryllium number
concentration as a possible metric for chronic beryllium disease
risk. Appl Occup Environ Hyg 16(5):631-638.
McCord DP. (1951) Beryllium as a sensitizing agent. Ind Med Surg.
Jul; 20(7):336-7.
McDonough AK, Curtis JR, Saag KG. (2008). The epidemiology of
glucocorticoid-associated adverse events. Curr Opin Rheumatol.
Mar;20(2):131-7.
Metzner FN, Lieben J. (1961) Respiratory disease associated with
beryllium refining and alloy fabrication; a case study. J Occup Med.
Jul; 3:341-5.
Meyer KC. (1994) Beryllium and Lung Disease. Chest 106; 942-946.
Middleton DC. (1998) Chronic beryllium disease: Uncommon disease,
less common diagnosis. Environ Health Perspect 106(12):765-767.
Middleton DC, Lewin MD, Kowalski PJ, Cox SS, Kleinbaum D. (2006) The
BeLPT: algorithms and implications. Am J Ind Med. Jan; 49(1):36-44.
Middleton DC, Fink J, Kowalski PJ, Lewin MD, Sinks T. (2008)
Optimizing BeLPT criteria for beryllium sensitization. Am J Ind Med.
49 (1); 36-44.
Middleton DC, Mayer AS, Lewin MD, Mroz MM, Maier LA. (2011)
Interpreting borderline BeLPT results. Am J Ind Med. Mar;54(3):205-
9.
Miller FJ, Anjilvel S, Menache MG, Asgharian B, Gerrity T. (1995)
Dosimetric issues relating to particulate toxicity. Inhal Toxicol. 7
(5): 615-632.
Misra, U.K., G. Gawdi, and S.V. Pizzo. (2002) Beryllium fluoride-
induced cell proliferation: A process requiring P21-rasdependent
activated signal transduction and NF-[kappa]B-dependent gene
regulation. J. Leukoc. Biol. 71(3):487-494.
Miyaki M, Akamatsu N, Ono T, Koymam H. (1979) Mutagenicity of metal
cations in cultured cells from Chinese hamster. Mutat Res. 68 (3);
25-263.
Mossman BT. (2000) Mechanisms of action of poorly soluble
particulates in overload-related lung pathology. Inhal Toxicol. Jan-
Feb;12(1-2):141-8.
Mroz MM, Kreiss K, Lezotte DC, Campbell PA, Newman LS. (1991)
Reexamination of the blood lymphocyte transformation test in the
diagnosis of chronic beryllium disease. J allergy Clin Immunol. 88
(1); 54-60.
Mroz MM, Maier LA, Strand M, Silviera L, Newman LS. (2009) Beryllium
lymphocyte proliferation test surveillance identifies clinically
significant beryllium disease. Am J Ind Med. Oct; 52(10):762-73.
Mueller JJ, Adolphson DR. (1979) Corrosion/Electrochemistry of
Beryllium and Beryllium. In Beryllium Science and Technology, Vol 2,
DR Floyd and JN Lowe, eds New York: Plenum Press pp 417-433.
Mullen AL, Stanley RE, Lloyd SR, Moghissi AA. (1972) Radioberyllium
metabolism by the dairy cow. Health physics, 22:17-22.
Muller-Quernheim, J. (2005) Chronic Beryllium Disease. Orphanet
encyclopedia. http://www.orpha.net/consor/cgibin/Disease_Search.php?lng=EN&data_id=1061&Disease_Disease_Search_diseaseGroup=chronic-beryllium-disease&Disease_Disease_Search_diseaseType=Pat&Disease(s)/group of
diseases=Chronic-berylliosis--Chronic-beryllium-disease-
&title=Chronic-berylliosis-Chronic-beryllium-disease-
&search=Disease_Search_Simple.
Muller-Quernheim J, Gaede KI, Fireman E, Zissel G. (2006) Diagnoses
of chronic beryllium disease with cohorts of sarcoidosis patients.
Eur Respir J. Jun; 27(6):1190-5.
[NAS] National Academies of Science (2008) Managing Health Effects
of Beryllium Exposure Committee on Beryllium Alloy Exposures.
National Research Council of the National Academies; The National
Academies Press, Washington, DC.
[NCI] National Cancer Institute. Cancer Trends Progress Report--
2009/2010 Update, National Cancer Institute, NIH, DHHS, Bethesda,
MD, April 2010, http://progressreport.cancer.gov.

Ndejembi MP, Teijaro JR, Patke DS, Bingaman AW, Chandok MR, Azimadeh
A, Nadler SG, Farber DL. (2006) Control of memory CD4 T cell recall
by the CD28/B7 costimulatory pathway. J Immunol; 177(11): 7698-7706.
[NEHC] Navy Environmental Health Center. (2003a). Navy Response to
Occupational Safety and Health Administration's Occupational
Exposure to Beryllium; Request for Information, February 2003. Navy
Environmental Health Center, Portsmouth, VA.
[NEHC] Navy Environmental Health Center. (2003b). Attachment (1)
Navy Occupational Exposure Database (NOED) Query Report Personal
Breathing Zone Air Sampling Results for Beryllium. Samples taken May
7, 1982 through June 7, 2002. Navy Environmental Health Center,
Portsmouth, VA.
Newman LS, Kreiss K, King TE, Seay S, Campbell PA. (1989) Pathologic
and immunologic alterations in early stages of beryllium disease.
Reexamination of disease definition and natural history. Am Rev
Respir Dis. 139 (6); 1479-1486.
Newman LS, Kreiss K. (1992) Non-occupational beryllium disease
masquerading as sarcoidosis; identification by blood lymphocyte
proliferation response to beryllium. Am Rev Respir Dis.
May;145(5):1212-4.
Newman et al. (1994). Beryllium disease: assessment with CT.
Radiology; 190(3): 835-840.
Newman LS. (1996) Immunology Genetics and Epidemiology of Beryllium
Disease. Chest. 109; 40S-43S.
Newman LS, Llyody J, Daniloff E. (1996) The natural history of
beryllium sensitization and chronic beryllium disease. Environ
Health Perspect. Oct;104 Suppl 5:937-43.
Newman LS, Mroz MM, Maier LA, Daniloff DA, Balkissoon. (2001)
Efficacy of serial medical surveillance from chronic beryllium
disease in a beryllium machining plant. J Occup Environ Health.
43(3): 231-237.
Newman, L.S., L.A. Maier, J.W. Martyny, M.M. Mroz, and E.A. Barker,
2003. National Jewish Medical and Research Center public comment to
``Occupational Exposure to Beryllium: Request for Information,''
OSHA Docket No. OSHA-H005C-2006-0870-0155.
Newman LS, Mroz MM, Balkissoon R, Maier LA. (2005) Beryllium
sensitization progresses to chronic beryllium disease: A
longitudinal study of disease risk. Am J Respir Crit Care Med. 171
(1): 54-60.
Newman LS. (2007) Immunotoxicology of beryllium lung disease.
Environ Health Prev Med; 12 (4): 161-164.
Nicholson W. (1976) Case study 1: asbestos--the TLV approach. Ann NY
Acad Sci 271:152-169.
Nickell-Brady C, Hahn FF, Finch GL, and Belinsky SA. (1994) Analysis
of K-ras, p53, and c-raf-1 mutations in beryllium-induced rat lung
tumors. Carcinogenesis 15:257-262.
Nikula KJ, Swafford DS, Hoover MD, Tohulka MD, and Finch GL. (1997)
Chronic granulomatous pneumonia and lymphocytic responses induced by
inhaled beryllium metal in A/J and C3HlHe J mice. Toxicologic
Pathology 25 (1): 2-12.
Nilsen AM, Vik R, Behrens C, Drablos PA, Espevik T. (2010) Beryllium
sensitivity among workers at a Norwegian aluminum smelter. Am J Ind
Med. 53 (7); 724-732.
[NIOSH] National Institute of Occupational Safety and Health. (1972)
Occupational Exposure to Beryllium; Criteria for a Recommended
Standard. DHEW (HSM) 72-10268. US Department of Health, Education,
and Welfare, Health Services and Mental Health Administration,
National Institute of Occupational Safety and Health, Rockville, MD.
[NIOSH] National Institute of Occupational Safety and Health. HHE
75-87-280. Health Hazard Evaluation Determination Report No. 75-87-
280, Kawecki Berylco Industries, Inc., Reading, Pennsylvania (NTIS
document number PB89-161251). Cincinnati, Ohio. April 1976.
[NIOSH] National Institute of Occupational Safety and Health. HHE
78-17-567. Health Hazard Evaluation Determination Report No. 78-17-
567, Kawecki Berylco Industries, Inc., Reading, Pennsylvania (NTIS
document number PB81-143703). Cincinnati, Ohio. March 1979.
[NIOSH] National Institute for Occupational Safety and Health.
(1994) NIOSH Pocket Guide to Chemical Hazards. DHHS (NIOSH)
Publication No. 94-116. Washington, DC: U.S. Government Printing
Office, June 1994, p. 29.
[NIOSH] National Institute of Occupational Safety and Health. (2005)
NIOSH Pocket Guide to Chemical Hazards.
[NIOSH] National Institute of Occupational Safety and Health. NIOSH
Elmore database, 2011. Spreadsheet containing beryllium exposure
values collected by NIOSH at the Materion Elmore facility in 2007
and 2008; provided by Materion Corporation to OSHA-Directorate of
Standards and Guidance. Fall 2011.
Nishimura M. (1966). Clinical and experimental studies on acute
beryllium disease. Nagoya J Med Sci. Nov; 29(1):17-44.
Nishioka H. (1975). Mutagenic activites pf metal compounds I
bacteria. Mutat Res. 31(3); 185-189.
[NJMRC] National Jewish Medical and Research Center. (2003). NJMRC's
response to OSHA's Request for Information on occupational exposure
to beryllium. Dated: February 20, 2003. Pp. 17.
[NJMRC] National Jewish Medical and Research Center. (2013). Web
page on Chronic Beryllium Disease: Work Environment Management, from
http://www.nationaljewish.org/healthinfo/conditions/beryllium-disease/environment-management/, accessed May 2013.
[NLST] National Lung Screening Trial (2011).--Bach PB (2011).
Inconsistencies in findings from the early lung cancer action
project studies of lung cancer screening. J Natl Cancer Instl
103(13): 1002-1006.
[NTP] National Toxicology Program. (1993). Toxicology and
Carcinogenesis Studies of Talc (CAS No. 14807-96-6)(Non-Asbestiform)
in F344/N Rats and B6C3F1 Mice (Inhalation Studies).
[NTP] National Toxicology Program. (1999). Final Report on
Carcinogens: Background Document for Beryllium and Beryllium
Compounds. http://ntp.niehs.nih.gov/ntp/newhomeroc/roc10/be_no_appendices_508.
[NTP] National Toxicology Program. (2002). Tenth report on
carcinogens. U.S. Department of Health and Human Services, National
Toxicology Program, Research Triangle Park, NC. http://ntp-server.niehs.nih.gov/NewHomeROC/RAHC_list.html. July 12, 2002.
[NTP] National Toxicology Program. (2014). Report on Carcinogens,
Thirteenth Edition. Beryllium and Beryllium compounds. CAS No. 7440-
41-7. http://ntp.niehs.nih.gov/go/roc13.
Oberdorster G. (1996). Significance of particle parameters in the
evaluation of exposure-dose-response relationships of inhaled
particles. Inhal Toxicol. 8 Suppl:73-89.
[OMB] U.S. Office of Management and Budget. (2003). Circular A-4,
Regulatory Analysis, September 17, 2003. Available at: http://www.whitehouse.gov/omb/circulars_a004_a-4/.
[OSHA] U.S. Occupational Safety and Health Administration. (2002).
Request for Information (RFI) for ``Occupational Exposure to
Beryllium'', 67 FR 70707, 70708, 70709, November 26, 2002.
[OSHA] U.S. Occupational Safety and Health Administration. (2003).
Letter of Interpretation. Directorate of Enforcement Programs.
http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=25617.
[OSHA] U.S. Occupational Safety and Health Administration. (2006).
Final Economic and Regulatory Flexibility Analysis for OSHA's Final
Standard for Occupational Exposure to Hexavalent Chromium; Docket
H054A, Exhibit 49, pp. VI-16 to VI-18.
[OSHA] U.S. Occupational Safety and Health Administration. (2007).
Preliminary Initial Regulatory Flexibility Analysis of the
Preliminary Draft Standard for Occupational Exposure to Beryllium,
September 17. OSHA Beryllium Docket Document ID Number: OSHA-H005C-
2006-0870-0338.
[OSHA] U.S. Occupational Safety and Health Administration. (2007a).
Appendix C. Beryllium Small Business Advocacy Review (SBAR) Panel
Report. Written comments from Small Entity Representatives (SERs).
[OSHA] U.S. Occupational Safety and Health Administration. (2007b).
Preliminary Initial Considerations for a Draft Proposed Standard for
General Industries, Construction and Maritime.
[OSHA] U.S. Occupational Safety and Health Administration. (2008a).
Compliance Directive, CPL 02-02-074.
[OSHA] U.S. Occupational Safety and Health Administration. (2008b).
Report of the

Small Business Advocacy Review Panel on the OSHA Draft Proposed
Standard for Occupational Exposure to Beryllium. January 15, 2008.
[OSHA] U.S. Occupational Safety and Health Administration. (2009).
Integrated Management Information System (IMIS). Beryllium exposure
data, updated April 21, 2009, covering the period 1978 through
September 2008. Data provided to Eastern Research Group, Inc. by the
U.S. Department of Labor, Occupational Safety and Health
Administration, Washington, DC. [Unpublished, electronic files].
[OSHA] Occupational Safety and Health Administration. (2010a).
Occupational Exposure to Beryllium: Preliminary OSHA Health Effects
Evaluation. August 3, 2010.
[OSHA] Occupational Safety and Health Administration. (2010b).
Preliminary Beryllium Risk Assessment. August 3, 2010.
[OSHA] U.S. Occupational Safety and Health Administration. (2013).
Occupational Exposure to Respirable Crystalline Silica, Proposed
Rule, Federal Register, 78 FR 56273.
[OSHA] U.S. Occupational Safety and Health Administration. (2014).
Preliminary Economic Analysis and Initial Regulatory Flexibility
Analysis in support of the Notice of Proposed Rulemaking for
Occupational Exposure to Beryllium.
[OSHA] Occupational Safety and Health Administration. (2014a). Risk
Analysis of a Worker Population at a Beryllium Machining Facility.
[OSHA] Occupational Safety and Health Administration. (2015a).
Spreadsheets in Support of OSHA's Preliminary Economic Analysis for
the Proposed Beryllium Standard.
[OSHA] Occupational Safety and Health Administration. (2015b).
``Comparing Two Models for Beryllium Benefits.''
[OSHA] Occupational Safety and Health Administration. (2015c).
``Spreadsheet for an Alternative Benefit Model.''
Pallavicino F., Pellicano R., Reggiani S., Simondi D., Sguazzini C.,
Bonagura A.G., Cisaro F., Rizzetto M., Astegiano M. (2013).
Inflammatory Bowel Disease And Primary Sclerosing Cholangitis:
Hepatic And Pancreatic Side Effects Due To Azathioprine. Eur Rev Med
Pharma Sci; 17: 84-87.
Palmer B.E., Mack D.G., Martin A.K., Gillespie M., Mroz M.M., Maier
L.A., Fontenot A.P. (2008). Up-regulation of programmed death-1
expression on beryllium-specific CD4+ T cells in chronic beryllium
disease. J Immunol; 180(4): 2704-2712.
Pappas G.P., Newman L.S. (1993). Early pulmonary physiologic
abnormalities in beryllium disease. American review of respiratory
disease, 148:661-666.
Pikarsky E., Porat R.M., Stein I., Abramovitch R., Amit S., Kasem
S., Gutkovich-Pyest E., Urieli-Shoval S., Galun E., Ben-Neriah Y.
(2004). NF-kappaB functions as a tumour promoter in inflammation-
associated cancer. Nature. Sep 23; 431(7007):461-6.
Polak L., Barnes J.M., Turk J.L. (1968). The genetic control of
contact sensitization to inorganic metal compounds in guinea-pigs.
Immunology. 1968 May; 14(5):707-11.
Rana S.V. (2008). Metals and apoptosis: Recent developments. J trace
Elem Biol; 22(4):262-284.
Reeves A.L. (1965). The absorption of beryllium from the
gastrointestinal tract. Arch Environ Health. Aug; 11(2):209-14.
Reeves A.L., Vorwald A.J. (1967). Beryllium carcinogenesis. II.
Pulmonary deposition and clearance of inhaled beryllium sulfate in
the rat. Cancer Res 27:446-451.
Reeves A.L., Deitch D., Vorwald A.J. (1967). Beryllium
carcinogenesis. I. Inhalation exposure of rats to beryllium sulfate
aerosol. Cancer Res 27:439-445.
Reeves A.L., Krivanek N.D., Busby E.K., Swanborg R.H. (1972).
Immunity to pulmonary berylliosis in guinea pigs. Int Arch
Arbeitsmed. 29(3):209-20.
Refsnes M., Hetland R.B., Ovrevik J., Sundfor I., Schwarze P.E., Lag
M. (2006). Different particle determinants induce apoptosis and
cytokine release in primary alveolar macrophage cultures. Part Fibre
Toxicol. Jun 14;3:10.
Rhoads K., Sanders C.L. (1985). Lung clearance, translocation, and
acute toxicity of arsenic, beryllium, cadmium, cobalt, lead,
selenium, vanadium, and ytterbium oxides following deposition in rat
lung.Environ Res 36:359-378.
Richeldi L., Sorrentino R., Saltini C. (1993). HLA-DPB1 glutamate
69: A genetic marker of beryllium disease. Science. Oct
8;262(5131):242-4.
Ritz B., Morgenstern H., Froines J., Young B. (1999). Effects of
exposure to external ionizing radiation on cancer mortality in
nuclear workers monitored for radiation at Rocketdyne/Atomics
International. Am J Ind Med 35:21-31.
Robinson F.R., Schaffner F., and Trachtenburg E. (1968).
Ultrastructure of the lungs of dogs exposed to beryllium-containing
dusts. Arch. Environ. Health 16:374-379.
Rom, W.N., J.E. Lockey, J.S. Lee, A.C. Kimball, K.M. Bang, H.
Leaman, R.E. Johns, D. Perrota, and H.L. Gibbons. (1984).
Pneumoconiosis and Exposures of Dental Laboratory Technicians.
American Journal of Public Health 74(11):1252-1257. November.
Rosenkranz H.S. and Poirer L.A. (1979). Evaluation of the
mutagenicity and DNA-modifying activity of carcinogens and
noncarcinogens in microbial systems. J Natl Cancer Inst. 62(4):873-
891.
Rosenman K., Hertzberg V., Rice C., Reilly M.J., Aronchick J.,
Parker J.E., Regovich J., Rossman M. (2005). Chronic beryllium
disease and sensitization at a beryllium processing facility.
Environ Health Perspect Oct;113(10):1366-72; Erratum (2006).
Rossman T.G., Molina M. (1984). The genetic toxicology of metal
compounds: I. Induction of prophage in E coli WP2. Environ Mut.
6(1); 59-69.
Rossman M.D., Kern J.A., Elias J.A., Cullen M.R., Epstein P.E.,
Preuss O.P., Markham T.N., Daniele R.P. (1988). Proliferative
Response of Bronchoalveolar Lymphocytes to Beryllium: A test for
chronic beryllium disease. Annals Int Med; 108(5):687-693.
Rossman M.D., Preuss O.P., Powers M.B., eds. (1991). Beryllium:
Biomedical and Environmental Aspects. Immunopathogenesis of Chronic
Beryllium Disease. Chapter 10. Baltimore, MD: Williams and Wilkins.
Rossman M. (1996). Chronic beryllium disease; diagnosis and
management. Environ Health Perspect. Oct; 104 Suppl 5:945-7.
Rossman M.D. (2001). Chronic beryllium disease: A hypersensitivity
disorder. Appl Occup Environ Hyg. May; 16(5):615-8.
Rossman M., Kreider. (2003). Is chronic beryllium disease
sarcoidosis of known etiology? Sarcoidosis Vasc Diffuse Lung Dis.
Jun; 20(2):104-9.
Roth H.D. Memorandum to Brush Wellman enclosing a critique of the
EPA health assessment document for beryllium. February 22, 1985.
Saber W., Dweik R.A. (2000). A 65-year-old factory worker with
dyspnea on exertion and a normal chest x-ray. Cleve Clin J Med. Nov;
67(11):791-2, 794, 797-8, 800.
Saltini C., Winestock K., Kirby M., Pinkston P., Crystal R.G.
(1989). Maintenace of alveolitis in patients with chronic beryllium
disease by beryllium-specific helper T cells. N Engl J Med. Apr 27;
320(17):1103-9.
Saltini C., Kirby M., Trapnell B.C., Tamura N., Crystal R.G. (1990).
Biased accumulation of T-lymphocytes with ``memory''-type CD45
leukocyte common antigen gene expression on the epithelial surface
of human lung. J Exp Med. Apr 1; 171(4):1123-40.
Saltini C., Amicosante M. (2001). Beryllium disease. Am J Med Sci
321(1):89-98.
Saltini C., Richeldi L., Losi M., Amicosante M., Voorter C., van den
Berg-Loonen E., Dweik R.A., Wiedmeann H.P., Deubner D.C., Tinelli C.
(2001). Major Histocompatibility Locus Genetic Markers of Beryllium
Sensitization and Disease. Eur Respir J 18(4):677-684.
Salvator H., Gille T., Herve A., Bron C., Lamberto C., Valeyre D.
(2013). Chronic beryllium disease: Azathioprine as a possible
alternative to corticosteroid treatment. Eur Respir J; 41(1):234-
236.
Sanders C.L., Cannon W.C., Powers G.J., et al. (1975). Toxicology of
high-fired beryllium oxide inhaled by rodents. Arch Environ Health
30:546-551.
Sanders, C.L., W.C. Cannon, and G.J. Powers. (1978). Lung
carcinogenesis induced by inhaled high-fired oxides of beryllium and
plutonium. Health Phys. 35(2):193-199.
Sanderson W.T., Henneberger P.K., Martyny J., Ellis K., Mroz M.M.,
Newman L.S. (1999). Beryllium contamination inside vehicles of
machine shop workers. Appl Occup Environ Hyg 14(4):223-230.
Sanderson W.T., Ward E.M., Steenland K., Petersen M.R. (2001a). Lung
Cancer Case Control Study of Beryllium Workers. Am J Ind Med.
39(2):133-44.

Sanderson W.T., Petersen M.R., Ward E.M. (2001b). Estimating
Historical Exposures Of Workers In A Beryllium Manufacturing Plant.
Am J Ind Med. 39(2):145-57.
Saracci R. (1991) Beryllium and lung cancer: Adding another piece to
the puzzle of epidemiologic evidence. J Natl Cancer Inst 83:1362-
1363.
Sawyer, R.T., V.A. Fadok, L.A. Kittle, L.A. Maier, and L.S. Newman.
(2000). Beryllium-stimulated apoptosis in macrophage cell lines.
Toxicology 149(2-3):129-142.
Sawyer R.T., Parsons C.E., Fontenot A.P., Maier L.A., Gillespie
M.M., Gottschall E.B., Silveira L., Newman L.S. (2004). Beryllium-
induced tumor necrosis factor-alpha production by CD4+ T cells is
mediated by HLA-DP. Am J Respir Cell Mol Biol. Jul; 31(1):122-30.
Sawyer, R.T., D.R. Dobis, M. Goldstein, L. Velsor, L.A. Maier, A.P.
Fontenot, L. Silveira, L.S. Newman, and B.J. Day. (2005). Beryllium-
stimulated reactive oxygen species and macrophage apoptosis. Free
Radic. Biol. Med. 38(7):928-937.
[SBAR] Small Business Advocacy Review. (2008). Report of the Small
Business Advocacy Review (SBAR) Panel on the OSHA Draft Proposed
Standard for Occupational Exposure to Beryllium. Small Business
Advisory Review Panel Report with Appendices A, B, C, and D. Final
version, January 15, 2008. OSHA Beryllium Docket Document ID Number:
OSHA-H005C-2006-0870-0345.
Schepers GW, Durkan TM, Delahant AB, Creedon FT. (1957) The
biological action of inhalaed beryllium sulfate; a preliminary
chronic toxicity study in rats. AMA Arch Ind Health. 15 (1); 32-58.
Schepers GW. (1962) The mineral content of the lung in chronic
berylliosis. Dis Chest. Dec; 42:600-7.
Schlesinger RB, Ben-Jebria A, Dahl AR, Snipes MB, Ultman J 1997.
Chapter 12. Disposition of inhaled toxicants. In: Handbook of Human
Toxicology (Massaro EJ, ed). New York:CRC Press, 493-550.
Schubauer-Berigan MK, Deddens JA, Steenland K, Sanderson WT,
Petersen MR. (2008) Adjustment for temporal confounders in a
reanalysis of a case-control study of beryllium and lung cancer.
Occup Environ Med. Jun; 65(6):379-83.
Schubauer-Berigan MK, Deddens JA, Peterson MR. (2011) Risk of lung
cancer associated with quantitative beryllium exposure metrics
within an occupational cohort. Occup Environ Med 68(5): 354-60.
Schubauer-Berigan, 4-22-2011, NIOSH, personal communication. (table
of lifetime risk estimates, Table VI-20 p. 64 of draft risk doc).
Schuler CR, Kent MS, Deubner DC, Berakis MT, McCawley M, Henneberger
PK, Rossman MD, Kreiss K. (2005) Process-Related Risk of Beryllium
Sensitization and Disease in a Copper-Beryllium Alloy Facility. Am J
Ind Med. 47(3):195-205.
Schuler CR, Kitt MM, Henneberger PK, Deubner, DC, Kreiss K. (2008)
Cumulative Sensitization and Disease in a Beryllium Oxide Ceramics
Worker Cohort. J Occup Environ Med. Dec;50(12):1343-1350.
Schuler CR, Virji MA, Deubner DC, Stanton ML, Stefaniak AB, Day GA,
Park JY, Kent MS, Sparks R, Kreiss K. (2012) Sensitization and
Chronic Beryllium Disease at a Primary Manufacturing Facility, Part
3: Exposure-Response Among Short-Term Workers. Scand J Work Environ
Health. May;38(3): 270-81. Epub 2011 Aug 29.
Scott JK, Neumann WF, Allen R. (1950) The effect of added carrier on
the distribution and excretion of soluble beryllium. J Biol Chem,
182:291-298.
Seidler A, Euler U, Muller-Quernheim J, Gaede KI, Latza U, Groneberg
D, Letzel S. (2012) Systematic review: progression of beryllium
sensitization to chronic beryllium disease. Occup Med; 62 (7): 506-
513.
Seiler D, Rice C, Herrick R, Hertzberg V. (1996) A study of
beryllium exposure measurements: parts 1 and 2. Appl Occup Environ
Hyg 11:89-102.
Sendelbach LE, Witschi HP, Tryka AF. (1986) Acute pulmonary toxicity
of beryllium sulfate inhalation in rats and mice: Cell kinetics and
histopathology. Toxicol Appl Pharmacol 85:248-256.
Sendelbach LE, Witschi HP. (1987) Bronchoalveolar lavage in rats and
mice following beryllium sulfate inhalation. Toxicol Appl Pharmacol
90:322-329.
Sendelbach LE, Tryka AF, Witschi H. (1989) Progressive lung injury
over a one-year period after a single inhalation exposure to
beryllium sulfate. Am Rev Respir Dis 139:1003-1009.
Silva DR, Coelho AC, Dumke A, Valentini JD, de Nunes JN, Stefani CL,
da Silva Mendes LF, Knorst MM (2011) Osteoporosis prevalence and
associated factors in patients with COPD: a cross-sectional study.
Respir Care. 56(7):961-8.
Silveira LJ, McCanlies EC, Fingerlin TE, Van Dyke MV, Mroz MM,
Strand M, Fontenot AP, Bowerman N, Dabelea DM, Schuler CR, Weston A,
Maier LA. (2012) Chronic beryllium disease, HLA-DPB1, and the DP
peptide binding groove. J Immunol 189(8): 4014-4023.
Simmon VF. (1979) In vitro assays for recombinogenic activity of
chemical carcinogens and realted compounds with saccharomyces
cerevisiae D3. Nat Cancer Inst. 62 (4); 901-909.
Skilleter DN, Price RJ. (1978) The uptake and subsequent loss of
beryllium by rat liver parenchymal and non-parenchymal cells after
the intravenous administration of particulate and soluble forms.
Chem Biol Interact. Mar;20(3):383-96.
Skilleter DN, Paine AJ. (1979) Relative toxicities of particulate
and soluble forms of beryllium to a rat liver parenchymal cell line
in culture and possible mechanisms of uptake. Chem Biol Interact.
Jan; 24(1):19-33.
Skilleter DN, Price RJ. (1981) Effects of beryllium compounds on rat
liver Kupffer cells in culture. Toxicol Appl Pharmacol. Jun
30;59(2):279-86.
Skilleter DN, Price RJ. (1988) Effects of beryllium ions on tyrosine
phosphorylation. Biochem SocTrans 16:1047-1048.
Snyder, J. A., Weston, A., Tinkle, S. S., & Demchuk, E. (2003).
Electrostatic potential on human leukocyte antigen: implications for
putative mechanism of chronic beryllium disease. Environmental
health perspectives, 111(15), 1827.
Snyder JA, Demchuk E, McCanlies EC, Schuler CR, Kreiss K, Andrew ME,
Frye BL, Ensey JS, Stanton ML, Weston A. (2008) Impact of negatively
charged patches on the surface of MHC class II antigen-presneting
proteins on risk of chronic beryllium disease. J R Soc Interface;
5(24): 749-758.
Sood A, Beckett WS, Cullen MR. (2004) Variable response to long-term
corticosteroid therapy in chronic beryllium disease. Chest; 126 (6):
2000-2007.
Sood A. (2009) Current treatment of chronic beryllium disease. J
Occup Environ Hyg; 6 (12): 762-765.
Spencer HC, Sadek SE., Jones JC, Hook RH, Blumentshine JA,
McCollister SB. (1967) Toxicological studies on beryllium oxides and
beryllium containing exhaust products, technical report. AMRL-TR-67-
46. Wright Patterson Air Force Base, Aerospace Medical Research
Laboratories. May: 1-53.
Sprince NL, Kazemi H, Hardy HL. (1976) Current (1975) problem of
differentiating between beryllium disease and sarcoidosis. Ann N Y
Acad Sci. 278:654-64.
Sprince NL, Kazemi H. (1980) U.S. beryllium case registry through
1977. Environmental research, 21:44-47.
Stange AW, Hilmas DE, Furman FJ, Gatliffe TR. (2001) Beryllium
sensitization and chronic beryllium disease at a former nuclear
weapons facility. Appl Occup Environ Hyg. 16(3): 405-417.
Stange AW, Furman FJ, Hilmas DE. (2004) The beryllium lymphocyte
proliferation test: Relevant issues in beryllium helath
surveillance. Am J Ind Med. 46 (5): 453-462.
Stanton ML, Henneberger PK, Kent MS, Deubner DC, Kreiss K, Schuler
CR. (2006) Sensitization and chronic berullium disease among workers
in copper-beryllium distribution centers. J Occup Environ Med. 48
(2): 204-211.
Steele VE, Wilkinson BP, Arnold JT, and Kutzman RS. (1989) Study of
beryllium oxide genotoxicity in cultured respiratory epithelial
cells. Inhalation Toxicology 1: 95-110.
Steenland K, Ward E. (1991) Lung cancer incidence among patients
with beryllium disease: A cohort mortality study. J Natl Cancer Inst
83:1380-1385.
Stefaniak AB, Weaver VM, Cadorette M, Puckett LG, Schwartz BS, Wiggs
LD, Jankowski MD, and Breysse PN. (2003) Summary of historical
beryllium uses and airborne concentration levels at Los Alamos
National Laboratory. Appl. Occup. Environ. Hyg. 18(9):708-715.

Stefaniak AB, Hoover MD, Dickerson RM, Peterson EJ, Day GA, Breysse
PN, Kent MS, Scripsick RC. (2003a) Surface area of respirable
beryllium metal, oxide, and copper alloy aerosols and implications
for assessment of exposure risk of chronic beryllium disease. Am.
Ind. Hyg. Assoc. J. 64(3):297-305.
Stefaniak AB, Guilmette RA, Day GA, Hoover MD, Breysse PN, Scripsick
RC. (2005) Characterization of phagolysomal simulant fluid of
beryllium aerosol particle dissolution. Toxicol In Vitro; 19(1):123-
134.
Stefaniak, AB, Day GA, Hoover MD, Breysse PN, Scripsick RC. (2006)
Differences in dissolution behavior in a phagolysosomal stimulant
fluid for single-constituent and multi-constituent materials
associated with beryllium sensitization and chronic beryllium
disease. Toxicol. In Vitro 20(1):82-95.
Stefaniak AB, Chipera SJ, Day GA, Sabey P, Dickerson RM, Sbarra DC,
Duling MG, Lawrence RB, Stanton ML, Scripsick RC. (2008)
Physicochemical characteristics of aerosol particles generated
during the milling of beryllium silicate ores: Implications for risk
assessment. J Toxicol Environ Health A. 71(22):1468-81.
Stefaniak AB, et al. 2008. Size-selective poorly soluble particulate
reference materials for evaluation of quantitative analytical
methods. Anal. Bioan. Chem. 391:2071-2077.
Stefaniak, A. B., Virji, M. A., & Day, G. A. (2011). Dissolution of
beryllium in artificial lung alveolar macrophage phagolysosomal
fluid. Chemosphere, 83(8), 1181-1187.
Stefaniak AB, Virji A, Day GA. (2012) Release of beryllium into
artificial airway epithelial lining fluid. Arch Environ Occup
Health; 67(4):219-228.
Stiefel T, Schultze K, Zorn H, Tolg G. (1980) Toxicokinetic and
toxicodynamic studies on beryllium. Arch Toxicol. Jul; 45(2):81-92.
Sterner JH and Eisenbud M. (1951) Epidemiology of Beryllium
Intoxification. A M A Arch Ind Hyg Occup Med. Aug; 4(2):123-51.
Stoeckle JD, Hardy HL, Weber AL. (1969) Chronic beryllium disease.
Long-term follow-up of sixty cases and selective review of the
literature. Am J Med. 46 (4); 545-561.
Stokes RF, Rossman MD. (1991) Blood cell proliferation response to
beryllium: Analysis by receiver-operating characteristics. J Occup
Med. Jan; 33(1):23-8.
Stokinger HE, Sprague GF, Hall RH, et al. (1950) Acute inhalation
toxicity of beryllium. I. Four definitive studies of beryllium
sulfate at exposure concentrations of 100, 50, 10 and 1 mg per cubic
meter. Arch Ind Hyg Occup Med 1:379-397.
Stokinger HE, Altman KI, Salomon K. (1953) The effect of various
pathological-conditions on in vivo hemoglobin synthesis. I.
Hemoglobin synthesis in beryllium-induced anemia as studied with
alpha-14C-acetate. Biochim Biophys Acta. Nov; 12(3):439-44.
Stubbs J, Argyris E, Lee CW, Monos D, Rossman MD. (1996) Genetic
markers in beryllium hypersensitization. Chest. Mar; 109 (3 Suppl):
45S.
Sutton M, Burastero SR. (2003) Beryllium chemical speciation in
elemental human biological fluids. Chem Res Toxicol. Sep;
16(9):1145-54.
Swafford DS, Middleton SK, Palmisano WA, Nikula KJ, Tesfaigzi J,
Baylin SB, Herman JG, and Belinsky SJ. (1997) Frequent aberrant
methylation of p16INK4a in primary rat lung tumors. Molecular and
Cellular Biology 17 (3):1366-1374.
Sweiss NJ, Lower EE, Korsten P, Niewold TB, Favus MJ, Baughman RP.
(2011). Bone health issues in sarcoidosis. Curr Rheumatol Rep. Jun;
13(3):265-72.
Taiwo OA, Slade MD, Cantley LF, Fiellin MG, Wesdock JC, Bayer FJ,
Cullen MR. (2008) Beryllium Sensitization in Aluminum Smelter
Workers. JOEM 50(2):157-162.
Taiwo OA, Slade MD, Cantley LF, Kirsche SR, Wesdock JC, Cullen MR.
(2010) Prevalence of beryllium sensitization among aluminum smelter
workers. Occup Med 60:569-571.
Tan MH, Commens CA, Burnett L, Snitch PJ. (1996) A pilot study on
the percutaneous absorption of microfine titanium dioxide from
sunscreens. Australas J Dermatol. Nov; 37(4):185-7.
Tarantino-Hutchison LM, Sorrentino C, Nadas A, Zhu Y, Rubin EM,
Tinkle SS, Weston A, Gordon T (2009). Genetic determinants of
sensitivity to beryllium in mice. J Immunotoxicol. 6 (2):130-135.
Thomas CA, Bailey RL, Kent MS, Deubner DC, Kreiss K, Schuler CR.
(2009) Efficacy of a program to prevent beryllium sensitization
among new employees at a copper-beryllium alloy processing facility.
Public Health Rep. Jul-Aug; 124 Suppl 1:112-24.
Thaler, R., and S. Rosen, 1976. ``The Value of Saving a Life:
Evidence from the Labor Market,'' in Household Production and
Consumption, N E. Terleckyj (ed.), New York: Columbia University
Press, 1976, pp. 265-298.
Thomas CA, Bailey RL, Kent MS, Deubner DC, Kreiss K, Schuler CR.
(2009) Efficacy of a Program to Prevent Beryllium Sensitization
Among New Employees at a Copper-Beryllium Alloy Processing Facility.
Public Health Rep.124 Suppl 1:112-24.
Thorat DD, Mahadevan TN, Ghosh DK. (2003) Particle size distribution
and respiratory deposition estimates of beryllium aerosols in an
extraction and processing plant. Am Ind Hyg Assoc J. 64 (4):522-527.
Tinkle SS, Newman LS. (1997) Beryllium-stimulated release of tumor
necrosis factor-alpha, IL-6 and their soluble receptors in chronic
beryllium disease. Am J Respir Crit Care Med. Dec; 156 (6):1884-91.
Tinkle SS, Kittle LA, Schumacher BA, Newman LS. (1997) Beryllium
induces IL-2 and IFN-gamma in berylliosis. J Immunol. Jan 1;
158(1):518-26.
Tinkle S, Kittle L, Schwitters PW, Addison JR, Newman LS. (1996)
Beryllium stimulates release of T helper 1 cytokines interleukin-2
and interferon gamma from BAL cells in chronic beryllium disease.
Chest; 109 (Suppl 3):5S-6S.
Tinkle SS, Antonini JM, Rich BA, Roberts JR, Salmen R, DePree K,
Adkins EJ. (2003) Skin as a route of exposure and sensitization in
chronic beryllium disease. Environ Health Perspect. Jul;
111(9):1202-8.
Toledo, F., Silvestre, J. F., Cuesta, L., Latorre, N., & Monteagudo,
A. (2011). Contact allergy to beryllium chloride: Report of 12
cases. Contact dermatitis, 64(2), 104-109.
Torres, S.J., & Nowson, C.A. (2007). Relationship between stress,
eating behavior, and obesity. Nutrition, 23, 887-94.
Trikudanathan S, McMahon GT. (2008). Optimum management of
glucocorticoid-treated patients. Nat Clin Pract Endocrinol Metab.
May; 4(5):262-71.
Tso WW, Fung WP. (1981) Mutagencity of metallic cations. Toxicol
Lett. 8 (4-5); 195-200.
Turk J.L. and Polak L. (1969) Experimental studies on metal
dermatitis in guinea pigs. Int Arch Allergy Appl Immunol. 36(1):75-
81.
U.S. Census Bureau. (2010). Income, Poverty, and Health Insurance
Coverage in the United States: 2008, Current Population Reports,
P60-236(RV), and Historical Tables--Table P-1, September 2009.
Internet release date: December 15, 2010. Available at: http://www.census.gov/hhes/www/income/data/historical/people/index.html.
[USGS] United States Geological Survey. (2013a). 2011 Minerals
Yearbook: Beryllium [Advance Release]. Available at: http://minerals.usgs.gov/minerals/pubs/commodity/beryllium/myb1-2011-beryl.pdf.
[USGS] United States Geological Survey. (2013b). Mineral Commodity
Summaries. [Online]. Available at http://minerals.usgs.gov/minerals/pubs/mcs/2013/mcs2013.pdf.
Vacher J. (1972) Immunological response of guinea pigs to beryllium
salts. J Med Microbiol. Feb; 5(1):91-108.
Van Cleave C.D., Kaylor C.T. (1955) Distribution, retention, and
elimination of Be in the rat after intratracheal injection. Archives
of industrial health, 11:375-392.
Van Dyke M.V., Martyny J.W., Mroz M.M., Silveira L.J., Strand M.,
Fingerlin T.E., Sato H., Newman L.S., Maier L.A. (2011) Risk of
chronic beryllium disease by HLA-DPB1 E69 genotype and beryllium
exposure in nuclear workers. Am J Respir Crit Care Med 183
(12):1680-1688.
Van Ordstrand H., Hughes R., Carmody M.G. (1943). Chemical Pneumonia
in Workers Extracting Beryllium Oxide. Archives of the Cleveland
Clinic Quarterly. The Cleveland Clinic Foundation. (1984) 51(2):
431-439. (originally in Cleveland Clinic Quarterly 10:10-18, 1943).
Van Ordstrand H., Hughes R., DeNardi J.M., et al. (1945). Beryllium
poisoning. J Am Med Assoc129:1084-1090.

Vainio H., Rice J. Beryllium revisted. (1997) J Occup Environ Med
39:203-204.
Vegni-Talluri M. and Guiggiani V. (1967) Action of beryllium ions on
primary cultures of swine cells. Carlogia 20:355-367.
Viet S.M., Torma-Krajewski J., Rogers J. (2000) Chronic beryllium
disease and beryllium sensitization at Rocky Flats: A case-control
study. Am Ind Hyg Assoc J 61:244-254.
Virji M.A., Stefaniak A.B., Day G.A., Stanton M.L., Kent M.S.,
Kreiss K., Schuler C.R. (2011). Characteristics of Beryllium
Exposure to Small Particles At A Beryllium Production Facility. Ann
Occup Hyg; 55 (1):70-85.
Virji M.A., Park J.Y., Stefaniak A.B., Stanton M.L., Day G.A., Kent
M.S., Kreiss K., Schuler C.R. (2012) Sensitization and chronic
beryllium disease at a primary manufacturing facility, part 1:
Historical exposure reconstruction. Scand J Work Environ Health; 38
(3):247-258.
Viscusi, W. and J. Aldy, 2003. ``The Value of a Statistical Life: A
Critical Review of Market Estimates Throughout the World,'' Journal
of Risk and Uncertainty, 27, pp. 5-76.
Votto J.J., Barton R.W., Gionfriddo M.A., Cole S.R., McCormick J.R.,
and Thrall R.S. (1987) A model of pulmonary granulomata induced by
beryllium sulfate in the rat. Sarcoidosis 4(1):71-76.
Vorwald A.J. (1968) Biologic manifestations of toxic inhalants in
monkeys. In: Vagrborg H., ed. Use of Nonhuman primates in drug
evaluation: A symposium. Southwest Foundation for Research and
Education. Austin, Texas: University of Texas Press, 222-228.
Vorwald A.J., Reeves A.L. (1959) Pathologic changes induced by
beryllium compounds. Arch Ind Health 19:190-199.
Vourlekis J.A., R.T. Sawyer, L.S. Newman. (2000) Sarcoidosis:
Developments in etiology, immunology, and therapeutics. Adv Intern
Med; 45:209-257.
Wagoner J., Infante P., Bayliss D. (1980) Beryllium: An etiologic
agent in the induction of lung cancer, nonneoplastic respiratory
disease and heart disease among industrially exposed workers.
Environ Res 21:15-34.
Wagner W.D., Groth D.H., Holtz J.L., Madden G.E., and Stokinger H.E.
(1969) Comparative chronic inhalation toxicity of beryllium ores,
bertrandite and beryl, with production of pulmonary tumors by beryl.
Toxicology and Applied Pharmacology 15:10-29.
Ward E., Okun A., Ruder A., Fingerhut M., Steenland K. (1992) A
mortality study of workers at seven beryllium processing plants. Am
J Ind Med 22:885-904.
Warrington T.P., Bostwick J.M. (2006). Psychiatric adverse effects
of corticosteroids. Mayo Clin Proc. Oct; 81(10):1361-7.
Warheit D.B., Yuen I.S., Kelly D.P., Snajdr S., Hartsky M.A. (1996)
Subchronic inhalation of high concentrations of low toxicity, low
solubility particulates produces sustained pulmonary inflammation
and cellular proliferation. Toxicol Lett. Nov; 88(1-3):249-53.
Weston A., Snyder J., McCanlies E.C., Schuler C.R., Andrew M.E.,
Kreiss K., Demchuk E. (2005) Immunogenetic factors in beryllium
sensitization and chronic beryllium disease. Mutat Res 592 (1-2):68-
78.
Williams W.J. and Williams W.R. (1983) Value of beryllium lymphocyte
transformation tests in chronic beryllium disease and in potentially
exposed workers. Thorax. Jan; 38(1):41-4.
[WHO] World Health Organization. (1990). International Programme on
Chemical Safety (IPCS 1990). Beryllium: Health and safety guide. No.
44. [online]. Available at: http://www.inchem.org/documents/hsg/hsg/hsg044.htm#SectionNumber:7.3.
[WHO] World Health Organization. (2001). Concise International
Chemical Assessment Document (CICAD) 32 Beryllium and Beryllium
compounds.
Winchester M.R., et al. (2009). Certification of beryllium mass
fraction in SRM 1877 Beryllium Oxide Powder using high-performance
inductively-coupled plasma optical emission spectrometry with exact
matching. Analytical Chemistry. 81:2208-2217.
Wolf G. (2002). Glucocorticoids in adipocytes stimulate visceral
obesity. Nutr Rev. May; 60(5 Pt 1):148-51.
Yeh H.C., Cuddihy R.G., Phalen R.F., Chang I.Y. (1996) Comparison of
calculated respiratory tract deposition of particles based on the
proposed NCRP model and the new ICRP 66 model. Aerosol Sci Techn;
25:134-140.
Yoshida T., Shima S., Nagaoka K., Taniwaki H., Wada A., Kurita H.,
Morita K. (1997) A study on the beryllium lymphocyte transformation
test and the beryllium levels in working environment. Ind Health
35:374-379.
Yucesoy B., Johnson V.J. (2011) Genetic variability in
susceptibility to occupational respiratory sensitization. J Allergy;
2011, 346719:1-7.
Zaki M.H., Lyons H.A., Leilop L., Huang C.T. (1987) Corticosteroid
therapy in sarcoidosis. A five-year, controlled follow-up study. NY
State J Med. Sep; 87(9):496-9.
Zakour R.A., Glickman B.W. (1984) Metal-induced mutagenesis in the
lacI gene of Escherichia coli. Mutation research, 126:9-18.
Zissu D., Binet S., Cavelier C. (1996) Patch testing with beryllium
alloy samples in guinea pigs. Contact Dermatitis. Mar; 34(3):196-
200.
Zorn, H., Stiefel, T., & Diem, H. (1977). The importance of
beryllium and its compounds for the industrial physician-2.
communication. Zentralblatt f[uuml]r Arbeitsmedizin, Arbeitsschutz
und Prophylaxe, 27(4), 8.

List of Subjects in 29 CFR Part 1910

    Cancer, Chemicals, Hazardous substances, Health, Occupational
safety and health, Reporting and recordkeeping requirements.

Authority and Signature

    David Michaels, Ph.D., MPH, Assistant Secretary of Labor for
Occupational Safety and Health, U.S. Department of Labor, 200
Constitution Avenue NW., Washington, DC 20210, directed the preparation
of this notice. OSHA is issuing this notice under Sections 4, 6, and 8
of the Occupational Safety and Health Act of 1970 (29 U.S.C. 653, 655,
657); section 41 of the Longshore and Harbor Worker's Compensation Act
(33 U.S.C. 941); section 107 of the Contract Work Hours and Safety
Standards Act (Construction Safety Act) (40 U.S.C. 3704); Secretary of
Labor's Order 1-2012 (77 FR 3912, January 25, 2012); and 29 CFR part
1911.

    Signed at Washington, DC, on July 14, 2015.
David Michaels,
Assistant Secretary of Labor for Occupational Safety and Health.

Proposed Standard

    Chapter XVII of Title 29 of the Code of Federal Regulations is
proposed to be amended as follows:

PART 1910--OCCUPATIONAL SAFETY AND HEALTH STANDARDS

Subpart Z--Toxic and Hazardous Substances

0
1. The authority citation for subpart Z of part 1910 is revised to read
as follows:

     Authority: Sections 4, 6, 8 of the Occupational Safety and
Health Act of 1970 (29 U.S.C. 653, 655, 657); Secretary of Labor's
Order No. 8-76 (41 FR 25059), 9-83 (48 FR 35736), 1-90 (55 FR 9033),
6-96 (62 FR 111), 3-2000 (65 FR 50017), 5-2002 (67 FR 65008), 5-2007
(72 FR 31159), 4-2010 (75 FR 55355), or 1-2012 (77 FR 3912), as
applicable; and 29 CFR part 1911.

    All of subpart Z issued under section 6(b) of the Occupational
Safety and Health Act of 1970, except those substances that have
exposure limits listed in Tables Z-1, Z-2, and Z-3 of 29 CFR
1910.1000. The latter were issued under section 6(a) (29 U.S.C.
655(a)).
    Section 1910.1000, Tables Z-1, Z-2 and Z-3 also issued under 5
U.S.C. 553, but not under 29 CFR part 1911 except for the arsenic
(organic compounds), benzene, cotton dust, and chromium (VI)
listings.
    Section 1910.1001 also issued under section 107 of the Contract
Work Hours and Safety Standards Act (40 U.S.C. 3704) and 5 U.S.C.
553.
    Section 1910.1002 also issued under 5 U.S.C. 553, but not under
29 U.S.C. 655 or 29 CFR part 1911.
    Sections 1910.1018, 1910.1029, and 1910.1200 also issued under
29 U.S.C. 653. Section 1910.1030 also issued under Pub. L. 106-430,
114 Stat. 1901.

Sec.  1910.1000  [Amended]

0
2. In Sec.  1910.1000:
0
a. Table Z-1 is amended by revising the entry for ``Beryllium and
beryllium compounds (as Be)''; and by adding footnote ``W''; and
0
b. Table Z-2 is amended by adding footnote ``Y''.
    The revisions and additions read as follows:

                                     Table Z-1--Limits for Air Contaminants
----------------------------------------------------------------------------------------------------------------
                                                                            ppm (a)    mg/m\3\ (b)      Skin
                       Substance                           CAS No. (c)        \1\          \1\       designation
----------------------------------------------------------------------------------------------------------------

                                                  * * * * * * *
Beryllium and beryllium compounds (as Be); see
 1910.1024 \W\........................................

                                                  * * * * * * *
----------------------------------------------------------------------------------------------------------------
\1\ The PELs are 8-hour TWAs unless otherwise noted; a (C) designation denotes a ceiling limit. They are to be
  determined from breathing-zone air samples.
a. Parts of vapor or gas per million parts of contaminated air by volume at 25 [deg]C and 760 torr.
b. Milligrams of substance per cubic meter of air. When entry is in this column only, the value is exact; when
  listed with a ppm entry, it is approximate.
c. The CAS number is for information only. Enforcement is based on the substance name. For an entry covering
  more than one metal compound, measured as the metal, the CAS number for the metal is given--not CAS numbers
  for the individual compounds.
d. The final benzene standard in Sec.   1910.1028 applies to all occupational exposures to benzene except in
  some circumstances the distribution and sale of fuels, sealed containers and pipelines, coke production, oil
  and gas drilling and production, natural gas processing, and the percentage exclusion for liquid mixtures; for
  the excepted subsegments, the benzene limits in Table Z-2 apply. See Sec.   1910.1028 for specific
  circumstances.
e. This 8-hour TWA applies to respirable dust as measured by a vertical elutriator cotton dust sampler or
  equivalent instrument. The time-weighted average applies to the cottom waste processing operations of waste
  recycling (sorting, blending, cleaning and willowing) and garnetting. See also Sec.   1910.1043 for cotton
  dust limits applicable to other sectors.
f. All inert or nuisance dusts, whether mineral, inorganic, or organic, not listed specifically by substance
  name are covered by the Particulates Not Otherwise Regulated (PNOR) limit which is the same as the inert or
  nuisance dust limit of Table Z-3.
 * * * * * * *
\W\ See Table Z-2 for the exposure limits for any operations or sectors for which the exposure limits in Sec.
  1910.1024 are not in effect.

                                                    Table Z-2
----------------------------------------------------------------------------------------------------------------
                                                                           Acceptable maximum peak above the
                                         8-hour time     Acceptable     acceptable ceiling average concentration
              Substance                   weighted         ceiling                 for an 8-hr shift
                                           average      concentration ------------------------------------------
                                                                        Concentration       Maximum duration
----------------------------------------------------------------------------------------------------------------

                                                  * * * * * * *
Beryllium and beryllium compounds (as    2 [mu]g/m\3\    5 [mu]g/m\3\     25[mu]g/m\3\  30 minutes
 Be) \Y\.

                                                  * * * * * * *
----------------------------------------------------------------------------------------------------------------
 * * * * * *
\Y\ This standard applies to any operations or sectors for which the Beryllium standard, 1910.1024, is not in
  effect.

0
3. Section 1910.1024 is added to subpart Z to read as follows:

Sec.  1910.1024  Beryllium

    (a) Scope and application. (1) This section applies to occupational
exposures to beryllium in all forms, compounds, and mixtures in general
industry, except those articles and materials exempted by paragraphs
(a)(2) and (3) of this section.
    (2) This section does not apply to articles, as defined in the
Hazard Communication standard (HCS) (29 CFR 1910.1200(c)), that contain
beryllium and that the employer does not process.
    (3) This section does not apply to materials containing less than
0.1% beryllium by weight.
    (b) Definitions.
    Action level means a concentration of airborne beryllium of 0.1
micrograms per cubic meter of air ([mu]g/m\3\) calculated as an 8-hour
time-weighted average (TWA).
    Assistant Secretary means the Assistant Secretary of Labor for
Occupational Safety and Health, United States Department of Labor, or
designee.
    Beryllium lymphocyte proliferation test (BeLPT) means the
measurement of blood lymphocyte proliferation in a laboratory test when
lymphocytes are challenged with a soluble beryllium salt. A confirmed
positive test result indicates the person has beryllium sensitization.
    Beryllium work area means any work area where employees are, or can
reasonably be expected to be, exposed to airborne beryllium, regardless
of the level of exposure.
    CBD Diagnostic Center means a medical diagnostic center that has
on-site facilities to perform a clinical evaluation for the presence of
chronic beryllium disease (CBD) that includes bronchoalveolar lavage,
transbronchial biopsy and interpretation of the biopsy pathology, and
the beryllium bronchoalveolar lavage lymphocyte proliferation test
(BeBALLPT).
    Chronic beryllium disease (CBD) means a chronic lung disease
associated with exposure to airborne beryllium.
    Confirmed Positive means two abnormal test results from either
consecutive BeLPTs or a second abnormal BeLPT result within a 2-year
period of the first abnormal test result. It also means the result of a
more reliable and accurate test indicating a

person has been identified as having beryllium sensitization.
    Director means the Director of the National Institute for
Occupational Safety and Health (NIOSH), U.S. Department of Health and
Human Services, or designee.
    Emergency means any uncontrolled release of airborne beryllium.
    Exposure and exposure to beryllium mean the exposure to airborne
beryllium that would occur if the employee were not using a respirator.
    High-efficiency particulate air (HEPA) filter means a filter that
is at least 99.97 percent efficient in removing particles 0.3
micrometers in diameter.
    Physician or other licensed health care professional (PLHCP) means
an individual whose legally permitted scope of practice (i.e., license,
registration, or certification) allows the individual to independently
provide or be delegated the responsibility to provide some or all of
the health care services required by paragraph (k) of this standard.
    Regulated area means an area that the employer must demarcate,
including temporary work areas where maintenance or non-routine tasks
are performed, where an employee's exposure exceeds, or can reasonably
be expected to exceed, either of the permissible exposure limits
(PELs).
    This standard means this beryllium standard, 29 CFR 1910.1024.
    (c) Permissible Exposure Limits (PELs). (1) Time-weighted average
(TWA) PEL. The employer shall ensure that each employee's exposure does
not exceed 0.2 [mu]g/m\3\ calculated as an 8-hour TWA.
    (2) Short-term exposure limit (STEL). The employer shall ensure
that each employee's exposure does not exceed 2.0 [mu]g/m\3\ as
determined over a sampling period of 15 minutes.
    (d) Exposure monitoring--(1) General. (i) These exposure monitoring
requirements apply when employees are, or may reasonably be expected to
be, exposed to airborne beryllium.
    (ii) Except as provided in paragraphs (d)(2)(i) and (ii) of this
section, the employer shall determine the 8-hour TWA exposure for each
employee based on one or more breathing zone samples that reflect the
exposure of employees on each work shift, for each job classification,
in each beryllium work area.
    (iii) Except as provided in paragraph (d)(2)(i) and (ii) of this
section, the employer shall determine short-term exposure from 15-
minute breathing zone samples measured in operations that are likely to
produce exposures above the STEL for each work shift, for each job
classification, and in each beryllium work area.
    (iv) The employer may perform representative sampling to
characterize exposure, provided that the employer:
    (A) Performs representative sampling where several employees
perform the same job tasks, in the same job classification, on the same
work shift, and in the same work area, and have similar duration and
frequency of exposure;
    (B) Takes sufficient personal breathing zone air samples to
accurately characterize exposure on each work shift, for each job
classification, in each work area; and
    (C) Samples those employee(s) who are expected to have the highest
exposure.
    (v) Accuracy of measurement. The employer shall use a method of
exposure monitoring and analysis that can measure beryllium to an
accuracy of plus or minus 25 percent within a statistical confidence
level of 95 percent for airborne concentrations at or above the action
level.
    (2) Initial exposure monitoring. The employer shall conduct initial
exposure monitoring to determine the 8-hour TWA exposure and 15-minute
short-term exposure for each employee. The employer does not have to
conduct initial exposure monitoring in the following situations:
    (i) Where the employer has conducted exposure monitoring for
beryllium and relies on these historical data, provided that:
    (A) The work operations and workplace conditions that were in place
when the historical monitoring data were obtained reflect workplace
conditions closely resembling the processes, material, control methods,
work practices, and environmental conditions used and prevailing in the
employer's current operations;
    (B) The characteristics of the beryllium-containing material being
handled when the historical monitoring data were obtained closely
resemble the characteristics of the beryllium-containing material used
during the job for which initial monitoring will not be performed; and
    (C) The exposure monitoring satisfied all other requirements of
this section, including Accuracy of Measurement in paragraph (d)(1)(v).
    (ii) Where the employer relies on objective data to satisfy initial
monitoring requirements, provided that such data:
    (A) Demonstrate that any material containing beryllium or any
specific process, operation, or activity involving beryllium cannot
release beryllium dust, fumes, or mist in concentrations at or above
the action level or above the STEL under any expected conditions of
use; and
    (B) Reflect workplace conditions closely resembling the processes,
material, control methods, work practices, and environmental conditions
used and prevailing in the employer's current operations.
    (3) Periodic exposure monitoring. If initial exposure monitoring
indicates that exposures are at or above the action level and at or
below the TWA PEL, the employer shall conduct periodic exposure
monitoring at least annually in accordance with paragraph (d)(1) of
this section.
    (4) Additional monitoring. The employer also shall conduct exposure
monitoring within 30 days after any of the following situations occur:
    (i) Any change in production processes, equipment, materials,
personnel, work practices, or control methods that can reasonably be
expected to result in new or additional exposure; or
    (ii) The employer has any other reason to believe that new or
additional exposure is occurring.
    (5) Employee notification of monitoring results. (i) Within 15
working days after receiving the results of any exposure monitoring
completed under this standard, the employer shall notify each employee
whose exposure is measured or represented by the monitoring
individually in writing of the monitoring results or shall post the
monitoring results in an appropriate location that is accessible to
each of these employees.
    (ii) Where exposures exceed the TWA PEL or STEL, the written
notification required by paragraph (d)(5)(i) of this section shall
include suspected or known sources of exposure and the corrective
action(s) the employer has taken or will take to reduce exposure to or
below the PELs, where feasible corrective action exists but had not
been implemented when the monitoring was conducted.
    (6) Observation of monitoring. (i) The employer shall provide an
opportunity to observe any exposure monitoring required by this
standard to each employee whose exposures are measured or represented
by the monitoring and each employee's representative(s).
    (ii) When observation of monitoring requires entry into an area
where the use of protective clothing or equipment (which may include
respirators) is required, the employer shall provide each observer with
appropriate protective clothing and equipment at no

cost to the observer and shall ensure that each observer uses such
clothing and equipment.
    (iii) The employer shall ensure that each observer complies with
all applicable OSHA requirements and the employer's workplace safety
and health procedures.
    (e) Beryllium work areas and regulated areas--(1) Establishment.
(i) The employer shall establish and maintain a beryllium work area
wherever employees are, or can reasonably be expected to be, exposed to
airborne beryllium, regardless of the level of exposure.
    (ii) The employer shall establish and maintain a regulated area
wherever employees are, or can reasonably be expected to be, exposed to
airborne beryllium at levels above the TWA PEL or STEL.
    (2) Demarcation. (i) The employer shall identify each beryllium
work area through signs or any other methods that adequately establish
and inform each employee of the boundaries of each beryllium work area.
    (ii) The employer shall identify each regulated area in accordance
with paragraph (m)(2) of this section.
    (3) Access.The employer shall limit access to regulated areas to:
    (i) Persons the employer authorizes or requires to be in a
regulated area to perform work duties;
    (ii) Persons entering a regulated area as designated
representatives of employees for the purpose of exercising the right to
observe exposure monitoring procedures under paragraph (d)(6) of this
section; and
    (iii) Persons authorized by law to be in a regulated area.
    (4) Provision of personal protective clothing and equipment,
including respirators. The employer shall provide and ensure that each
employee entering a regulated area uses:
    (i) Respiratory protection in accordance with paragraph (g) of this
section; and
    (ii) Personal protective clothing and equipment in accordance with
paragraph (h) of this section.
    (f) Methods of compliance--(1) Written exposure control plan.
    (i) The employer shall establish, implement, and maintain a written
exposure control plan for beryllium work areas, which shall contain:
    (A) An inventory of operations and job titles reasonably expected
to have exposure;
    (B) An inventory of operations and job titles reasonably expected
to have exposure at or above the action level;
    (C) An inventory of operations and job titles reasonably expected
to have exposure above the TWA PEL or STEL;
    (D) Procedures for minimizing cross-contamination, including but
not limited to preventing the transfer of beryllium between surfaces,
equipment, clothing, materials, and articles within beryllium work
areas;
    (E) Procedures for keeping surfaces in the beryllium work area as
free as practicable of beryllium;
    (F) Procedures for minimizing the migration of beryllium from
beryllium work areas to other locations within or outside the
workplace;
    (G) An inventory of engineering and work practice controls required
by paragraph (f)(2) of this standard; and
    (H) Procedures for removal, laundering, storage, cleaning,
repairing, and disposal of beryllium-contaminated personal protective
clothing and equipment, including respirators.
    (ii) The employer shall update the exposure control plan when:
    (A) Any change in production processes, materials, equipment,
personnel, work practices, or control methods results or can reasonably
be expected to result in new or additional exposures to beryllium;
    (B) An employee is confirmed positive, is diagnosed with CBD, or
shows signs or symptoms associated with exposure; or
    (C) The employer has any reason to believe that new or additional
exposures are occurring or will occur.
    (iii) The employer shall make a copy of the exposure control plan
accessible to each employee who is or can reasonably be expected to be
exposed to airborne beryllium in accordance with OSHA's Access to
Employee Exposure and Medical Records (Records Access) standard (29 CFR
1910.1020(e)).
    (2) Engineering and work practice controls. (i) (A) For each
operation in a beryllium work area, the employer shall ensure that at
least one of the following engineering and work practice controls is in
place to minimize employee exposure:
    (1) Material and/or process substitution;
    (2) Ventilated partial or full enclosures;
    (3) Local exhaust ventilation at the points of operation, material
handling, and transfer; or
    (4) Process control, such as wet methods and automation.
    (B) An employer is exempt from using the above controls to the
extent that:
    (1) The employer can establish that such controls are not feasible;
or
    (2) The employer can demonstrate that exposures are below the
action level, using no fewer than two representative personal breathing
zone samples taken 7 days apart, for each affected operation.
    (ii) If after implementing the control(s) required by (f)(2)(i)(A)
exposures exceed the TWA PEL or STEL, the employer shall implement
additional or enhanced engineering and work practice controls to reduce
exposures to or below the PELs.
    (iii) Wherever the employer demonstrates that it is not feasible to
reduce exposures to or below the PELs by the engineering and work
practice controls required by paragraphs (f)(2)(i) and (ii) of this
section, the employer shall implement and maintain engineering and work
practice controls to reduce exposures to the lowest levels feasible and
supplement these controls by using respiratory protection in accordance
with paragraph (g) of this section.
    (3) Prohibition of rotation. The employer shall not rotate
employees to different jobs to achieve compliance with the PELs.
    (g) Respiratory protection--(1) General. The employer shall provide
at no cost and ensure that each employee uses respiratory protection
during:
    (i) Periods necessary to install or implement feasible engineering
and work practice controls where exposures exceed or can reasonably be
expected to exceed the TWA PEL or STEL;
    (ii) Operations, including maintenance and repair activities and
non-routine tasks, when engineering and work practice controls are not
feasible and exposures exceed or can reasonably be expected to exceed
the TWA PEL or STEL;
    (iii) Work operations for which an employer has implemented all
feasible engineering and work practice controls when such controls are
not sufficient to reduce exposure to or below the TWA PEL or STEL;
    (iv) Emergencies.
    (2) Respiratory protection program. Where this standard requires an
employee to use respiratory protection, such use shall be in accordance
with the Respiratory Protection Standard (29 CFR 1910.134).
    (h) Personal protective clothing and equipment--(1) Provision and
use. The employer shall provide at no cost and ensure that each
employee uses appropriate personal protective clothing and equipment in
accordance with the written exposure control plan required under
paragraph (f)(1) of this section and OSHA's Personal Protective
Equipment standards (29 CFR part 1910 subpart I):
    (i) Where employee exposure exceeds or can reasonably be expected
to exceed the TWA PEL or STEL;
    (ii) Where employees' clothing or skin may become visibly
contaminated with

beryllium including during maintenance and repair activities or during
non-routine tasks; or
    (iii) Where employees' skin can reasonably be expected to be
exposed to soluble beryllium compounds.
    (2) Removal and storage. (i) The employer shall ensure that each
employee removes all beryllium-contaminated protective clothing and
equipment:
    (A) At the end of the work shift or at the completion of tasks
involving beryllium, whichever comes first, or
    (B) When protective clothing or equipment becomes visibly
contaminated with beryllium.
    (ii) The employer shall ensure that each employee removes
protective clothing visibly contaminated with beryllium as specified in
the exposure control plan required by paragraph (f)(1) of this section.
    (iii) The employer shall ensure that each employee stores and keeps
required protective clothing separate from street clothing.
    (iv) The employer shall ensure that no employee removes beryllium-
contaminated protective clothing or equipment from the workplace,
except for employees authorized to do so for the purposes of
laundering, cleaning, maintaining or disposing of beryllium-
contaminated protective clothing and equipment at an appropriate
location or facility away from the workplace.
    (v) When protective clothing or equipment required by this standard
is removed from the workplace for laundering, cleaning, maintenance or
disposal, the employer shall ensure that protective clothing and
equipment are stored and transported in sealed bags or other closed
containers that are impermeable and are labeled in accordance with
paragraph (m)(3) of this section and the HCS (29 CFR 1910.1200).
    (3) Cleaning and replacement. (i) The employer shall ensure that
all reusable protective clothing and equipment required by this
standard is cleaned, laundered, repaired, and replaced as needed to
maintain its effectiveness.
    (ii) The employer shall ensure that beryllium is not removed from
protective clothing and equipment by blowing, shaking or any other
means that disperses beryllium into the air.
    (iii) The employer shall inform in writing the persons or the
business entities who launder, clean or repair the protective clothing
or equipment required by this standard of the potentially harmful
effects of exposure to airborne beryllium and contact with soluble
beryllium compounds and that the protective clothing and equipment must
be handled in accordance with this standard.
    (i) Hygiene areas and practices--(1) General. For each employee
working in a beryllium work area, the employer shall:
    (i) Provide readily accessible washing facilities to remove
beryllium from the hands, face, and neck; and
    (ii) Ensure each employee exposed to beryllium to use these
facilities when necessary.
    (2) Change rooms. In addition to the requirements of paragraph
(i)(1)(i) of this section, the employer shall provide affected
employees with a designated change room and washing facilities in
accordance with this standard and the Sanitation Standard (29 CFR
1910.141) where employees are required to remove their personal
clothing.
    (3) Showers. (i) The employer shall provide showers in accordance
with the Sanitation standard (29 CFR 1910.141) where:
    (A) Exposure exceeds or can reasonably be expected to exceed the
TWA PEL or STEL; and
    (B) Beryllium can reasonably be expected to contaminate employees'
hair or body parts other than hands, face, and neck.
    (ii) Employers required to provide showers under paragraph
(i)(3)(i) of this section shall ensure that each employee showers at
the end of the work shift or work activity if:
    (A) The employee reasonably could have been exposed above the TWA
PEL or STEL; and
    (B) Beryllium could reasonably have contaminated the employee's
hair or body parts other than hands, face, and neck.
    (4) Eating and drinking areas. Whenever the employer allows
employees to consume food or beverages in a beryllium work area, the
employer shall ensure that:
    (i) Surfaces in eating and drinking areas are as free as
practicable of beryllium;
    (ii) No employee in eating and drinking areas is exposed to
airborne beryllium at or above the action level; and
    (iii) Eating and drinking facilities provided by the employer are
in accordance with the Sanitation standard (29 CFR 1910.141).
    (5) Prohibited activities. (i) The employer shall ensure that no
employees eat, drink, smoke, chew tobacco or gum, or apply cosmetics in
regulated areas.
    (ii) The employer shall ensure that no employees enter any eating
or drinking area with protective work clothing or equipment unless
surface beryllium has been removed from the clothing or equipment by
methods that do not disperse beryllium into the air or onto an
employee's body.
    (j) Housekeeping--(1) General. (i) The employer shall maintain all
surfaces in beryllium work areas as free as practicable of
accumulations of beryllium and in accordance with the exposure control
plan required under paragraph (f)(1) of this section and the cleaning
methods required under paragraph (j)(2) of this section; and
    (ii) The employer shall ensure that all spills and emergency
releases of beryllium are cleaned up promptly and in accordance with
the exposure control plan required under paragraph (f)(1) of this
section and the cleaning methods required under paragraph (j)(2) of
this section.
    (2) Cleaning methods. (i) The employer shall ensure that surfaces
in beryllium work areas are cleaned by HEPA-filter vacuuming or other
methods that minimize the likelihood and level of exposure.
    (ii) The employer shall not allow dry sweeping or brushing for
cleaning surfaces in beryllium work areas unless HEPA-filtered
vacuuming or other methods that minimize the likelihood and level of
exposure have been tried and were not effective.
    (iii) The employer shall not allow the use of compressed air for
cleaning beryllium-contaminated surfaces unless the compressed air is
used in conjunction with a ventilation system designed to capture the
particulates made airborne by the use of compressed air.
    (iv) Where employees use dry sweeping, brushing, or compressed air
to clean beryllium-contaminated surfaces, the employer shall provide
and ensure that each employee uses respiratory protection and
protective clothing and equipment in accordance with paragraphs (g) and
(h) of this section.
    (v) The employer shall ensure that cleaning equipment is handled
and maintained in a manner that minimizes the likelihood and level of
employee exposure and the re-entrainment of airborne beryllium in the
workplace.
    (3) Disposal. The employer shall ensure that:
    (i) Waste, debris, and materials visibly contaminated with
beryllium and consigned for disposal are disposed of in sealed,
impermeable enclosures, such as bags or containers;
    (ii) Bags or containers of waste, debris, and materials required by
(j)(3)(i) of this section are labeled in accordance with paragraph
(m)(3) of this section; and

    (iii) Materials designated for recycling that are visibly
contaminated with beryllium shall be cleaned to remove visible
particulate, or placed in sealed, impermeable enclosures, such as bags
or containers, that are labeled in accordance with paragraph (m)(3) of
this section.
    (k) Medical surveillance--(1) General. (i) The employer shall make
medical surveillance as required by this paragraph available at no cost
to the employee, and at a reasonable time and place, as follows:
    (A) For each employee who has worked in a regulated area for more
than 30 days in the last 12 months;
    (B) For each employee showing signs or symptoms of CBD, such as
shortness of breath after a short walk or climbing stairs, persistent
dry cough, chest pain, or fatigue;
    (C) For each employee exposed to beryllium during an emergency; and
    (D) For each employee who was exposed to airborne beryllium above
.2 [mu]g/m\3\ for more than 30 days in a 12-month period for 5 years or
more, limited to the procedures described in paragraph (k)(3)(ii)(F) of
this section unless the employee also qualifies for an examination
under paragraph (k)(1)(i)(A), (B), or (C) of this section.
    (ii) The employer shall ensure that all medical examinations and
procedures required by this standard are performed by or under the
direction of a licensed physician.
    (2) Frequency. The employer shall provide a medical examination:
    (i) Within 30 days after determining that:
    (A) An employee meets the criteria of paragraph (k)(1)(i)(A) of
this section, unless the employee has received a medical examination,
provided in accordance with this standard, within the last 12 months;
or
    (B) An employee meets the criteria of paragraph (k)(1)(i)(B) or (C)
of this section.
    (ii) Annually thereafter for each employee who continues to meet
the criteria of paragraph (k)(1)(i)(A) or (B) of this section; and
    (iii) At the termination of employment for each employee who meets
the criteria of paragraph (k)(1)(i)(A), (B), or (C) of this section at
the time the employee's employment is terminated, unless an examination
has been provided in accordance with this standard during the 6 months
prior to the date of termination.
    (3) Contents of examination. (i) The employer shall ensure that the
PLHCP advises the employee of the risks and benefits of participating
in the medical surveillance program and the employee's right to opt out
of any or all parts of the medical examination.
    (ii) The employer shall ensure that the employee is offered a
medical examination that includes:
    (A) A medical and work history, with emphasis on past and present
exposure, smoking history, and any history of respiratory system
dysfunction;
    (B) A physical examination with emphasis on the respiratory tract;
    (C) A physical examination for skin breaks and wounds;
    (D) Pulmonary function tests, performed in accordance with the
guidelines established by the American Thoracic Society including
forced vital capacity and forced expiratory volume at one (1) second
(FEV1);
    (E) (1) A standardized BeLPT upon the first examination and within
every 2 years from the date of the first examination until the employee
is confirmed positive. If a more reliable and accurate diagnostic test
is developed after [EFFECTIVE DATE OF FINAL RULE] of this standard such
that beryllium sensitization can be confirmed after one test, a second
confirmation test need not be performed.
    (2) If an employee who has not been confirmed positive receives an
abnormal BeLPT result, a second BeLPT is to be performed within 1
month. This requirement for a second test is waived if a more reliable
and accurate test for beryllium sensitization does not need to be
repeated due to variability, repeatability and accuracy of the test
methodology.
    (F) Each employee who meets the criteria of paragraph (k)(1)(i)(D)
shall be offered a low dose helical tomography (CT Scan). The CT Scan
shall be offered every 2 years for the duration of the employee's
employment. This obligation begins on the [EFFECTIVE DATE OF FINAL
RULE], or on the 15th year after the employee's first exposure above .2
[mu]g/m\3\ for more than 30 days in a 12-month period, whichever is
later; and
    (G) Any other test deemed appropriate by the PLHCP.
    (4) Information provided to the PLHCP. The employer shall ensure
that the examining PLHCP has a copy of this standard and all appendices
and shall provide the following information, if known:
    (i) A description of the employee's former and current duties that
relate to the employee's occupational exposure;
    (ii) The employee's former and current levels of occupational
exposure;
    (iii) A description of any protective clothing and equipment,
including respirators, used by the employee, including when and for how
long the employee has used that protective clothing and equipment; and
    (iv) Information from records of employment-related medical
examinations previously provided to the employee, currently within the
control of the employer, after obtaining a medical release from the
employee.
    (5) Licensed physician's written medical opinion. (i) The employer
shall obtain a written medical opinion from the licensed physician
within 30 days of the examination, which contains:
    (A) The licensed physician's opinion as to whether the employee has
any detected medical condition that would place the employee at
increased risk of CBD from further exposure;
    (B) Any recommended limitations on the employee's exposure,
including the use and limitations of protective clothing or equipment,
including respirators; and
    (C) A statement that the PLHCP has explained the results of the
medical examination to the employee, including any tests conducted, any
medical conditions related to exposure that require further evaluation
or treatment, and any special provisions for use of protective clothing
or equipment.
    (ii) The employer shall ensure that neither the licensed physician
nor any other PLHCP reveals to the employer specific findings or
diagnoses unrelated to exposure to airborne beryllium or contact with
soluble beryllium compounds.
    (iii) The employer shall provide a copy of the licensed physician's
written medical opinion to the employee within 2 weeks after receiving
it.
    (6) Referral to a CBD diagnostic center. (i) Within 30 days after
an employer learns that an employee has been confirmed positive, the
employer's designated licensed physician shall consult with the
employee to discuss referral to a CBD diagnostic center that is
mutually agreed upon by the employer and the employee.
    (ii) If, after this consultation, the employee wishes to obtain a
clinical evaluation at a CBD diagnostic center, the employer shall
provide the evaluation at no cost to the employee.
    (7) Beryllium sensitization test results research. Upon request by
OSHA, employers must convey employees' beryllium sensitization test
results to OSHA for evaluation and analysis. Employers must remove
employees' names, social security numbers, and other personally
identifying information from the test results before conveying them to
OSHA.
    (l) Medical removal. (1) If an employee works in a job with
exposure

at or above the action level and is diagnosed with CBD or confirmed
positive, the employee is eligible for medical removal.
    (2) If an employee is eligible for medical removal, the employee
must choose:
    (i) Removal as described in paragraph (l)(3) of this section; or
    (ii) To remain in a job with exposure at or above the action level,
provided that the employee wears a respirator in accordance with the
Respiratory Protection standard (29 CFR 1910.134).
    (3) If the employee chooses removal:
    (i) The employer shall remove the employee to comparable work for
which the employee is qualified or can be trained within 1 month. In
this standard, comparable work must be in a work environment where the
exposure is below the action level. The employee must accept comparable
work if such work is available;
    (ii) If comparable work is not available, the employer shall place
the employee on paid leave for 6 months or until such time as
comparable work becomes available, whichever comes first; and
    (iii) Whether the employee is removed to comparable work or placed
on paid leave, the employer shall maintain for 6 months the employee's
base earnings, seniority, and other rights and benefits that existed at
the time of removal.
    (4) The employer's obligation to provide medical removal protection
benefits to a removed employee shall be reduced to the extent that the
employee receives compensation for earnings lost during the period of
removal from a publicly or employer-funded compensation program, or
receives income from another employer made possible by virtue of the
employee's removal.
    (m) Communication of hazards-- (1) General. (i) Chemical
manufacturers, importers, distributors, and employers shall comply with
all requirements of the HCS (29 CFR 1910.1200) for beryllium.
    (ii) In classifying the hazards of beryllium, the employer shall
address at least the following hazards: Cancer; lung effects (CBD and
acute beryllium disease); beryllium sensitization; skin sensitization;
and skin, eye, and respiratory tract irritation.
    (iii) Employers shall include beryllium in the hazard communication
program established to comply with the HCS. Employers shall ensure that
each employee has access to labels on containers of beryllium and to
safety data sheets, and is trained in accordance with the requirements
of the HCS (29 CFR 1910.1200) and paragraph (m)(4) of this section.
    (2) Warning signs--(i) Posting. The employer shall provide and
display warning signs at each approach to a regulated area so that each
employee is able to read and understand the signs and take necessary
protective steps before entering the area.
    (ii) Sign specification. (A) The employer shall ensure that the
warning signs required by paragraph (m)(2)(i) of this section are
legible and readily visible.
    (B) The employer shall ensure each warning sign required by
paragraph (m)(2)(i) of this section bears the following legend:

                                 DANGER
                                BERYLLIUM
                            MAY CAUSE CANCER
                         CAUSES DAMAGE TO LUNGS
                        AUTHORIZED PERSONNEL ONLY
  WEAR RESPIRATORY PROTECTION AND PROTECTIVE CLOTHING AND EQUIPMENT IN
                                THIS AREA

    (3) Warning labels. The employer shall label each bag and container
of clothing, equipment, and materials visibly contaminated with
beryllium consistent with the HCS (29 CFR 1910.1200), and shall, at a
minimum, include the following on the label:

                                 DANGER
                           CONTAINS BERYLLIUM
                            MAY CAUSE CANCER
                         CAUSES DAMAGE TO LUNGS
                           AVOID CREATING DUST
                           DO NOT GET ON SKIN

    (4) Employee information and training. (i) For each employee who is
or can reasonably be expected to be exposed to airborne beryllium:
    (A) The employer shall provide information and training in
accordance with the HCS (29 CFR 1910.1200(h));
    (B) The employer shall provide initial training to each employee by
the time of initial assignment; and
    (C) The employer shall repeat the training required under this
section annually for each employee.
    (ii) The employer shall ensure that each employee who is or can
reasonably be expected to be exposed to airborne beryllium can
demonstrate knowledge of the following:
    (A) The health hazards associated with exposure to beryllium and
contact with soluble beryllium compounds, including the signs and
symptoms of CBD;
    (B) The written exposure control plan, with emphasis on the
location(s) of beryllium work areas, including any regulated areas, and
the specific nature of operations that could result in employee
exposure, especially employee exposure above the TWA PEL or STEL;
    (C) The purpose, proper selection, fitting, proper use, and
limitations of personal protective clothing and equipment, including
respirators;
    (D) Applicable emergency procedures;
    (E) Measures employees can take to protect themselves from exposure
to beryllium and contact with soluble beryllium compounds, including
personal hygiene practices;
    (F) The purpose and a description of the medical surveillance
program required by paragraph (k) of this section including risks and
benefits of each test to be offered;
    (G) The purpose and a description of the medical removal protection
provided under paragraph (l) of this section;
    (H) The contents of the standard; and
    (I) The employee's right of access to records under the Records
Access standard (29 CFR 1910.1020).
    (iii) When a workplace change (such as modification of equipment,
tasks, or procedures) results in new or increased employee exposure
that exceeds, or can reasonably be expected to exceed, either the TWA
PEL or the STEL, the employer shall provide additional training to
those employees affected by the change in exposure.
    (iv) Employee information. The employer shall make a copy of this
standard and its appendices readily available at no cost to each
employee and designated employee representative(s).
    (n) Recordkeeping--(1) Exposure measurements. (i) The employer
shall maintain a record of all measurements taken to monitor employee
exposure as prescribed in paragraph (d) of this section.
    (ii) This record shall include at least the following information:
    (A) The date of measurement for each sample taken;
    (B) The operation that is being monitored;
    (C) The sampling and analytical methods used and evidence of their
accuracy;
    (D) The number, duration, and results of samples taken;
    (E) The type of personal protective clothing and equipment,
including respirators, worn by monitored employees at the time of
monitoring; and
    (F) The name, social security number, and job classification of
each employee represented by the monitoring, indicating which employees
were actually monitored.
    (iii) The employer shall maintain this record as required by the
Records

Access standard (29 CFR 1910.1020(d)(1)(ii)).
    (2) Historical monitoring data. (i) The employer shall establish
and maintain an accurate record of any historical data used to satisfy
the initial monitoring requirements of paragraph (d)(2) of this
standard.
    (ii) The record shall demonstrate that the data comply with the
requirements of paragraph (d)(2) of this section.
    (iii) The employer shall maintain this record as required by the
Records Access standard (29 CFR 1910.1020).
    (3) Objective data. (i) Where an employer uses objective data to
satisfy the monitoring requirements under paragraph (d)(2) of this
section, the employer shall establish and maintain a record of the
objective data relied upon.
    (ii) This record shall include at least the following information:
    (A) The data relied upon;
    (B) The beryllium-containing material in question;
    (C) The source of the objective data;
    (D) A description of the operation exempted from initial monitoring
and how the data support the exemption; and
    (E) Other information demonstrating that the data meet the
requirements for objective data contained in paragraph (d)(2)(ii) of
this section.
    (iii) The employer shall maintain this record as required by the
Records Access standard (29 CFR 1910.1020).
    (4) Medical surveillance. (i) The employer shall establish and
maintain a record for each employee covered by medical surveillance
under paragraph (k) of this section.
    (ii) The record shall include the following information about the
employee:
    (A) Name, social security number, and job classification;
    (B) A copy of all licensed physicians' written opinions; and
    (C) A copy of the information provided to the PLHCP as required by
paragraph (k)(4) of this section.
    (iii) The employer shall ensure that medical records are maintained
in accordance with the Records Access standard (29 CFR 1910.1020).
    (5) Training. (i) At the completion of any training required by
this standard, the employer shall prepare a record that indicates the
name, social security number, and job classification of each employee
trained, the date the training was completed, and the topic of the
training.
    (ii) This record shall be maintained for 3 years after the
completion of training.
    (6) Access to records. Upon request, the employer shall make all
records maintained as a requirement of this standard available for
examination and copying to the Assistant Secretary, the Director, each
employee, and each employee's designated representative(s) in
accordance the Records Access standard (29 CFR 1910.1020).
    (7) Transfer of records. The employer shall comply with the
requirements involving transfer of records set forth in the Records
Access standard (29 CFR 1910.1020).
    (o) Dates. (1) Effective date.This standard shall become effective
[DATE 60 DAYS AFTER PUBLICATION OF FINAL RULE IN THE Federal Register].
    (2) Start-up dates. All obligations of this standard commence and
become enforceable [DATE 90 DAYS AFTER EFFECTIVE DATE OF FINAL RULE]
except:
    (i) Change rooms required by paragraph (i) of this section shall be
provided no later than 1 year after [EFFECTIVE DATE OF FINAL RULE]; and
    (ii) Engineering controls required by paragraph (f) of this
standard shall be implemented no later than 2 years after [EFFECTIVE
DATE OF FINAL RULE].
    (p) Appendices. Appendices A and B of this section are non-
mandatory.

Appendix A to Sec.  1910.1024--Immunological Testing for the
Determination of Beryllium Sensitization (Non-Mandatory)

I. Background

    Exposure to beryllium via inhalation or dermal contact has been
determined to cause an immunological reaction (sensitization) in
some individuals. Beryllium sensitization can progress to chronic
beryllium disease (CBD). Identifying sensitized workers through an
immunological screening program is an essential element in any
monitoring and surveillance program designed to reduce the risk of
developing CBD in the workplace (Kreiss, 1993b, Newman, 2005).
Immunological testing for sensitization to beryllium serves to
identify workers at risk for progression to CBD. The medical
surveillance and medical removal provisions of the proposed standard
provide for clinical evaluation of sensitized workers for early-
stage CBD and intervention before progression to more debilitating
health effects occurs.
    2. This appendix provides an overview of the test currently used
to detect beryllium sensitization, the peripheral blood Beryllium
Lymphocyte Proliferation Test (BeLPT) as well as a description of
the test procedure, the best available information on the accuracy
of the test, and several repeat-testing algorithms designed to
improve the predictive value of the test. It is important that this
information be made available to employers, employees, physicians
and other medical personnel to ensure their understanding of the
test and the meaning of test results, and to provide a basis to
compare the reliability and validity (utility) of any other
sensitization tests that may be developed with the utility of the
BeLPT.

II. The Peripheral Blood Beryllium Lymphocyte Proliferation Test
(BeLPT)

    1. The BeLPT is an in-vitro blood test that measures the
beryllium antigen-specific T-cell mediated immune response.
Currently, the BeLPT is the most commonly available diagnostic tool
for identifying beryllium sensitization.
    2. To perform the BeLPT, venous blood is collected in
heparinized tubes. Lymphocytes are isolated from the blood using
centrifugation and washed in salt solution. The lymphocytes are
counted and evaluated for cell viability. These cells are then
cultured in quadruplicate in the presence or absence of beryllium
sulfate at 1, 10, and 100 [mu]M concentrations for 3-7 days. During
the last 4 hours of the culture, cells are pulsed with a
radiolabeled DNA precursor (tritiated thymidine deoxyriboside),
harvested onto filters and counted in a liquid scintillation
counter. The counts per minute (cpm) from each set of quadruplicates
are averaged and expressed as a ratio of the cpm of the beryllium
stimulated cells to the unstimulated cells. This ratio is called the
stimulation index (SI) (Maier, 2003).
    3. The BeLPT is interpreted based on the proportion of SIs that
exceeds a cut-off value, the expected SI for non-sensitized
individuals. Each laboratory sets its own cut-off for the test
(Newman 1996). Traditionally, this cut-off value is determined by
testing cells from control/non-exposed individuals, and must be
determined with each new serum lot that will be used for culturing
the peripheral blood lymphocytes. The cut-off is based on the mean
value of the peak stimulation index among controls plus 2 or 3
standard deviations. This methodology was modeled into a statistical
method known as the ``least absolute values'' (an adaptation of the
``statistical-biological positive'' method) and relies on natural
log modeling of the median stimulation index values (DOE 2001, Frome
2003). This methodology is recommended by the Department of Energy
in guidance (DOE-SPEC-1142-2001) developed by DOE to optimize and
standardize beryllium sensitivity testing. It is recommended, but
not mandated, to be used in all DOE contracts with laboratories for
the purchase of BeLPT services. Other labs have used a standard
ratio of 3.0 (stimulated to unstimulated) as the cut-off for an
abnormal result (Stange 2004, Deubner 2001).
    4. BeLPT results are reported as ``normal,'' ``abnormal,'' or
``borderline abnormal.'' According to the DOE a BeLPT result is
considered ``abnormal'' if at least two of the six stimulation
indices are elevated (DOE 2001). If only one of the six stimulation
indices is elevated, the test is considered ``borderline abnormal''
(DOE 2001). If no stimulation index is elevated, the test is normal.
A BeLPT may be considered uninterpretable if there are problems with
the viability of the cells or lack of response to mitogen, or other
problems with the test procedure. (DOE 2001).
    5. Due to the nature of the test, issues with variability and
reproducibility of a test can

arise between and within labs. Potential sources of variability
include: technical problems such as bacterial contamination, cell
death, omission of tritiated thymidine pulse, technician skill,
degree of automation, use of flat- or round-bottom culture plates,
serum concentration, use of beryllium sulfate versus beryllium
fluoride, concentration of the culture serum, and the handling of
outlier SIs (Mroz 1991).
    6. Test characteristics and testing algorithms. The utility of
any diagnostic, screening or surveillance test relies on the
capacity of the test to predict whether or not an individual indeed
has the condition intended to be reflected by the test. In the
discussion below, sensitivity refers to the proportion of sensitized
persons who test positive for sensitization using the BeLPT.
Specificity refers to the proportion of non-sensitized persons who
test negative. Positive predictive value (PPV) refers to the
proportion of persons who test positive, who are actually
sensitized. The PPV is related not only to the utility of the test,
but also to the prevalence of the condition in the tested
population. In the remainder of this discussion, we will refer to
the results of a single BeLPT as ``abnormal,'' ``normal,'' and
``borderline,'' and will refer to the outcome of a testing algorithm
as ``positive'' for sensitization or ``negative.''
    7. Stange et al. (2004) investigated the utility of BeLPT
testing in a population of employees of 18 United States Department
of Energy (DOE) sites. At these sites, 12,194 current and former
employees were tested for beryllium sensitization at four
laboratories with BeLPT expertise. Stange et al. reported that 68.3
percent of beryllium-sensitized workers tested positive based on a
single abnormal BeLPT result (sensitivity). Thus, the rate of false
negatives (undetected cases of beryllium sensitization) based on one
normal result was 31.7 percent. Stange et al. reported a false
positive rate of 1.09 percent for one abnormal BeLPT result and a
PPV of 0.253, which they found comparable to other widely accepted
medical tests. Middleton et al. (2006) adjusted Stange's parameters
to consider borderline test results and estimated that 59.7 percent
of sensitized persons would test abnormal, 27.7 percent would test
normal, and 12.6 percent would have borderline results. They
estimated that among non-sensitized persons, 97.37 percent would
test normal, 1.09 percent would test abnormal, and 1.58 percent
would have borderline results. Stange et al. recommended repeat
testing to confirm an abnormal BeLPT result to assure appropriate
referral for CBD medical evaluation (Stange et al., 2004).
    8. Middleton et al. (2006) studied the characteristics of two
testing algorithms. The more basic algorithm used a single initial
test plus subsequent split specimen confirmation tests. In the
second, enhanced algorithm, an initial test was split and sent to
different laboratories for analysis. The sensitivity, specificity,
and PPV reported by Middleton were 65.7 percent, 99.9 percent, and
93 percent respectively for the basic algorithm, and 86 percent,
99.8 percent, and 90 percent respectively for the enhanced
algorithm. The authors concluded that an algorithm for BeLPT testing
and interpretation is best selected or designed after considering
the (1) likelihood and level of exposure; (2) purpose of testing
(i.e., screening versus medical testing of patients; (3) opportunity
for one-time testing versus serial testing; (4) importance of
getting the right answer the first time; and (5) number of persons
to be tested and the funds available.
    9. In April 2006, the Agency for Toxic Substances and Disease
Registry (ATSDR) convened an expert panel of seven physicians and
scientists to discuss the BeLPT and to consider what algorithm
should be used to interpret BeLPT results to establish beryllium
sensitization (Middleton et al., 2008). The three criteria proposed
by panel members were Criteria A (one abnormal BeLPT result
establishes sensitization); Criteria B (one abnormal and one
borderline result establish sensitization); and Criteria C (two
abnormal results establish sensitization).
    10. Using the single-test outcome probabilities developed by
Stange et al., the panel convened by ATSDR calculated and compared
the sensitivity, specificity, and positive predictive values (PPVs)
for each algorithm. The characteristics for each algorithm were as
follows:

                                 Table A.1--Characteristics of BeLPT Algorithms
                                      [Adapted from Middleton et al., 2008]
----------------------------------------------------------------------------------------------------------------
                                                                               Criteria B  (1
                                                             Criteria A  (1     abnormal + 1     Criteria C  (2
                                                                abnormal)        borderline)        abnormal)
----------------------------------------------------------------------------------------------------------------
Sensitivity...............................................             68.2%             65.7%             61.2%
Specificity...............................................            98.89%            99.92%            99.98%
PPV at 1% prevalence......................................             38.3%             89.3%             96.8%
PPV at 10% prevalence.....................................             87.2%             98.9%             99.7%
False positives per 10,000................................               111                 8                 2
----------------------------------------------------------------------------------------------------------------

    11. The study demonstrated that confirmation of BeLPT results,
whether as one abnormal and one borderline abnormal or as two
abnormals, enhances the test's PPV and protects the persons tested
from unnecessary and invasive medical procedures. In populations
with a high prevalence of beryllium sensitization (i.e., 10 percent
or more), however, a single test may be adequate to predict
sensitization (Middleton et al., 2008).
    12. In a later analysis, Middleton et al. (2011) conducted an
evaluation using borderline results from BeLPT testing. Utilizing
the common clinical algorithm with a criterion that accepted 1
abnormal and 1 borderline as establishing beryllium sensitization
resulted in a PPV of 94.4 percent. This study also found that 3
borderline results resulted in a PPV of 91 percent. Both of these
PPVs were based on a population prevalence of 2 percent. This study
further demonstrates borderline results' value in predicting
beryllium sensitization using the BeLPT.

III. New Beryllium-Specific Immunological Test Protocols

    1. In the medical surveillance provisions of this standard, OSHA
requires the use of a standardized BeLPT, but states that a ``more
reliable and accurate diagnostic test'' for beryllium sensitization
may be used in lieu of the BeLPT if such a test is developed. The
Agency considers the following criteria to be important in judging a
new test's validity and reliability:
    a. A test report prepared by an independent \1\ research
laboratory stating that the laboratory has tested the protocol and
has found it to be valid and reliable; and
    b. An article that has been published in a peer-reviewed journal
describing the protocol and explaining how test data support the
protocol's validity and reliability.
    c. Sensitivity and specificity that meet or exceed those
reported for the BeLPT in peer-reviewed publications.
---------------------------------------------------------------------------

    \1\ An example of an ``independent'' research laboratory would
be a laboratory with no financial interest in the protocol, and no
affiliation with the manufacture or supply of beryllium.
---------------------------------------------------------------------------

Appendix B to Sec.  1910.1024: Control Strategies To Minimize Beryllium
Exposure (Non-Mandatory)

    Paragraph (f)(2)(i) of Sec.  1910.1024 requires employers to use
one or more of the control methods listed in paragraph (f)(2)(i)(A)
of Sec.  1910.1024 to minimize worker exposure in each operation in
a beryllium work area, unless the operation is exempt under
paragraph (f)(2)(i)(B) of Sec.  1910.1024. This appendix sets forth
a non-exhaustive list of control options that employers could use to
comply with paragraph (f)(2)(i)(A) of Sec.  1910.1024 for a number
of specific beryllium operations.

                                   Table B.1--Exposure Control Recommendations
----------------------------------------------------------------------------------------------------------------
                Operation                         Minimal control strategy *               Application group
----------------------------------------------------------------------------------------------------------------
Beryllium Oxide Forming (e.g., pressing,  For pressing operations:..................  Primary Beryllium
 extruding).                              (1) Install local exhaust ventilation        Production; Beryllium
                                           (LEV) on oxide press tables, oxide feed     Oxide Ceramics and
                                           drum breaks, press tumblers, powder         Composites.
                                           rollers, and die set disassembly
                                           stations;.
                                          (2) Enclose the oxide presses; and........
                                          (3) Install mechanical ventilation (make-
                                           up air) in processing areas..
                                          For extruding operations:.................
                                          (1) Install LEV on extruder powder loading
                                           hoods, oxide supply bottles, rod breaking
                                           operations, centerless grinders, rod
                                           laydown tables, dicing operations,
                                           surface grinders, discharge end of
                                           extrusion presses;.
                                          (2) Enclose the centerless grinders; and..
                                          (3) Install mechanical ventilation (make-
                                           up air) in processing areas..
Chemical Processing Operations (e.g.,     For medium and high gassing operations....  Primary Beryllium
 leaching, pickling, degreasing,          (1) Perform operation with a hood having a   Production; Beryllium
 etching, plating).                        maximum of one open side; and.              Oxide Ceramics and
                                          (2) Design process so as to minimize         Composites; Copper
                                           spills; if accidental spills occur,         Rolling, Drawing and
                                           perform immediate cleanup..                 Extruding.
Finishing (e.g., grinding, sanding,       (1) Perform portable finishing operations   Secondary Smelting;
 polishing, deburring).                    in a ventilated hood. The hood should       Fabrication of Beryllium
                                           include both downdraft and backdraft        Alloy Products; Dental
                                           ventilation, and have at least two sides    Labs.
                                           and a top.
                                          (2) Perform stationary finishing
                                           operations using a ventilated and
                                           enclosed hood at the point of operation.
                                           The grinding wheel of the stationary unit
                                           should be enclosed and ventilated..
Furnace Operations (e.g., Melting and     (1) Use LEV on furnaces, pelletizer; arc    Primary Beryllium
 Casting).                                 furnace ingot machine discharge; pellet     Production; Beryllium
                                           sampling; arc furnace bins and conveyors;   Oxide Ceramics and
                                           beryllium hydroxide drum dumper and         Composites; Nonferrous
                                           dryer; furnace rebuilding; furnace tool     Foundries; Secondary
                                           holders; arc furnace tundish and tundish    Smelting.
                                           skimming, tundish preheat hood, and
                                           tundish cleaning hoods; dross handling
                                           equipment and drums; dross recycling; and
                                           tool repair station, charge make-up
                                           station, oxide screener, product sampling
                                           locations, drum changing stations, and
                                           drum cleaning stations.
                                          (2) Use mechanical ventilation (make-up
                                           air) in furnace building..
Machining...............................  Use (1) LEV consistent with ACGIH[supreg]   Primary Beryllium
                                           ventilation guidelines on deburring         Production; Beryllium
                                           hoods, wet surface grinder enclosures,      Oxide Ceramics and
                                           belt sanding hoods, and electrical          Composites; Copper
                                           discharge machines (for operations such     Rolling, Drawing, and
                                           as polishing, lapping, and buffing);        Extruding; Precision
                                          (2) high velocity low volume hoods or        Turned Products.
                                           ventilated enclosures on lathes, vertical
                                           mills, CNC mills, and tool grinding
                                           operations;.
                                          (3) for beryllium oxide ceramics, LEV on
                                           lapping, dicing, and laser cutting; and.
                                          (4) wet methods (e.g., coolants)..........
Mechanical Processing (e.g., material     (1) Enclose and ventilate sources of        Primary Beryllium
 handling (including scrap), sorting,      emission;                                   Production; Beryllium
 crushing, screening, pulverizing,        (2) Prohibit open handling of materials;     Oxide Ceramics and
 shredding, pouring, mixing, blending).    and.                                        Composites; Aluminum and
                                          (3) Use mechanical ventilation (make-up      Copper Foundries;
                                           air) in processing areas..                  Secondary Smelting.
Metal Forming (e.g., rolling, drawing,    (1) For rolling operations, install LEV on  Primary Beryllium
 straightening, annealing, extruding).     mill stands and reels such that a hood      Production; Copper
                                           extends the length of the mill;             Rolling, Drawing, and
                                          (2) For point and chamfer operations,        Extruding; Fabrication of
                                           install LEV hoods at both ends of the       Beryllium Alloy Products.
                                           rod;.
                                          (3) For annealing operations, provide an
                                           inert atmosphere for annealing furnaces,
                                           and LEV hoods at entry and exit points;.
                                          (4) For swaging operations, install LEV on
                                           the cutting head;.
                                          (5) For drawing, straightening, and
                                           extruding operations, install LEV at
                                           entry and exit points; and.
                                          (6) For all metal forming operations,
                                           install mechanical ventilation (make-up
                                           air) for processing areas..
Welding.................................  For fixed welding operations:               Primary Beryllium
                                          (1) Enclose work locations around the        Production; Fabrication
                                           source of fume generation and use local     of Beryllium Alloy
                                           exhaust ventilation; and.                   Products; Welding.
                                          (2) Install close capture hood enclosure
                                           designed so as to minimize fume emission
                                           from the enclosure welding operation..
                                          For manual operations:....................
                                          (1) Use portable local exhaust and general
                                           ventilation..
----------------------------------------------------------------------------------------------------------------
* All LEV specifications should be in accordance with the ACGIH[supreg] Publication No. 2094, ``Industrial
  Ventilation--A Manual of Recommended Practice'' wherever applicable.

[FR Doc. 2015-17596 Filed 8-6-15; 8:45 am]
 BILLING CODE 4510-26-P