Weapons of Mass Destruction (WMD)

Testimony of Kenneth D. Rosenman, M. D.

Regarding Bills on Compensation for Beryllium-Related Illness

Before the Subcommittee on Immigration and Claims of the

Committee on the Judiciary

9/21/00

Kenneth D. Rosenman, M. D.

Professor of Medicine

Michigan State University

Department of Medicine

117 West Fee Hall

East Lansing, MI 48824-1316

Rosenman@msu.edu

517-353-1846

FAX: 517-432-3606

Summary

Chronic Beryllium Disease primarily affects the lungs. It is a progressive, potentially fatal disease with few treatment options, that may occur years after beryllium exposure has ended.

Among 1,370 individuals tested at two beryllium extraction facilities in Eastern Pennsylvania, 72 (5.3%) people were diagnosed with Chronic Beryllium Disease and 73 (5.3%) were diagnosed with sensitization.

Pennsylvania Workers' Compensation Law precludes filing a workers' compensation claim more than five years after cessation of exposure. Most individuals we have diagnosed with Chronic Beryllium Disease or sensitization have been precluded from filing by this statute of limitation. Some have been denied medical coverage by their existing health insurance plan because they have a work-related disease. Accordingly, they have been left to fend for themselves to pay their medical bills.

Thank you for the invitation to speak today before the Subcommittee on Immigration and Claims of the Committee on the Judiciary.

My name is Kenneth Rosenman. I am a physician and Professor of Medicine at Michigan State University. In conjunction with colleagues at Emory University, the University of Cincinnati, and the University of Pennsylvania, we have been conducting medical screening of workers from two former beryllium processing plants in Hazleton and Reading, Pennsylvania. The Reading plant closed this year and the Hazleton plant closed in 1978. Both plants extracted beryllium from ore to make beryllium oxide and various alloys. Both facilities were major suppliers to the nuclear agencies that preceded the DOE. To date we have examined 1,370 workers from these two sites. There were a total of 5,286 individuals who ever worked at the these two locations beginning in 1935 in Reading and 1958 in Hazleton: 2,312 have died; 323 could not be located; 1,370 have been tested; 907 have declined medical testing; and 74 are scheduled to be tested (Table I). Many individuals declined to be tested because of the compensation issue and I will come back to that point shortly.

Among the 1,370 individuals tested, we diagnosed 72 (5.3%) with Chronic Beryllium Disease and 73 (5.3%) with sensitization to beryllium (Table II).

What is Chronic Beryllium Disease and what is sensitization to beryllium?

Chronic Beryllium Disease is primarily a lung disease from scarring in the lungs caused by breathing in beryllium dust or fumes. Patients may present with symptoms of cough, shortness of breath, fatigue and/or weight loss. Less commonly, it also affects the skin and other organs including the liver. Beryllium is a direct irritant and can also cause acute beryllium disease with conjunctivitis, dermatitis, nasopharyngitis, and/or pneumonitis. Acute beryllium disease occurs with ongoing high levels of exposure. Chronic Beryllium Disease, on the other hand, typically occurs after repeated low level exposure and may not occur until 20-30 years after all exposure has ceased. Chronic Beryllium Disease is caused by an immunological reaction where blood and tissue cells in the exposed individual become sensitized to beryllium and scarring occurs in response to the body's immunological reaction to the beryllium. Individuals who have the immunological reaction without evidence of scarring are considered to be sensitized. Although low levels of beryllium dust have been reported in the soil and general environment, disease has only occurred in relation to work: (1) workers; (2) family members of workers who brought beryllium home on their clothes/shoes; or (3) individuals living around beryllium facilities who have been exposed to emissions.

Chronic Beryllium Disease can occur years after exposure has ended because the beryllium inhaled can remain in the lung and the body can continue to react to the beryllium. Individuals with beryllium disease can have progression of their scarring even with cessation of exposure. With progression there is increased shortness of breath with increasing impairment which can lead to being too short of breath to leave one's bed, and finally to death. Treatment consists of high doses of prednisone, a steroid used to reduce the immunological reaction, to try and prevent the progression of the scarring. Once scarring has occurred it cannot be reversed. As the disease progresses treatment consists of oxygen therapy and possibly a lung transplant.

Since 1988 there has been a blood test which allows doctors to determine if a patient has an immunological reaction to beryllium. This blood test can be positive before scarring has occurred in the lung. These people are considered to be sensitized. They show the same immunological reaction as someone with Chronic Beryllium Disease but they don't have scarring. It is estimated that approximately 10% of individuals each year with sensitization will develop scarring in their lungs and therefore develop Chronic Beryllium Disease.

The former workers at Hazleton and Reading have received no compensation for their beryllium disease no matter what its severity, including death. This is because Pennsylvania workers' compensation law excludes individuals from applying for compensation more than five years after their employment and exposure ended. At the same time workers who we have diagnosed with Chronic Beryllium Disease have been denied health benefits from their regular health insurance because they have a work-related illness. These individuals have been left without any avenue to obtain funds for medical care. Denied workers' compensation and health insurance, some workers have tried to sue but Pennsylvania workers' compensation law precludes them from suing their employer and they are unable to sue the beryllium ore supplier because the beryllium was provided by the federal government. These individuals have clearly been left with no options and are in dire need of the proposed legislation.

I previously mentioned that approximately 900 individuals have declined the free medical testing we are offering. There are a number of reasons for this but a major one is the problem with insurance coverage. Some individuals have decided they are better off not knowing if their lung disease is caused by beryllium because they would lose their medical coverage for their lung problem.

I have two specific comments on the proposed legislation as it relates to covered beryllium illness.

The criteria for radiographic studies after January 1, 1993 should be the same as for radiographic studies prior to January 1, 1993. Requiring the CT scan for a diagnosis made after 1993 increases the costs of medical screening without improving the diagnostic specificity of the testing.

Beryllium is considered a human carcinogen. Individuals with chronic exposure to beryllium are at increased risk of lung cancer. Compensation for individuals with beryllium exposure who develop lung cancer is missing from the proposed legislation.

Thank you. I would be happy to answer any questions.