ADA: Beryllium in Dentalmaterialien verboten!
Zitat aus http://www.dimensional.com/~mhj/1999.html:
------------------------------------------------------------------------------- Beryllium Support Group 1999 Beryllium Related Journal Articles Balkissoon, R. C. and L. S. Newman (1999). Beryllium copper alloy (2%) causes chronic beryllium disease. J Occup Environ Med 41(4): 304-8. We describe two newly confirmed cases of chronic beryllium disease who presented to our clinic from a facility that only used 2% beryllium copper alloy. These cases illustrate that the 2% beryllium copper alloy continues to cause chronic beryllium disease and that appropriate preventive measures must be taken to control exposures and educate industries and their workers about the hazards of beryllium alloys. -------------------------------------------------------------------------------
Bei der Bearbeitung von Beryllium und Beryllium-haltigen Legierungen durch Sägen, Fräsen, Bohren und Feilen entstehen feine Späne, die in der Lunge die unheilbare Beryllium-Krankheit, eine Krebs-Art, verursachen können.
Beryllium ist enthalten in Beryllium-Kupfer, aus dem Kühlkörper und Kontaktfedern für Elektronik hergestellt werden.
Wieviel Beryllium ist in Dental-Legierungen ?
Mit Datum vom 10.1.2003 teilt die ADA mit :
------------------------------------------------------------------------------- [/QUOTE] ADA News Posted Jan. 10, 2003 Court denies injunction of ADA Seal program By James Berry A federal judge Dec. 31 rejected a dental manufacturer's plea for an injunction that would have prevented the ADA from going public with a decision to lift its Seal of Acceptance from all products containing the base metal beryllium. In denying the preliminary injunction sought by CMP Industries LLC, Judge John A. Nordberg of the Northern Illinois U.S. District Court said the Association's Council on Scientific Affairs relied on a "significant amount of new evidence" in deciding to withdraw the ADA Seal from products containing beryllium alloy. New York-based CMP sued the ADA in October 2002, alleging that the council had unlawfully revised its requirements for acceptance of base metal alloys to exclude beryllium as a component of an ADA-accepted product. The company also sought an injunction to bar the Association from making its decision public knowledge (see related story, Change of requirements for ADA Acceptance of base metal alloys). Judge Nordberg noted in a six-page opinion that, in making its decision, the council reviewed a warning on beryllium from the U.S. Occupational Safety and Health Administration, as well as other information on beryllium safety. In April 2002, OSHA issued a Hazard Information Bulletin warning that beryllium exposure posed a serious potential health threat in dental workplaces. The agency also recommended, for the first time, that alternatives to beryllium be used. CMP is one of nine companies with a total of 14 beryllium-containing products granted the ADA Seal since the mid-1960s. Used in fabricating some partial dentures and crowns, beryllium has been linked to respiratory ailments in humans. ADA Chief Counsel Peter M. Sfikas hailed Judge Nordberg's decision as a victory for both the Association and the public at large. "The court's decision recognizes the importance of the ADA as a respected and impartial body, and reaffirms the right of the ADA to express its opinion on matters affecting public safety," Mr. Sfikas said. CMP argued that the ADA's proposed statement on beryllium constituted "trade disparagement" because it implied that CMP's products are unsafe. Judge Nordberg said he found it "hard to see how the implied statement is untrue." He added, "The ADA correctly states that the only implied statement that can be taken from the proposed announcement is that the ADA believes that beryllium products pose enough of a safety concern to justify removing the Seal. This statement cannot be untrue; the ADA's opinion is what it is." CMP also argued that the ADA must have a "significant amount of new evidence" that a product is no longer safe or effective before revoking the Seal or declining to renew it. "The argument," said Judge Nordberg, "boils down to whether the OSHA bulletin could be considered significant new evidence. The ADA council thought it was, and this court agrees." If CMP were to prevail in this case, he said, "the harm to the ADA would be significant. It would be unable to express a truthful opinion on an important public safety issue, its reputation as an impartial body could be questioned, and it would be subject to lawsuits from those harmed from products bearing the ADA Seal." The Council on Scientific Affairs "acted in a conscientious manner," Judge Nordberg said. "Its decision was not specifically targeted at CMP but applied to all applicable companies." He added, "The reason that the Seal is so respectedand, in fact, the reason why CMP is fighting so hard to keep itis that it represents the independent and respected opinion of the ADA." CMP's lawsuit contending the ADA wrongfully terminated the Seal is still pending before the court. The ADA has filed a motion to dismiss the lawsuit. [/QUOTE] -------------------------------------------------------------------------------
------------------------------------------------------------------------------- [QUOTE] ADA News Posted Jan. 10, 2003 Change of requirements for ADA Acceptance of base metal alloys The Council on Scientific Affairs recently changed the requirements for ADA Acceptance of base metal alloys. Products containing beryllium will no longer be considered for Acceptance. This action was taken in response to an April 2002 OSHA Hazard Information Bulletin (HIB) titled, Preventing Adverse Health Effects for Exposure to Beryllium in Dental Laboratories. The OSHA HIB makes the following points: * Cases of chronic beryllium disease (CBD) are continuing to occur among dental laboratory technicians working with dental alloys containing beryllium. Recent studies have questioned whether the Permissible Exposure Limit (PEL) is adequate to prevent CBD among exposed workers. The current PEL limits occupational exposure to 2.0 μg/cubic meter over an 8-hour time weighted average. * Extensive engineering, work practice and other controls are recommended to protect workers exposed to beryllium in dental laboratories and dental offices where appliances containing beryllium are fabricated or modified. However, the very first OSHA recommendation is, "Where possible, alloys that do not contain beryllium should be substituted for beryllium-containing alloys in dental work." There are many substances used in dentistry that require proper handling by dental care workers to avoid occupational risk. However, this is the first time that OSHA has gone on record recommending substitution of one dental product for another as the first level of control. The Council concluded that suitable base metal alloys without beryllium are available to replace beryllium-containing alloys in all dental applications. Consequently, beryllium-containing base metal alloys will no longer be considered for ADA Acceptance. The Council saw no evidence to suggest that dental devices made from items made from beryllium-containing alloys (e.g., crowns, bridges, partial dentures) cause any ill effects in patients. For more information, see the statement on the proper use of beryllium-containing alloys. --> LINK: http://ada.org/prof/prac/issues/statements/alloys.html [/QUOTE] -------------------------------------------------------------------------------
------------------------------------------------------------------------------- [QUOTE] Proper Use of Beryllium-Containing Alloys Many dental prosthetic restorations placed in the United States are made of a variety of base metal alloys. Base metal alloys are composed of metallic elements other than gold, silver, platinum, palladium, ruthenium, iridium, rhodium, and osmium. Beryllium is added to some base metal alloys for use in crowns, bridges and partial denture frameworks. Incorporation of beryllium into the base metal alloy formulation facilitates castability (lowering the melting temperature and surface tension) and increases the porcelain metal bond strength.1,2 Beryllium also allows the alloys to be electrolytically etchable for bonding veneers in conjunction with resin-bonded restorations.3 However, exposure to beryllium vapor or particles is associated with a number of diseases from contact dermatitis4,5 to chronic granulomatous lung disease, known as chronic beryllium disease (CBD). In addition, beryllium and some beryllium compounds in vapor and particulate form have been shown to be carcinogenic based on human epidemiological and animal experimental models.6 Tumors linked to beryllium include lung carcinoma6 and osteosarcoma.7 Potential hazards or risks from exposure to beryllium result from melting, grinding, polishing and finishing procedures. The risk is greatest during the casting process in the absence of an adequate exhaust and filtration system. Both the National Institute of Occupational Safety and Health (NIOSH) and the ADA8 have promulgated standard practices for the safe management of beryllium-containing alloys. These practices have focused on dental laboratories where beryllium-containing alloys are routinely used for the fabrication of crowns, bridges and partial dentures. According to the Occupational Safety and Health Administration (OSHA) the current Permissible Exposure Limits (PELs) for beryllium allow exposure to 2 micrograms per cubic meter of air (2 mg/m3) as an 8-hour time-weighted average (TWA), between 5 mg/m3 and 25 mg/m3 exposure for up to 30 minutes at a time, and 25 mg/m3 as a maximum peak limit that can never be exceeded. However, some recent studies and reports have questioned whether the current 2 mg/m3 PEL for beryllium in the workplace is adequate to prevent the occurrence of CBD among exposed workers.9,10 A recommendation of 0.1 mg/m3 for the 8-hour TWA has been made based on a study of unaffected populations near a beryllium plant.11 In a recent Hazard Information Bulletin entitled Preventing Adverse Health Effects from Exposure to Beryllium in Dental Laboratories ("OSHA Bulletin"), 12 OSHA expressed concern that cases of CBD are continuing to occur among dental laboratory technicians and cautioned the nation's dental laboratories and lab technicians to be alert to the risk of developing CBD from exposure to dust from beryllium. With regard to the dental office, reports of toxicity to beryllium-containing alloys are limited to a few cases of transient contact dermatitis.4,5 The recent OSHA Bulletin does not appear to question the fundamental safety and effectiveness of beryllium-containing alloys when handled appropriately, and no cases of CBD have been documented to date in dental practitioners, dental office employees, or patients. The OSHA Bulletin does, however, indicate that the precautions regarding the use of beryllium-containing alloys apply to dental offices if these are fabricated or modified there. So in cases where beryllium-containing dental prostheses are ground or polished in the dental office, precautions should be considered to minimize any exposure to beryllium-containing dust. The following OSHA recommendations should be taken by dental practitioners using beryllium-containing alloys for dental prostheses: * Obtain Material Safety Data Sheets (MSDSs) for all dental alloys used in the dental office; Where possible, alloys that do not contain beryllium should be substituted for beryllium-containing alloys in dental prostheses (a number of other non-beryllium-containing alloys have been granted the ADA Seal of Acceptance); * All procedures related to grinding or polishing beryllium-containing dental alloys should be conducted using properly designed and installed local exhaust ventilation; Vacuum systems and local exhaust ventilation systems should be equipped with high-efficiency particulate air (HEPA) filters; * When possible, use local exhaust ventilation (hoods) properly to minimize the generation of dust when working with beryllium-containing alloys; * Use HEPA vacuums to clean equipment and the floor around the work area; * Monitor employee exposures to airborne beryllium dust, using personal sampling techniques on a regular basis, to ensure that beryllium exposures are below the OSHA PELs and are as low as feasible; * Limit the number of office staff who have access to areas where beryllium-containing alloys are being ground or polished; * To minimize skin contact and to reduce take-home exposures and beryllium contamination of non-work areas, ensure that protective clothing is worn in areas where dental prostheses containing beryllium alloy are being ground or polished; * Recent studies suggest that exposure to beryllium at levels below OSHA's 2 mg/m3 PEL may have caused CBD in some individuals. Therefore, even in the dental office where exposures are likely to be considerably below the 2 mg/m3 limit, dentists should consider providing their beryllium-exposed staff with National Institute of Occupational Safety and Health (NIOSH)-approved air-purifying respirators equipped with 100-series filters (either N-, P-, or R-type as applicable) or, where appropriate, powered air-purifying respirators equipped with HEPA filters. Clinicians should also note that short-term exposures may exceed the 2 mg/m3 PEL.11 * Use of a surgical type mask does not provide adequate respiratory protection because it does not seal the face or effectively filter out fine particles. Dentists and their staffs may obtain additional information about beryllium-containing products directly from manufacturers or at the OSHA Web site ( www.osha.gov ). This informational statement is advisory in nature and intended to assist dentists in providing a safe and healthful workplace. References 1. Leinfelder K. An evaluation of casting alloys used for restorative procedures. JADA 1997;128:37-45. 2. Covington J et al. Beryllium localization in base metal dental casting alloys. J Biomed Mat Res 1985;19:747-750. 3. Perez A. Given the recent controversy concerning beryllium, what should be our concern or not be our concern as dental lab managers. J Dent Tech 2000;17(5):28-29. 4. Haberman A et al. Contact dermatitis from beryllium in dental alloys. Contact Dermatitis 1993;28(3):157-62. 5. Vilaplana J et al. Occupational and non-occupational allergic contact dermatitis from beryllium. Contact Dermatitis 1992;26(5):195-8. 6. Kuschner M. The carcinogenicity of beryllium. Environ Health Perspect 1981;40:101-5. 7. Fodor I. Histogenesis of beryllium-induced bone tumors. Acta Morphol Acad Hung 1997;25(2-3):99-105. 8. Moffa, J. P. and Jenkins, W. A. Status report on base-metal crown and bridge alloys. JADA 1974; 89: 652-55 9. Balkissoon, R. C. and Newman, L. S. Beryllium Copper Alloy (2%) causes chronic beryllium disease. J. Occup Environ Med 1999; 41: 304-8. 10. Martyny J. W. Hoover, M. D. Mroz, M. M. Ellis, K. Maier, L. A. Sheff, K. L. Newman, L. S. Aerosols generated during beryllium machining. J. Occup. Environ. Med. 2000; 42: 8-18. 11. Wambach P.F. and Tuggle R.M. Development of an eight-hour occupational exposure limit for beryllium. Appl. Occup. Environ Hyg. 2000, 15. 581-87. 12. Occupational Safety and Health Administration. OSHA Hazard Information Bulletin: Preventing Adverse Health Effects from Exposure to Beryllium on the Job. Available at: http://www.osha-slc.gov/dts/hib/hib_data/hib19990902.html Accessed April 12, 2002. [/QUOTE] -------------------------------------------------------------------------------
------------------------------------------------------------------------------- [QUOTE] U.S. Department of Labor Occupational Safety & Health Administration www.osha.gov OSHA Hazard Information Bulletins Preventing Adverse Health Effects From Exposure to Beryllium on the Job. OSHA Hazard Information Bulletins - Table of Contents by Year Information Date: 1999 09 02 Record Type: Hazard Information Bulletin Subject: Preventing Adverse Health Effects From Exposure to Beryllium on the Job. September 2, 1999 WARNING! INHALING BERYLLIUM DUST OR FUMES MAY CAUSE SERIOUS, CHRONIC LUNG DISEASE AMONG EXPOSED WORKERS; THIS LUNG DISEASE CAN BE FATAL. BERYLLIUM CAN ALSO CAUSE LUNG CANCER. The Occupational Safety and Health Administration (OSHA) has recently obtained information suggesting that OSHA's current 2 micrograms per cubic meter of air (micrograms/m3) eight-hour time-weighted average (TWA) permissible exposure limit (PEL) for beryllium in the workplace may not be adequate to prevent the occurrence of chronic beryllium disease (CBD), a disabling and often fatal lung disease, among exposed workers. OSHA is publishing this Hazard Information Bulletin to alert employees working with beryllium about the hazards associated with their work. It describes engineering controls, work practices, and personal protective equipment recommended for controlling exposures to beryllium through inhalation and skin contact. It also suggests health surveillance methods to identify workers who may have become sensitized to beryllium, or who may have CBD. BACKGROUND Beryllium is a metal that is found in nature, especially in beryl and bertrandite rock. It is extremely lightweight and hard, is a good conductor of electricity and heat, and is non-magnetic. These properties make beryllium suitable for many industrial uses, including: metal working (pure beryllium, copper and aluminum alloys, jet brake pads, aerospace components); ceramic manufacturing (semi-conductor chips, ignition modules, crucibles, jet engine blades, rocket covers); electronic applications (transistors, heat sinks, x-ray windows); atomic energy applications (heat shields, nuclear reactors, nuclear weapons); laboratory work (research and development, metallurgy, chemistry); extraction (ore and scrap metal); and dental alloys (crowns, bridges, dental plates); and sporting goods (golf clubs, bicycle frames). CURRENT EXPOSURE LIMITS The current OSHA PELs for beryllium are 2 micrograms/m3 as an 8-hour TWA, 5 micrograms/m3as a ceiling not to be exceeded for more than 30 minutes at a time, and 25 micrograms/m3as a peak exposure never to be exceeded. The OSHA limits have been in place for nearly 30 years and have not been revised in that time. The American Conference of Governmental Industrial Hygienists (ACGIH) has recently published a Notice of Intended Change for its Threshold Limit Value (TLV) for beryllium that would lower the TLV from the current level of 2 micrograms/m3 to 0.2 micrograms/m3averaged over an 8-hour work shift. POTENTIAL ADVERSE HEALTH EFFECTS FROM BERYLLIUM EXPOSURE CHRONIC BERYLLIUM DISEASE Chronic beryllium disease (CBD) primarily affects the lungs. CBD may occur among people who are exposed to the dust or fumes from beryllium metal, metal oxides, alloys, ceramics or salts. It occurs when people inhale beryllium in these forms. CBD usually has a very slow onset, and even very small amounts of exposure to beryllium can cause the disease in some people. In some cases, CBD develops while workers are still on the job, but in others it may not develop until many years after a person has stopped working in the beryllium industry, or has been transferred to a job that does not involve beryllium exposure. The amount or length of exposure to beryllium necessary to cause a specific individual to develop CBD is not known, but recent information suggests that exposure below OSHA's 2 micrograms/m3 TWA PEL over a very short time (weeks or months) can lead to CBD in some workers. Signs and Symptoms of Chronic Beryllium Disease Workers with advanced CBD may have one or more of the following symptoms: unexplained cough; shortness of breath, especially with activity; fatigue; weight loss or loss of appetite; fever; or night sweats. However, because the disease may develop slowly over a period of many years, workers may have the disease for a long time without knowing it. BERYLLIUM SENSITIZATION CBD only develops in workers who have become sensitized to beryllium. A sensitized worker is one who has developed an allergic reaction to beryllium. A worker may become sensitized at any point during job exposure, or in some cases may not become sensitized until after leaving a job where there has been beryllium exposure. Beryllium sensitization can be detected through the use of a blood test called the BeLPT, which stands for beryllium lymphocyte proliferation test. This test measures how specific white blood cells called lymphocytes react to beryllium. A positive test result means that a worker is sensitized. ACUTE BERYLLIUM DISEASE Acute beryllium disease usually has a quick onset and has symptoms that resemble those of pneumonia or bronchitis. The acute form of the disease is believed to occur as a result of exposures well above the current PEL. This form of beryllium disease is now rare. CANCER Studies of workers exposed to beryllium have demonstrated significantly elevated risks of lung cancer. The International Agency for Research on Cancer (IARC), the expert cancer agency of the World Health Organization, has concluded that exposure to beryllium can cause lung cancer in humans. SKIN DISEASE A skin disease, which is characterized by poor wound healing and a rash or wart-like bumps, can occur as a result of the skin being exposed to beryllium dust. RECOMMENDATIONS OSHA recommends the following measures to reduce exposure to beryllium in the workplace and to determine whether workers have beryllium sensitization or CBD. 1. ENGINEERING CONTROLS Employers should use appropriate engineering controls and work practices to ensure that worker exposures to beryllium are maintained below the current OSHA PELs to the extent feasible. The following engineering controls and practices should be used by employers: * enclose processes; * design and install appropriate local exhaust ventilation; * use vacuum systems in machining operations; * use pellets instead of powders wherever possible; * use product substitution where possible; * minimize the number of workers who have access to areas where there is a potential for beryllium exposure; * monitor employee exposures to airborne beryllium dust and fume, using personal sampling techniques, on a regular basis to ensure that exposures are below the PELs and that proper respiratory protection is being used where necessary. 2. WORK PRACTICES TO REDUCE BERYLLIUM EXPOSURE Employers should ensure that employees use the following safe practices to reduce their exposure to beryllium: * use high-efficiency particulate air (HEPA) vacuums to clean equipment and the floor around their work areas; * do not leave a film of dust on the floor after the water dries if a wet mop is used to clean; * do not use long vacuum hoses and do not loop the hoses that are used; * do not disconnect or disable the vacuum system during any machining operation; * never use compressed air to clean parts or working surfaces; * avoid prolonged skin contact with beryllium particulate; and * do not allow workers to eat, drink, smoke, or apply cosmetics at their work stations. 3. HYGIENE AND PERSONAL PROTECTIVE CLOTHING OSHA is aware of CBD cases that have occurred among family members of beryllium-exposed workers. To reduce "carry-home" exposures, employers should provide showers, clean work clothes, and clean areas for storing street clothes. Protective clothing should be provided to employees who work in areas where beryllium-containing powders are used and where there is a potential for spills. In addition, employers should ensure that employees: * change into work uniforms before entering their work area; * place their uniforms in a labeled bin with a cover at the end of the work shift; * shower and change into street clothes prior to leaving the facility; * wash their face, hands, and forearms before eating, smoking, or applying cosmetics; * keep their work clothes as clean as possible during the workshift; wipe off their shoes before leaving the work area; and * do not wear their work uniform (including their work shoes) outside of the facility. 4. RESPIRATORY PROTECTION Recent data suggest that exposures to beryllium even at levels below the 2 micrograms/m3 PEL may have caused CBD in some workers. Therefore, employers should consider providing their beryllium-exposed workers with air-purifying respirators equipped with 100-series filters (either N-, P-, or R-type) or, where appropriate, powered air-purifying respirators equipped with HEPA filters, particularly in areas where material containing beryllium can become airborne. 5. TRAINING Employers should give employees exposed to beryllium training and information about the following items: * material safety data sheets (MSDSs) for beryllium; * the fatal lung disease that may occur as a result of exposure; * the availability of the BeLPT blood test to determine whether an exposed worker has become sensitized to beryllium; * the potential for developing lung cancer as a result of exposure; * the importance of avoiding skin contact; * the engineering controls the employer is using to reduce worker exposures to beryllium; * specific work practices that can be used to reduce exposure to beryllium; * the use of appropriate protective equipment, including the use of respirators; * the results of any industrial hygiene sampling for levels of beryllium in the workplace; and * a copy of this Hazard Information Bulletin. 6. HEALTH SCREENING METHODS FOR BERYLLIUM SENSITIZATION AND CHRONIC BERYLLIUM DISEASE To the Employer: Employers should consider sending beryllium-exposed employees to a physician or other licensed health care professional to be evaluated for beryllium sensitization or the presence of CBD. The screening examination for CBD usually begins with a chest x-ray and a blood test for beryllium sensitization, namely, the BeLPT, plus any further evaluation considered appropriate by the health care professional. The blood test can detect an adverse health response to beryllium exposure earlier than breathing tests or chest x-rays can. The BeLPT is not routinely done in most medical laboratories; however, the health care professional may order this test from any laboratory that has overnight courier service to one of the Medical Research Centers listed below. If a worker is sent to a health care professional for health screening, a copy of this Hazard Information Bulletin should accompany the employee. To the Employee: If you work in a place where beryllium is used and have developed any of the symptoms listed below, you should inform your health care professional of your past beryllium exposure, or seek information from a health care professional who specializes in occupational lung diseases to determine whether you may have developed CBD: * unexplained cough, * shortness of breath, * fatigue, * weight loss or loss of appetite, * fevers, and/or * skin rash. If you do not have any of the above symptoms but are concerned that you may have become sensitized to beryllium, you should inform your health care professional that you would like to be tested with the blood BeLPT. Take a copy of this Hazard Information Bulletin with you. BLOOD TESTING FOR BERYLLIUM SENSITIZATION Only the three medical research centers and the one laboratory listed below currently offer the blood test to identify beryllium-sensitized workers as indicated by a positive blood BeLPT. As other research centers and laboratories develop the capacity to screen workers for beryllium sensitization, they will be added to the list. Medical Research Centers Cleveland Clinic Foundation 9500 Euclid Avenue, L-15 Cleveland, Ohio 44195 phone: (800) 628-6816 Division of Environmental and Occupational Health Sciences National Jewish Medical and Research Center Denver, Colorado 80206 phone: (303) 398-1722 Pulmonary Immunology Laboratory Hospital of the University of Pennsylvania 421 Curie Blvd. 844 BRB II/III Phliadelphia, Pennsylvania 19104 phone: (215) 573-9875 Testing Laboratory Specialty Laboratories, Inc. 2211 Michigan Avenue Santa Monica, California 90404-3900 phone: (800) 421-4449 http://www.osha.gov http://www.dol.gov Occupational Safety & Health Administration 200 Constitution Avenue, NW Washington, DC 20210 USA [/QUOTE] -------------------------------------------------------------------------------
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