"It's important that we understand whether or not this is a community-acquired sensitization, or if it's rooted in the individual's prior occupation exposure," said Dennis Douglas, deputy county administrator for medical and health services, to the board in August.
"Most importantly," Douglas added, "(we need) to get this out in the open."
Local attention on beryllium is focused at Brush Ceramic Products, which utilizes the hard metal in its plant at Tucson Boulevard and Bilby Road.
After it opened in 1980, three-dozen plant employees developed chronic beryllium disease (CBD), described as "an irreversible and sometimes fatal scaring of the lungs," and at least one died as a result. (See "Something in the Air," Feb. 13, 2003, and "Passing On," May 22, 2003.)
Even though the company has made substantial changes since then, critics still worry about past and current emissions from the plant. (See "Next Door to Poison," June 22, 2006.) Because of these concerns, a few years ago, officials conducted a variety of tests nearby.
Based on the results of this investigation, in 2005, the Arizona Department of Health Services (ADHS) labeled the plant: "No Apparent Public Health Hazard."
In 1999, the Pima County Department of Environmental Quality started monitoring the plant's air quality, and has found that the air meets federal standards.
Despite that, two community groups proposed that beryllium-sensitivity testing be done due to questions about government oversight. Pima County agreed to fund 40 tests, mostly for 20-year residents living near the plant.
El Pueblo Health Center was hired to coordinate what it called a "public health service project." A total of 190 households met the established criteria, and 130 of them were contacted personally.
After this outreach, only nine people, including six residents, were tested. According to an El Pueblo report, one reason for the low response was "a fear among some community residents that negative economic consequences for nearby homeowners could result from a high-profile campaign to publicize the beryllium-testing opportunity."
Similarly low participation occurred in 2006 when the federal Agency for Toxic Substances and Disease Registry (ATSDR) offered 200 free tests, mostly to people living near a Brush Ceramics plant in Elmore, Ohio. In that case, only 18 people got involved, and all had normal blood tests.
However, in Tucson, one of the residents tested positive for beryllium sensitivity, while another resident's results were borderline. (Two retests proved negative for this individual.)
When this information was presented to the Board of Health, it was pointed out that those with CBD often have negative sensitivity-test results, while up to 2 percent of the population is naturally sensitive to beryllium.
John Scheatzle, general manager of Tucson's Brush Ceramics plant, writes in an e-mail: "The test is not recommended for public screening." Among other studies, Scheatzle cites a 2006 data review (which received funding from his company) that determined there isn't enough scientific information available to justify using the beryllium-sensitivity test for routine- screening purposes.
On the other hand, the ATSDR states that the test "can identify people whose immune system is sensitive to beryllium, a kind of allergic response to beryllium from past exposure." The agency also says, "In a study of exposed workers, a confirmed positive (blood test) had a positive predictive value for CBD of almost 50 percent."
At the Board of Health meeting, a representative of Brush Ceramics questioned the test. Despite those objections, the board voted to request that ATSDR "conduct an on-site scientific review of what may be a threat to public health and safety from the possible presence of beryllium in the local environment."
"They (ATSDR) can assist us in getting to the bottom of what we're dealing with here," Douglas said. If the federal agency declined the request, Douglas added, they could be asked to recommend experts who could help.
The county sent the request to the ATSDR in September; the agency responded at the end of 2007, declining the request. Referencing the 2005 ADHS report, the agency recommended instead that "the potential for occupational beryllium exposure should be evaluated for the one individual with a positive (blood) test."
County Administrator Chuck Huckelberry wrote the Board of Supervisors in February: "It would appear from all the responses related to this matter that no further action is warranted at this time."
That opinion isn't shared by either board chairman Richard Elías, who is also a member of the Board of Health, or Supervisor Ramón Valadez, who represents the area around the Brush Ceramics plant. Board of Health member Carolyn Trowbridge also thinks the group should be consulted again.
"We initiated it," Trowbridge says of the approach to ATSDR, "and I think we should appeal the decision."
Even though he believes this isn't a public health and safety issue, Douglas agreed last week that it should go back to the Board of Health as soon as possible.
Meanwhile, El Pueblo Health Center informed the individual who tested positive about further steps that can be taken, including a trip to Denver to be evaluated by a pulmonary specialist with expertise in beryllium disease. Whether that has been done is unknown.
Also uncertain is who, if anyone, will determine whether the test results were caused by occupational exposure to beryllium. Pima County hasn't evaluated that possibility, nor has El Pueblo, nor will the ATSDR.
So for the time being, the mystery behind the positive test for beryllium sensitivity remains unsolved.