Value-of-Information Analyses for Susceptibility Biomarkers: Occupational Berylliosis at DOE Sites. S. M. Bartell, R. A. Ponce, T. K. Takaro, G. S. Omenn, T. J. Kavanagh, and E. M. Faustman, CRESP Dept. Environmental Health, University of Washington, 4225 Roosevelt Way NE #100, Seattle, WA 98105
Recently, many biologically-based markers (biomarkers) that yield information on exposure, health effects, and individual or species susceptibility to chemical or radiological hazards have been proposed and developed. However, few analyses have been conducted to determine if their development and use is cost effective. We describe a generalized framework for assessing the utility of susceptibility biomarkers in risk management, and apply it to the example of chronic occupational beryllium disease. This pulmonary granulomatous disease results from an immune-mediated response to beryllium exposure. Because of their role in immune response, HLA-DP genes have been investigated for their relationship to beryllium hypersensitivity. One of the described HLA-DP variants, HLA-DPB1*0201, contains a substitution of glutamate for lysine at position 69 (Glu-69) of HLA-DPB1 that appears to have high sensitivity (86-97) but low specificity (52-70) in assessing the risk of chronic beryllium disease. Value-of-information analysis is used to examine the reduction in opportunity loss, as calculated from the net value of risk reduction, expected for proposed biomarker-based monitoring and intervention programs for occupational berylliosis. One proposed program is the use of Glu-69 as a screening device for more frequent beryllium lymphocyte proliferation testing (LPT). Assuming the value of avoiding an advanced case of berylliosis is 1000 times the cost per person of increasing LPT frequency, the reduction in berylliosis risk resulting from increased LPT frequency in individuals with apply it to the example of chronic occupational beryllium disease. This pulmonary granulomatous disease results from an immune-mediated response to beryllium exposure. Because of their role in immune response, HLA-DP genes have been investigated for their relationship to beryllium hypersensitivity. One of the described HLA-DP variants, HLA-DPB1*0201, contains a substitution of glutamate for lysine at position 69 (Glu-69) of . . . . . . . [RiskWorld Note: Submitted abstract incomplete]