Objective: The aim of this study was to verify and extend reported associations of beryllium exposure and lung cancer by reanalyzing data from a large occupational cohort at three beryllium processing plants. Methods: We used standardization and Poisson regression to evaluate the effect of cumulative and maximum exposure, unlagged, and lagged 10 years, adjusting for plant, employment tenure, and date of hire. Exposure was modeled either categorically or continuously using splines. Results: Categorical analyses displayed previously reported effect patterns, but not the spline analysis, which provided a more consistent picture of risk across all analyzed groups. Conclusions: We found modestly but monotonically increasing risk in the full cohort, by duration of tenure, and within most subgroups defined by plant and date of hire. Regression-based point-wise confidence bands, however, did not clearly separate risk for low versus high exposure groups.
