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Chronic beryllium disease (CBD) is associated with the allelic substitution of a Glu 69 in the HLA-DPB1 gene. Although up to 97% of CBD patients may have the Glu 69 marker, about 30–45% of beryllium-exposed, unaffected individuals carry the same marker. Because CBD occurs in only 1–6% of exposed workers, the presence of Glu 69 does not appear to be the sole genetic factor underlying the disease development. Using two rounds of direct automated DNA sequencing to precisely assign HLA-DPB1 haplotypes, we have discovered highly significant Glu 69-containing allele frequency differences between the CBD patients and a beryllium-exposed, nondiseased control group. Individuals with DPB1 Glu 69 in both alleles were almost exclusively found in the CBD group (6/20) vs the control group (1/75). Whereas most Glu 69 carriers from the control group had a DPB1 allele* 0201 (68%), most Glu 69 carriers …