Oh, and I'd vote for just the first instance on each page - as others have suggested.
I've been thinking about this, and I think that each time the abbreviation is mentioned it should be marked up. That is the only way to get across your specialised aural styles. Unless screen-readers have a learning ability for each page?
You do not necessarily need to add the title attribute for each instance after the first.
Also, from a typographical aspect, you may wish to place your initialisms in small-caps, and the best way to target them is through abbr.initialism {...}
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