- the Silicosis Project, an interdisciplinary research
Silicosis Colloquium 2014: "the role of inorganic particles in pulmonary, systemic and autoimmune diseases"
Sciences Po Paris, November 14th-15th, 2014
The conference gathered some specialists of history and social sciences, and scholars from different medical specialties, specialists in different diseases, in order to discuss the possible link between exposure to inorganic dust and the triggering of a range of systemic, autoimmune diseases, as well as pneumoconioses.
What was at stake was not only to try to create new knowledge, but also to try to stabilize older and current findings. In the case of several diseases (sarcoidosis, systemic lupus, systemic scleroderma… among others), the potential role of mineral dust has been mentioned here and there in the past, is still mentioned in contemporary literature reviews, and even happens to be acknowledged by national legislations on occupational diseases. But at the same time, these conclusions are repeatedly considered to be frail, partial and controversial. Moreover, they also remain unknown to a part of the medical profession who, in day-to-day practice, do not necessarily think of interrogating their patients on potential or environmental exposures.
The origin of this conference laid in the conviction that part of the uncertainty and instability of medical knowledge in this field is due to the cross-cutting character of inorganic dust hazards and to the heterogeneity of their pathological effects. Occupational and environmental diseases are split by national legislations and medical training. Several medical specialties are concerned far beyond pneumology. The diversity of exposures makes epidemiological evidence difficult to build. All these facts tend to divide up and fracture nosology, and consequently the search for etiological factors or immunopathogenic mechanisms, while mineral dust (and especially silica) is almost universal in the earth crust. Some clinical cases also show blurred boundaries between several diagnoses such as sarcoidosis, systemic lupus, rheumatoid arthritis or scleroderma. In some patients, a differential diagnosis between these pathologies is difficult to make; in some others, several pathologies are successively diagnosed in the course of the patient’s life.
The Paris conference successfully aimed at creating a discussion among various types of experts which could lead to future collaborations on a flexible basis, and possibly help identify and promote some consistent points of agreement on the origin of these “idiopathic” diseases. Its communications will be submitted to the journal Sarcoidosis, Vasculitis and Diffuse lung Diseases.