From the definition of Silicosis at the 1930 Johannesburg conference to the blurred boundaries between pneumoconioses, sarcoidosis and pulmonary alveolar proteinosis (PAP)

The 1930 International Labour Office Conference on silicosis in Johannesburg identified silicosis by setting a medicolegal framework to its nosology: as with other occupational illnesses, its medical content was fixed under economic pressure. This article follows a reading of all the proceedings of this conference (debates and reports of experts) to examine their potential impact on the etiology and nosology of other diseases, specifically sarcoidosis and pulmonary alveolar proteinosis (PAP), “idiopathic” diseases in which inorganic particles may be involved. We propose renewed study of the role of inorganic particles in these diseases. To do this, we propose to mobilize detection means such as mineralogical analysis and electron microscopy and in depth interviewing that are currently seldom used in France, in order to establish diagnosis and the potential occupational and environmental origin of these diseases

Détermination de la pollution atmosphérique métallique : étude critique de l'utilisation des écorces d'arbres

Human activities are responsible for the atmospheric transfer of several types of compounds among which elements are present. One of the secondary effects of such transfer may be to affect human health and the functionality of ecosystems. After atmospheric transfer, a complex deposition of the elements occurs on the earth surface, with very unequal distribution, accumulation or dilution inducing quite different effects on water and soil composition and on the functionalities of living beings. The deposition process has been studied for approximately half a century on tree trunks. These organs constitute a very common vertical matrix on which quantitative or biomonitoring studies can be efficiently carried out, thus offering widely used routine tests. However, for a better exploitation of the information contained in such deposits, a much better understanding of this type of deposition was required. Such is the purpose of this report. A single tree species was chosen for this study: Fraxinus excelsior L., a very common tree for our region, which was cultivated in the campus station and which could be found at several altitudes between 200 and 1700 m. Our methodological approach consisted in mixing two types of analytical techniques: ICP-MS and SEM-EDX which allowed to obtain an accurate concentration measurement of trace elements, a determination of their location or distribution at a microscopic scale and a chemical determination of the composition of crystallized or precipitated compounds. The time-scale of our studies on deposits ranged from 3 months to 40 years. Two types of fractions were analyzed separately: a superficial one, on the stems, and another one, integrated inside the suber tissue and also inside other tissues. It was demonstrated that the superficial deposit was in fact a component of a specific small ecosystem characterized by a non-negligible photosynthetic rate and by a reviviscent ability. The superficial deposit is submitted to a partial lixiviation by rain. The suber tissue is a waterproof, apoplastic layer able to tightly retain most of the elements over long periods of time. It seems to be the best tissue for retaining atmospheric components over several decades. The deposit has several possible origins geogenic, biogenic or anthropogenic. In order to focus on this last fraction, a new system of calculation was conceived, which allows to determine the composition of an atmospheric anthropic elements fraction (AAEF). Moreover, this AAEF was fractionated into two parts, a dispersed one inside the deposit and a pattern of solid particles which were found either in the superficial deposit or inside the suber but not in the other tissues. A purification of the solid particles fraction was carried out, separating the water-soluble elements, the HNO3 2N-soluble ones and the solid residue. This last fraction contains most of the geogenic components, and of the Pb and Mn contents. The HNO3 fraction concentrates the elements such as Zn and Cu. The main purification steps are associated to the presence of the whole stock of dispersed K and Na inside the water phase and of Ca in the HNO3 fraction. This fractionation probably allows interesting speciation studies. With all this new experimental approaches, it seems possible to obtain realistic analyses of the historical and geographical distributions of elements deposits on different spatial scales.L'atmosphère terrestre est le siège d'un transport de matière, en particulier d'éléments d'origines diverses, dont une proportion importante résulte des activités humaines. Ce phénomène induit des conséquences parfois graves, pour la santé humaine et pour la fonctionnalité des écosystèmes. Les éléments ainsi transférés sont redéposés, de manière complexe, à la surface de la terre, avec une cartographie de distribution très inégale, des possibilités d'accumulation, ou au contraire de dilution, variables, conduisant à des altérations diversifiées de la composition des eaux et des sols et de la fonctionnalité des êtres vivants. La redéposition atmosphérique est étudiée depuis une cinquantaine d'année sur les troncs des arbres, qui constituent une matrice verticale commune, très enrichie par l'apport atmosphérique, et pouvant mener soit à une analyse de composition, soit à des études de bioindication. Il en a découlé des tests de routine largement utilisés. Cependant, pour définir avec précision les apports d'origine anthropique et mieux maîtriser, en vue de les réduire, les apports anormaux ou dangereux, une étude en profondeur de cette déposition corticale devait être entreprise. C'est l'objet de ce mémoire. Au regard de la complexité du problème abordé, nous nous sommes essentiellement limité à l'étude d'une seule espèce d'arbre : Fraxinus excelsior L., très commun dans notre zone d'étude et couvrant une vaste échelle d'altitude. Notre démarche analytique a consisté à combiner une analyse élémentaire très complète et sensible, l'ICP-MS avec une observation en microscopie à balayage couplée à la détermination de l'émission de rayons X spécifique des éléments présents. Cet ensemble de deux méthodes a permis de combiner identification - dosage précis - localisation - distinction entre états particulaire et dispersé. La déposition atmosphérique a été considérée sur une échelle de temps allant de 3 mois à 40 ans, en séparant les pousses successives des arbres. Nous avons séparé le dépôt superficiel sur les surfaces végétales d'une fraction solidement intégrée dans les tissus des tiges, spécialement le suber. Ces deux entités ne correspondent pas à la même chronologie. Nous avons montré que le dépôt de surface était, de fait, un écosystème construit sur un biotope alimenté conjointement par l'atmosphère et par l'arbre lui-même et qu'il comportait une phase vivante reviviscente et pour partie photosynthétique. Ce dépôt superficiel est déplacé en grande partie par la pluie. Le suber, couche apoplastique imperméable, a une bonne capacité de rétention des éléments à long terme et constitue, comparativement aux autres tissus des tiges, une matrice très intéressante pour percevoir l'apport atmosphérique sur plusieurs décennies. Pour déterminer valablement les apports atmosphériques d'origine anthropique qui s'accumulaient dans ces deux types de matrices, nous avons conçu un système de calcul (AAEF) permettant de les séparer des apports géogéniques et biologiques. Par ailleurs, constatant que l'apport atmosphérique comportait deux types de constituants, soit dispersés, soit particulaires, nous avons conçu et mis en oeuvre un protocole de fractionnement basé 1) sur l'incinération, 2) sur les traitements successifs à l'eau et à l'acide nitrique concentré (2N) qui nous a permis d'étudier isolément une phase particulaire dans laquelle la masse des matériaux géogéniques se trouve rassemblée avec l'essentiel du plomb et du manganèse, la phase HNO3 concentrant les éléments comme le cuivre et le zinc et une phase H2O contenant l'essentiel du potassium. Les profils de distribution entre les différentes fractions semblent constituer une information intéressante sur la spéciation de plusieurs types d'éléments. L'ensemble du corpus méthodologique ainsi édifié permet d'accéder à des études assez réalistes d'historique et de distribution géographique des polluants élémentaires à des échelles de distances variées

Street Dust: Source and Sink of Heavy Metals To Urban Environment

Air-transferred solid material accumulated for 40 years in different places in an urban area, Grenoble city, France. An appropriate fractionation procedure allowed to separate: 1) a coarse inorganic fraction, 2) a coarse organic fraction, 3) a slowly depositing organo-clay fraction and 4) very fine particles. The composition of each fraction was determined for 20 elements and for isotopic lead signature. The organo-clay fraction was especially rich in Ag, Cd, Co, Cr, Ni and Ti. The sand fraction showed very high concentrations specifically in Cu, Pb and Fe. In contrast, Cd and Zn were mainly accumulated in the coarse organic fraction. The SEM-EDX study of the coarse inorganic fraction showed the presence of red particles associating Pb and Fe, black particles rich in Cu and typical fly ashes originating mostly from iron industry. This sand fraction is suspected to contribute to the contamination of the organo-clay fraction through adsorption. The Pb-Fe contamination likely originates from the neighbouring road surface contaminated by car traffic for several decades. The 206Pb/207Pb ratio showed that these street dust samples may contain up to 50% of lead originated from leaded gasoline additives, twelve years after their prohibition. All these features clearly differ from the composition found for the deposit on tree bark in the same place. These results demonstrate that the deposition over several decades is a very complex phenomenon which requires multi-techniques investigations to be understood thoroughly. They also show that large dense particles which can only be transported on a limited distance by high magnitude events may play a major role in the long-term contamination of urban soils

Sarcoidosis an occupational disease? The need for a mineral dust exposure questionnaire and scanning electron microscopy with EDX analysis

&amp;lt;p&amp;gt;We agreed with the question of Oliver C in a recent article in Chest [1] about &amp;amp;#8220;Sarcoidosis: An Occupational Disease&amp;amp;#160;?&amp;amp;#8221; and we plead for discontinuing the practice of assigning the idiopathic characterization to all cases of sarcoidosis without in depth questionnaire.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Indeed among the three criteria of American thoracic Society to define the sarcoidosis, the third was the exclusion of alternative causes and particularly foreign body reaction. In our Minasarc study [2], we demonstrated that the search for inorganic exposure was largely insufficient: there was no systematic in depth questionnaire about mineral exposome including occupation but also hobbies, and implanted device for example. There was also insufficient search for foreign bodies in granulomas with no polarized light study mentioned.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;In a historical perspective we demonstrated that there were blurred boundaries between pneumoconiosis and sarcoidosis and we proposed to mobilize detection means such as scanning electron microscopy coupled with energy dispersive x-ray spectroscopy (SEM-EDX) analysis [3]. In a recent study about Fallopian tube granulomatosis induced by Essure Implant device used for sterilization we demonstrated the better efficiency of SEM-EDX on simple optical microscopy [4].&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;We demonstrated the same SEM-EDX interest in a woman having been diagnosed lung sarcoidosis thirty years sooner [5] and after a new sub- diaphragmatic biopsy the transmission electron microscopy coupled with EDX analysis identified many steel particles. After deeper inquiry, the patient admitted using, every week end for more than forty years, sand paper and wire brush to polish wood furnitures as a hobby without no protection.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;That is why we suggest that the sarcoidosis diagnosis was only admitted after an in depth questionnaire and at less SEM-EDX analysis of the histologic specimen showing granulomatous and epithelioid cells and multinucleated giant cells.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;It would not be possible for talking about idiopathic disease without using a standardized, all along life questionnaire about mineral exposure and modern SEM-EDX allowing chemical analysis of foreign bodies identified associated with granulomas.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;We propose a paradigm modification on the manner to question the sarcoidosis diagnosis with use of new tools for identifying a new entity of mineral dust induced granulomatosis.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;amp;#160;&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;[1] &amp;lt;/strong&amp;gt;Oliver, LC., Zamke, AM.,&amp;lt;strong&amp;gt; &amp;lt;/strong&amp;gt;Sarcoidosis. An occupational study DOI: https://doi;org/10.1016/j.chest.2021.06.003&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;[2] &amp;lt;/strong&amp;gt;Catinon, M., Cavalin, C., Chemarin, C., ... &amp;amp; Vincent, M. (2018). Sarcoidosis, inorganic dust exposure and content of bronchoalveolar lavage fluid: the MINASARC pilot study.&amp;amp;#160;&amp;lt;em&amp;gt;Sarcoidosis, Vasculitis, and Diffuse Lung Diseases&amp;lt;/em&amp;gt;,&amp;amp;#160;&amp;lt;em&amp;gt;35&amp;lt;/em&amp;gt;(4), 327.&amp;lt;strong&amp;gt; &amp;lt;/strong&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;[3] &amp;lt;/strong&amp;gt;Vincent, M., Chemarin, C., Cavalin, C., Catinon, M., &amp;amp; Rosental, P. A. (2015). From the definition of silicosis at the 1930 Johannesburg conference to the blurred boundaries between pneumoconioses, sarcoidosis, and pulmonary alveolar proteinosis (PAP).&amp;amp;#160;&amp;lt;em&amp;gt;American journal of industrial medicine&amp;lt;/em&amp;gt;,&amp;amp;#160;&amp;lt;em&amp;gt;58&amp;lt;/em&amp;gt;(S1), 31-38.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;[4] &amp;lt;/strong&amp;gt;Catinon, M., Chemarin, C., Assaad, S.,... &amp;amp; Vincent, M. (2014). Wire brushing wood furniture, granulomatosis and microscopic mineralogical analysis.&amp;amp;#160;&amp;lt;em&amp;gt;Sarcoidosis Vasc Diffuse Lung Dis&amp;lt;/em&amp;gt;,&amp;amp;#160;&amp;lt;em&amp;gt;31&amp;lt;/em&amp;gt;(3), 262-4.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;[5] &amp;lt;/strong&amp;gt;Catinon, M., Roux, E., Auroux, A., ... &amp;amp; Vincent, M. (2020). Identification of inorganic particles resulting from degradation of ESSURE&amp;amp;#174; implants: Study of 10 cases.&amp;amp;#160;&amp;lt;em&amp;gt;European Journal of Obstetrics &amp;amp; Gynecology and Reproductive Biology&amp;lt;/em&amp;gt;,&amp;amp;#160;&amp;lt;em&amp;gt;250&amp;lt;/em&amp;gt;, 162-170.&amp;lt;/p&amp;gt;</jats:p

Expositions aux particules inorganiques : comment poser la question ?

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