France recognised silicosis as an occupational disease only in 1945, quite late in comparison with most industrialised countries. The Liberation government, which included the Communist Party, presented this reform as a major conquest for the working class. But actually, most of the recognition process got underway in the 1930s and then under the Vichy Regime. During all that period, the main University professors who worked for the coal mining industry – Jules Leclercq, Albert Policard,Édouard Rist and Serge Doubrow – negated the very existence of the disease, or reduced it to a side-effect of tuberculosis. Even during the “Popular front” after 1936, the French State, which was under the pressure of the powerful coal mining lobby, was reluctant to intervene strongly. Communist and, to some extent, catholic unions, assisted by a handful of occupational doctors, hygienists or radiologists, progressively managed to put the collieries on the defensive, thanks to the support of the ILO: in France as in most countries, transnational dynamics played a major role in the recognition of silicosis. But as an outcome of this tough negociation process, the 1945 recognition was limited and conditional. It allowed collieries to set up efficient strategies to cut down the compensation costs of silicosis and charge it partially to social insurances.