History of Occupational Medicine

Edited by prof. Antonio Bergamaschi

Bernardino Ramazzini is widely considered the "father of occupational medicine".

His treatise “De Morbis Artificum Diatriba”, published in 1700, is universally recognized as the first scientific work which systematically deals with work-related disease.

"What do you do?" is the question added by Ramazzini to complete the sequence of anamnestic information, which carries with it important and innovative social implications

Similar dictates could be previously found in some of Hippocrates, Georgius Agricola's and Paracelsus observations and insights, all supporters of the virtuous relationship between health and a good quality of the environment (living and working).

In the XVIII century the "industrial revolution" marked a radical turn in the social and economic organization of work.

Sir Percival Pott, Samuel-Auguste Tissot, Baron Antoine Portal, William Buchan recovered Ramazzini’s notes, with stringent and consistent references to the changes in the world of Occupational (in relation to European companies), which took place during the great eighteenth-century revolutions (agricultural , demographic, industrial).

In our country, the first important sources for the study of workers’ health derived from national and international meetings, which took place in 1906-1907 in Milan and Palermo.

At that time issues relating to the main occupational diseases and particularly risky work environments were dealt with. Among the first were: TB, infectious diseases (measles, hookworm, anthrax), hearing disorders, poisoning from exposure to lead, mercury, phosphorus, and solvents.

The working contexts in which risk assessment was conducted were concerned with mines, sulfur mines, paddy fields, the match-making industry, working in caissons, tobacco, and major works of tunneling works.

It is interesting to note that, at that time, Occupational issues of great social importance were also tackled: the work done by women and children, night work, alcoholism, malnutrition of workers, and physical and mental overload syndromes.

Gradually, provisions were adopted to put in place preventive measures and medical actions to reduce accidents at work until the drafting of an insurance system. This system was introduced in 1884 with the establishment of the "National Fund Insurance for Accidents of Workers at the Workplace" ("Cassa Nazionale di Assicurazione per gli Infortuni degli Operai sul Lavoro”). This was completed with the legislation enacted in 1898 and led, in 1933, to the advent of INAIL as the sole authority on insurance against industrial accidents.

After the Second World War, which was a period marked by an economic recovery in our country, there were important initiatives directed toward occupational medicine.

In 1955-56 and 1970 fundamental legislation was passed to protect the safety and health of workers. This legislation found full and effective enforcement in the following Legislative Decree no. 626/94 and 81/2008.

Both history and recent experience seem to hark back to and echo Ramazzini’s thoughts: a healthy environment, a healthy lifestyle, a sober way of life and a moderate indulgence in food, all dictates of Public Health that characterize occupational prevention.

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