Author | Bernardino Ramazzini |
---|---|
Language | Latin |
Subject | Occupational medicine |
Publication date | 1700 |
Publication place | Republic of Venice |
Media type |
The De Morbis Artificum Diatriba (Dissertation on Workers' Diseases) is the first book exploring working environments with the aim to identify the hazards that could harm health and cause specific disorders in individuals and in groups of workers who carried out the same activity (occupational diseases)(Di Pietro P 1999, Carnevale F et al. 2009). It was written in Latin by Bernardino Ramazzini and published in Modena in 1700. In 1713 the second edition was printed in Padua. For this work Ramazzini is the acknowledged father of occupational medicine (Pagel JL 1891; Garrison FH 1934) and the Diatriba has been cited by Adam Smith, Karl Marx, and Cotton Mather.
The book describes Ramazzini’s observations made as a doctor and as an investigator of the territory, combining clinical remarks of the patient-worker with the description of working conditions and techniques, and related risks to health (Di Pietro P 1999). In 54 chapters the book reports health risks faced by workers in more than one hundred occupations and currently it is considered the first textbook of occupational medicine [1] [2] [3] (Franco G 1999; Carnevale F et al 2009, Carnevale F 2016) and a precursor of occupational health (Franco G 2021).
The Diatriba describes specific disorders in individuals and in groups of workers carrying out the same activity. Whereas some clinical pictures deserve only a historical interest, several disorders represent even today a health problem for specific groups of workers. Ramazzini proposed several precautions for the prevention of diseases whose basic idea, mostly based on common sense, was correctly conceived.
Much space is dedicated to the discussion of musculoskeletal disorders in workers employed in many jobs. Ramazzini understood that different morbid pictures were associated with postures, movement repetition, weight lifting, muscular load, which today define the ergonomic factors (Franco G & Fusetti L 2004). The Diatriba lists 26 different occupations, from brick-makers to sailors and from printers to writers and notaries, affected by all kinds of musculoskeletal disorders (Franco G 2010).
Ramazzini identified stress-related health disorders associated with circumstances involving high job demands and repetitive job activity. In addition to the continuous sitting responsible for sedentariness issues, he detected in accounting clerks the psychological stress to avoid mistakes or cause loss to their employers and keenly noted that an intense application of the mind harmed those workers (Franco G 2020a).
Ramazzini described consumptive affections mostly in heavy occupations such as miners. However, he also made an explicit reference to tumors. In fact, he reported that breast cancers were very often found in nuns’ breasts more than in any other women. He explained that it might be due to their celibate life. This remark anticipated the observation between nulliparity and hormonal status of women by centuries. For this remark, Ramazzini has been acknowledged as a precursor in the search for the prevention of neoplastic diseases (Bode AM & Dong Z 2009).
He also observed diseases associated with the sensory system such as visual fatigue problems in people who did small objects (Franco G 2011), deafness among workers exposed to noise (Paladino ME et al 2023) and voice disorders and dysphonia involving intense voice exercise (Franco G 2008).
The Diatriba reports morbid forms such as dust-related lung problems and serious neurological disorders associated with lead and mercury exposure (Riva MA et al 2018). It reports still existing clinical pictures and important widespread health problems: bronchopulmonary pictures such as asthma in millers and hypersensitivity pneumonitis, of which he understood the pathophysiological mechanisms (Bisetti A 1985). The book describes risks from excessive exposure to heat and sunlight and night work health troubles (Galimberti E et al 2014) and it was the first to report headaches from chemical substances. [4]
The Diatriba reports an episode of chemical pollution associated with pathological pictures affecting the inhabitants who lived near a polluting site thus revealing that Ramazzini’s attention was not limited to the working environment but extended to the context of life. The episode is one of the earliest examples of chemical pollution associated with an increase in disease. Reporting of unexpected health damages represented yesterday and represents today, an alarm signal of a potential environmental problem of interest for public health. These observations have been valued as they anticipated modern epidemiological tools in work and living environments (Zocchetti C 2000).
Much attention was given to inequality and above all to the vulnerability that today remains a topic of great concern. He described health-related problems in ethnic minorities of that time and women. Women were usually employed in different occupations entailing exposure to dangerous materials and ergonomically challenging works, in agriculture and transport of stones and bricks, although they were committed to the production of commodities such as pasta, bread and clothing items (Franco G 2012).
The Diatriba goes well beyond the identification of health risks in workplaces and description of the work-related diseases and also deals with risk communication, risk prevention and health promotion (Carnevale F et al 2015; Franco G 2021). It foreshadowed many interventions that are well established today: removing the polluted air emitted from the minerals and carrying out the work in spacious places, interrupting the prolonged posture, reducing the working time to limit the exposure to hazards, using personal protective tools (Franco G 2020b).
His main precept was given in 1711 in his Oratio xiii. De contagiosa epidemia. On that occasion, he pronounced the well-known precept “far better to prevent than to cure”. This expression evokes the phrase he used some years later in the dissertation on nuns’ health that appeared in the 1713 edition of the Diatriba. He explained, with other words, the idea already expressed earlier, preaching this new message fully and with courageous perseverance.
A repetitive strain injury (RSI) is an injury to part of the musculoskeletal or nervous system caused by repetitive use, vibrations, compression or long periods in a fixed position. Other common names include repetitive stress injury, repetitive stress disorders, cumulative trauma disorders (CTDs), and overuse syndrome.
Sitting is a basic action and resting position in which the body weight is supported primarily by the bony ischial tuberosities with the buttocks in contact with the ground or a horizontal surface such as a chair seat, instead of by the lower limbs as in standing, squatting or kneeling. When sitting, the torso is more or less upright, although sometimes it can lean against other objects for a more relaxed posture.
The year 1700 in science and technology involved some significant events.
The year 1713 in science and technology involved some significant events.
Bernardino Ramazzini was an Italian physician.
An occupational disease or industrial disease is any chronic ailment that occurs as a result of work or occupational activity. It is an aspect of occupational safety and health. An occupational disease is typically identified when it is shown that it is more prevalent in a given body of workers than in the general population, or in other worker populations. The first such disease to be recognised, squamous-cell carcinoma of the scrotum, was identified in chimney sweep boys by Sir Percival Pott in 1775. Occupational hazards that are of a traumatic nature are not considered to be occupational diseases.
A waste collector, also known as a garbage man, garbage collector, trashman, binman or dustman, is a person employed by a public or private enterprise to collect and dispose of municipal solid waste (refuse) and recyclables from residential, commercial, industrial or other collection sites for further processing and waste disposal. Specialised waste collection vehicles featuring an array of automated functions are often deployed to assist waste collectors in reducing collection and transport time and for protection from exposure. Waste and recycling pickup work is physically demanding and usually exposes workers to an occupational hazard.
Musculoskeletal disorders (MSDs) are injuries or pain in the human musculoskeletal system, including the joints, ligaments, muscles, nerves, tendons, and structures that support limbs, neck and back. MSDs can arise from a sudden exertion, or they can arise from making the same motions repeatedly, or from repeated exposure to force, vibration, or awkward posture. Injuries and pain in the musculoskeletal system caused by acute traumatic events like a car accident or fall are not considered musculoskeletal disorders. MSDs can affect many different parts of the body including upper and lower back, neck, shoulders and extremities. Examples of MSDs include carpal tunnel syndrome, epicondylitis, tendinitis, back pain, tension neck syndrome, and hand-arm vibration syndrome.
Occupational and Environmental Medicine (OEM), previously called industrial medicine, is a board certified medical specialty under the American Board of Preventative Medicine that specializes in the prevention and treatment of work-related illnesses and injuries.
Work-related musculoskeletal disorders are disorders of the muscles, skeleton, and related tissues. They are of the most common occupational disorders around the world. They had been recognised as an issue since Bernardino Ramazzini's time in the 17th century. They have been known by many names including repetitive strain injury, occupational overuse syndrome and cumulative trauma disorders.
Occupational health psychology (OHP) is an interdisciplinary area of psychology that is concerned with the health and safety of workers. OHP addresses a number of major topic areas including the impact of occupational stressors on physical and mental health, the impact of involuntary unemployment on physical and mental health, work-family balance, workplace violence and other forms of mistreatment, psychosocial workplace factors that affect accident risk and safety, and interventions designed to improve and/or protect worker health. Although OHP emerged from two distinct disciplines within applied psychology, namely, health psychology and industrial and organizational psychology, for a long time the psychology establishment, including leaders of industrial/organizational psychology, rarely dealt with occupational stress and employee health, creating a need for the emergence of OHP. OHP has also been informed by other disciplines, including occupational medicine, sociology, industrial engineering, and economics, as well as preventive medicine and public health. OHP is thus concerned with the relationship of psychosocial workplace factors to the development, maintenance, and promotion of workers' health and that of their families. The World Health Organization and the International Labour Organization estimate that exposure to long working hours causes an estimated 745,000 workers to die from ischemic heart disease and stroke in 2016, mediated by occupational stress.
A physical hazard is an agent, factor or circumstance that can cause harm with contact. They can be classified as type of occupational hazard or environmental hazard. Physical hazards include ergonomic hazards, radiation, heat and cold stress, vibration hazards, and noise hazards. Engineering controls are often used to mitigate physical hazards.
The Collegium Ramazzini is an independent, international academy composed of physicians, scientists, and scholars from 35 countries. Through its members and activities, it seeks to advance occupational and environmental health by bridging scientific knowledge with socio-political centers that have the responsibility to protect public health. The organization is named after physician Bernardino Ramazzini (1633–1714), known as “the father of occupational medicine.”
Occupational safety and health (OSH) or occupational health and safety (OHS) is a multidisciplinary field concerned with the safety, health, and welfare of people at work. OSH is related to the fields of occupational medicine and occupational hygiene and aligns with workplace health promotion initiatives. OSH also protects all the general public who may be affected by the occupational environment.
Ergonomics, also known as human factors or human factors engineering (HFE), is the application of psychological and physiological principles to the engineering and design of products, processes, and systems. Primary goals of human factors engineering are to reduce human error, increase productivity and system availability, and enhance safety, health and comfort with a specific focus on the interaction between the human and equipment.
Agricultural safety and health is an aspect of occupational safety and health in the agricultural workplace. It specifically addresses the health and safety of farmers, farm workers, and their families.
Ergonomic hazards are physical conditions that may pose a risk of injury to the musculoskeletal system due to poor ergonomics. These hazards include awkward or static postures, high forces, repetitive motion, or short intervals between activities. The risk of injury is often magnified when multiple factors are present.
Occupational epidemiology is a subdiscipline of epidemiology that focuses on investigations of workers and the workplace. Occupational epidemiologic studies examine health outcomes among workers, and their potential association with conditions in the workplace including noise, chemicals, heat, or radiation, or work organization such as schedules.
Emily Wilmer Cave Wright was a British-born American classical philologist, and a contributor to the culture and history of medicine. She was a professor at Bryn Mawr College, where she taught Greek. Wright's works include, The Emperor Julian’s relation to the new sophistic and neo-Platonism (1896), A Short History of Greek Literature, from Homer to Julian (1907), Julian (1913–23), Philostratus and Eunapius: The Lives of the Sophists (1922), Against the Galilaeans (1923), Hieronymi Fracastorii de contagione et contagiosis morbis et eorum curatione libri III (1930), and De morbis artificum Bernardini Ramazini diatriba (1940). Giovanni Maria Lancisi: De aneurysmatibus, opus posthumum (1952), and Bernardino Ramazzini: De Morbis Typographorum (1989) were published postmortem.
Manual material handling (MMH) work contributes to a large percentage of the over half a million cases of musculoskeletal disorders reported annually in the United States. Musculoskeletal disorders often involve strains and sprains to the lower back, shoulders, and upper limbs. They can result in protracted pain, disability, medical treatment, and financial stress for those afflicted with them, and employers often fi nd themselves paying the bill, either directly or through workers’ compensation insurance, at the same time they must cope with the loss of the full capacity of their workers.
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