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With Benedetto Terracini as guest editor, the last issue of the International Journal of Occupational and Environmental Health (vol. 11, n° 1, 2005) presents a very rich overview of occupational health in Italy with a historical perspective. In his editorial Professor Terracini indicates the pivotal role of the workers’ struggle. He wrote: “With the exception of the fascist period, since the late 19th century, Italy has been characterized by a highly active movement of industrial workers and powerful trade unions.
At the time of the “Italian miracle”, around 1960, workers realized the revolutionary potential of a fight against the physical and mental harm produced by work. Some principles were laid down and put into practice in order to identify cause-to-effect relationships based on workers’ experience and knowledge: subjectivity and refusal to hand over the control of workers’ health and working conditions were the watchwords. On that basis, workers were able to formulate specific requests for interventions intended to remove hazards from the workplace. For more than a decade the Italian workers’ approach to protecting their own occupational health was regarded as a model in other Western European countries. It is questionable whether, without the action of the workers and the strength of the unions, Italy would ever have reached the 1978 health reform, which consisted in the creation of a National Health Service along the lines of the 1948 British model and in the promulgation of the priority of prevention in health care (a principle which -ala- has never been fully implemented and is now progressively falling into disuse).
By and large, the medical–academic community had hardly realized that the country was ripe for such a reform and was reluctant to take notice of the level of the debate on health issues that had been reached among “non-experts.” Nevertheless, some outstanding intellectuals cropped up as leading figures associated with the principles of the workers’ movement. Two of them (both of whom died prematurely) were Franco Basaglia, whose name is linked to the reform of Italian psychiatry, and Giulio Alfredo Maccacaro, professor of biostatistics at the University of Milan. Maccacaro’s weltanschauung could hardly be better described than through his own words in a famous open letter sent to the Chairman of the Board of Medical Doctors of the Province of Milan in 1972.
. . . Mr. Chairman . . . I could hardly tell you more [about illness induced by capital[ism]], but perhaps somebody else could. I would like him to be a farmer from Southern Italy, who survived the childhood mortality typical of his land, just to lose some years of adult life as a hodman or as a laborer in Northern Italy. Somebody who realized how certain diseases may affect his children but not the children of his master. A man who lost two fingers under a press or who gained a bladder cancer. . . . This man, unless he has turned to alcoholism . . . could explain better than me, Mr. Chairman, the means through which capital[ists] manipulate also humans’ diseases for their own interests.”
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