The professions supplementary to Medicine Act 1960.
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Bernardino Ramazzini was a renowned physician and a prolific writer, born in Capri in 1633. He is considered the father of occupational medicine for having written the first paper on workers' diseases (De morbis artificum diatriba). His Treaty on Workers' diseases included 53 different professions, one particular and specific method of analysis, and a methodological proposal to prevent these diseases. This essay supports the approach taken by the father of occupational medicine and confirms that the principles established in his work are applicable to this day. A fair tribute is paid to the man and his writings in the third century after their publication. The English version of this paper is available at: http://www.insp.mx/salud/index.html.
1. There are three kinds of work-related diseases: officially recognised occupational diseases; occupational diseases; work-related but unspecific diseases. 2. These unspecific diseases occur more often than would be by mere chance, among certain professional groups. 3. Cancer mortality may increase as a result of occupational cancer-promoting factors, whereas the overall mortality may be unaffected. 4. In such cases, the mortality of other diseases not related to the occupation, is diminished ("vicarious mortality"). 5. The overall cancer mortality is probably not greatly increased by professional influences. This mortality is nearly constant in males and tends to decrease in females. 6. A strong inequality of mortality rates has been found in various occupational groups. The reason for these discrepancies is unknown. 7. Mortality is most strongly related to the mental demands made on individuals by their profession. 8. Death through accidents is six times more frequent in the general population compared with job-related accidents. 9. Health hazard due to occupation is low in relation to mortality, but marked in work-related diseases.
Since the work of Dr William Ogle in 1886 the health and mortality of members of the Victorian medical profession has been a relatively neglected subject. 'Physicians, surgeons and general practitioners' represents probably the only occupation whose mortality experience--both in terms of age and cause of death--may be traced continuously since the 1860s. Ogle's work, together with that based on the Registrar General's Decennial Supplements, shows how vulnerable especially young doctors were to high mortality risks. Their use in conjunction with data compiled by the Friendly Societies also suggests that before the twentieth century members of the medical profession may have experienced substantial periods of work-preventing illness which would certainly have affected their ability to make a satisfactory living. It is also clear that among members of the medical profession there were substantial variations in life chances; that Fellows of the Royal colleges fared far better than their less well-placed colleagues, but that among Fellows the surgeons and physicians shared similar experiences.
This review opens with the most important examples from the history of medicine until the end of the 17th century, which anticipated the affirmation of occupational medicine as separate medical discipline. The article remembers the famous Italian physician Bernardino Ramazzini (1633-1714) and his book De morbis artificum diatriba (Diseases of Workers) published in Modena in 1700 in which he described the effects of work on health for some fifty professions. By doing that, Ramazzini had laid scientific foundation to modern industrial hygiene, that is, today's occupational medicine. The authors conclude that even 300 years after the first publication of Diatriba, Ramazzini is still relevant, and that it deserves much greater attention than it is given on occasions such as this year's anniversary.