Bernardino Ramazzini and the linkage of clinical pictures with ergonomic factors

Ramazzini realised that it was not possible to ascribe the whole spectrum of workers’ diseases to chemicals or physical agents and he observed that a variety of common diseases (above all musculoskeletal disorders) could originate following the prolonged, violent and irregular movements and the prolonged unnatural postures of the worker’s body. He observed that the causes of these abnormalities were essentially due to the maintenance either of prolonged stationary postures or of unnatural postures and to activities that require heavy muscular performance. Although Ramazzini did not develop a detailed approach for the assessment of the factors associated with work related musculoskeletal disorders, he understood the relationship between posture, repetition of movements, weight lifting, muscular load and certain disorders, allowing him not only to describe the anatomical localization of the disorder, but also to identify intensity and duration of the risk factor.