[Development of labor and cardiopathy in the 20th century]

The 20th century began with symbolic dates (1902-1903) for cardiology and occupational medicine: Willem Einthoven (1860-1927) invented the electrocardiograph; Milan city council decided (November 20, 1902) the foundation of the Clinic of Occupational Diseases (afterwards the Clinica del Lavoro).

To explain how the concepts of heart and work have evolved during the 20th century, two aspects have been considered: evolution of techniques and instruments.

A review of the historical literature was made using history of medicine databases (HISTMED, WELLCOME) and bibliographical sources.

The first landmark was physiology in the late 19th century (Angelo Mosso, 1846-1910, and his studies on fatigue and physiology of inhabitants of the Alps). In the 1930's there were fatigue tests; after Second World War came threadmills and from the 1960's CCU's. At present, electronics and informatics dominate the scene. What can we say about occupational cardiology? We can recall figures like Luigi Ferrannini (the first professor of Occupational Medicine in Italy), who studied the cardiovascular system in connection with work, or Domenico Cesa-Bianchi (1879-1956), who studied animal fatigue (with tapis roulant). In the 1940's the problem was: cardiopathic subjects and work (i.e. cardiopathic patients who can work, or who should work). Then, new risk factors were analysed. In conclusion, the message that the historian of medicine should give to cardiologists and occupational physicians, is that efforts must be made to preserve this specific scientific and technical heritage.