[The health of workers: between science and ethics].

In a magnificent book, pioneer of occupational psychology Robert Kahn describes the affective relationships to work (1). Mainly for didactic purposes, his description characterizes these relationships as afflictive, addictive, or fulfilling. The author exemplifies afflictive relationships by describing a worker on an assembly line repeating the same movements over and over, thousands of times a day over the course of his active working life; that is, a characteristic of the so-called “scientific” organization of labor. Addictive relationships are illustrated with the life of an executive at a big company, who does not take interest in anything but his job, even favoring work over his family. In order to describe fulfilling relationships, the author relates the story of three friends who decided to run a bakery in a very poor area, setting as an objective the production of high-quality bread at a low price. Job rotation was structured around three tasks: kneading, baking, and retailing. Despite precarious working conditions this work was very gratifying, particularly the act of delivering the bread. One of the workers told Kahn that what he enjoyed the most was answering the question of what he did for a living, to which he responded, simply: “I make bread.” Clearly, the relationships that people have to their jobs can be analyzed from a variety of perspectives, emphasizing everything from pleasure to suffering, or from the standpoints of health promotion or deprivation, illness, and death. Among professionals in the field of occupational health it is widely acknowledged that work affects people’s health. How can we ignore this knowledge that originated hundreds of years ago (with Hippocrates, Pliny the Elder, Ulrich Ellenbog, Georgius Agricola, Paracelsus, and Bernardino Ramazzini)? What is unacceptable is that so many centuries after the discoveries of these masters we are faced with a situation in which – according to data provided by the International Labor Organization (ILO) – between 1.9 and 2.3 million workers worldwide die each year as a result of poor working conditions (2). In previous editorials published by this journal (3,4), we have seen how power relations and the capitalist economic structure function within the contemporary State. Nonetheless, many of us would be inclined to adopt the position put forth by Gramsci and Rosa Luxemburg, when disputing Lenin they argued that human beings are at the center of every process of change, and their beliefs, civil society organization, culture, and forms of hegemony are the basis for revolutionary transformations, not the determinism of the economy. Rodríguez, Carlos Aníbal1