"The Italian worker based model of occupational health and its implications for United States occupational health policy are examined. A brief historical sketch of Italian approaches (university, industry and government based) to occupational health is given. The worker based approach, which arose between 1960 and 1970, is analyzed in detail. Five key concepts are used to illustrate how the social processes of worker mobilization and institutionalization have affected Italian occupational health. Most fundamental of these concepts is the homogeneous work group which is a group performing a similar task in a single section and having similar experience in exposure to occupational hazards and work related health problems. The other key concepts discussed are: subjectivity of workers in recognition of workplace hazards; the incorporation of specific occupational health regulations in contract language; local occupational health regulations in contract language; local occupational health institutions as a means to provide expert assistance to workers; and the use of occupational hazard risk maps. A comparison is made of reasons for increased interest in occupational health in Italy and the United States, and the structural manifestations of that concern. The advantages and limitations of a worker based approached to occupational health in the United States are presented. It is noted that gradual integration of these concepts into institutional structures resulted in decreased worker participation and increased tension between workers and health experts. "

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