Italy became an industrial country in 1880, although it maintained a rural-orientated economy until the 1950s. The tipping point was reached in 1958, when the number of industrial workers exceeded that of workers employed in agriculture [1]. Two relevant social indices paralleled this change: a decrease in mortality and the concomitant, although less pronounced, decrease in birth rates. Between the decade 1881–90 and the decade 1951–60, there was a 65% decrease in mortality rate, whereas the birth rate dropped 53%, and life expectancy almost doubled from 35 years in 1870 to 70 years in 1960 [2]. The pictures of Italian workers shown here from the Alinari Collection and covering the period between the end of the 19th century and 1950 do not hint at global economic improvement or necessarily translate into better work conditions, especially for blue-collar workers. The lack of any safeguard in the performance of work is a common feature: workers almost always wear their own clothes, and in the case of a picture taken in 1949, two naked miners are literally covered by toxic dust. Indeed, occupational physicians simply did not exist in Italy until 1929 when the Italian Society for Occupational Medicine was established in Naples. Health and safety legislation commenced slightly earlier with laws concerning juveniles and women at work in 1902 and from 1906, the International Committee for Occupational Health was established in Milan. Legislative measures, however, were only enforced in large factories and the pictures reported here (except one) document a quite different reality. Indeed, they mirror a semi-artisan system of work in which archaic jobs performed with primitive tools are carried out. The selected pictures can be divided into three parts, in terms of interaction between people and work environment. The first picture (Figure 1), taken before the First World War, transmits a sensation of concentration and tension: workers seem aware that even these hard and distressing conditions represent an improvement, at least in term of perspectives, in comparison to the rural work they had recently come from. The third picture (Figure 3) shows a young and strong worker of the Fascist period, apparently insensitive to the effort needed to maintain in his hands the two heavy tools needed for his work: the message from the picture is that he is not working for himself, but for a more important purpose. Another picture (Figure 2), taken during the Fascist government, shows women at work in a pharmaceutical firm. We can see two aspects typical of the approach of the regime to the work world: from one side, there is the progressive introduction of women and the presence of rudimentary protection measures; on the other hand, the protection of workers seems finalized to the safeguard of the product more than to the workers’ health. Finally, the last two pictures are emblematic of the contradictions of a transitional period like that immediately following the Second World War. One picture (Figure 4), featuring two naked miners covered with sulphur, cited above, gives the idea of the persistence of inhuman conditions, rendering work a sort of damnation. By contrast in the other one (Figure 5), we can observe the assembly process of a modern industrial plant; we have the impression that these workers may talk to each other and that a real change in the work environment is arriving, as indicated by the appearance of overalls (although not for all workers), and by the fact that, for the first time, a worker smiles. The road was long, however, and certainly not yet entirely travelled. Italy is now one of the most industrialized countries in the world, with a widespread economic well-being. In 2002, 73% of people owned their own houses (45% in 1961), ownership of refrigerators and TVs approached 100%, washing machines 94%, cars 80% and there were more contracts for mobile phones than living people (102%) [3]. Nevertheless, conditions at work are still problematic in terms of safety: the last available data on mortality at work showed that in 2006 in Italy 1200 people died because of accidents at work, with a 2.2% increase in comparison to the preceding year [4]. This suggests that workplace health and safety requires a high public profile in Italy as well as in Europe. In this respect, Department of Biopathology–Occupational Medicine, Tor Vergata University, Rome, Italy.