The protection of health has always been a stepchild of the working culture. Only since the 1970s has this tradition changed, in response to the environmental movement, Italian struggles for better working conditions and efforts to develop a critical medicine. These topics were introduced to the world of work by left-wing groups, often in open conflict with unions and works councils. The article examines cases related to chemical toxins, asbestos and other health risks and asks to what extent the struggle for better health at the workplace has been successful. Health protection and health promotion have been bureaucratized and made to conform with managerial notions of performance enhancement. Thus the core aim of the health movement – creating decent working and living conditions – remains unachieved.