The upcoming Fourth National Occupational Health Conference in 2014 is the inspiration for this thematic issue. It was conceived with the aim of contributing to the debate that has been developing in preparation for the Conference, the central theme of which is the implementation of the National Occupational Health Policy (PNST), established in 2012. This policy responds to the proposal that entities representing civil society and health professionals had been calling for since the First National Occupational Health Conference. The conceptual heritage and accumulated practice acquired over the past decades is expressed in a decidedly coherent and detailed manner in the PNST document.
It also sets out the principles, guidelines, and strategies to be followed by the three levels of the Unified Health System (SUS) management for the development of comprehensive health care for workers, with a view to promoting and protecting their health and reducing morbidity and mortality resulting from illness and injuries in occupational activities. It encompasses all workers, namely both men and women, irrespective of their urban or rural location, their formal or informal inclusion in the labor market, and their form of employment. This includes public or private contract, salaried, self-employed, part-time, temporary, cooperative, apprentice, trainee, domestic, retired or unemployed people.
In recent decades, the country has produced an impressive amount of scientific literature on issues relating to the health of workers, mostly from some graduate programs on Public Health and from other areas of knowledge. The increase in professional intellectual production of services that implement actions in this area is also worthy of note. Despite the advances in knowledge, the benchmark of work as a fundamental dimension of living conditions is still not a matter sufficiently addressed in day-to-day public health practice and health promotion and prevention policies. The legal framework of PNST proposes an ambitious model of actions to be undertaken by Occupational Health Surveillance (VISAT), the implementation of which is the major current challenge.
This thematic issue focuses primarily on the priority defined by the PNST to bolster VISAT and its integration with the other components of health surveillance, aimed at promoting health and healthy work environments and processes. In the first article, the vast body of existing legislation on VISAT and the challenges to make it effective are examined. Among other considerations, it is suggested that by virtue of the pressing need for the exercise of social control - as this is the Fourth Conference - the participation of this aspect in VISAT be evaluated, as a prerequisite to ensure the effectiveness of the actions. In the following articles, experiences of health surveillance of workers' priority sectors are reported, such as sugarcane harvesters, gas station attendants and cold storage employees. Other articles address a series of relevant issues at this juncture, and also provide relevant operational input for strengthening actions of VISAT in the territories covered by the Occupational Health Reference Centers (CEREST). Taken together, these recent studies offer studies and proposals on: (1) analysis of work-related accidents, according to the model adopted in interventions for surveillance and prevention of occupational accidents; (2) inclusion of mental health in VISAT; (3) implementation of surveillance actions together with subsistence fishermen; and (4) monitoring of exposure to pesticides in Brazilian municipalities. Articles on various health hazards faced by workers in various categories, including the health of workers in the health services, are also included in this issue.
Carlos Minayo Gomez
- Publication in this collection