Abstract
The Surveillance System for Occupational Accidents (Sistema de Vigilância em Acidentes de Trabalho - SIVAT) established by Reference Center for Workers' Health (Centro de Referência em Saúde do Trabalhador - CEREST-Piracicaba) in 2003 represents an experience consolidated according to the guidelines formulated by the National Network for Integral Care of the Workers' Health (Rede Nacional de Atenção Integral à Saúde do Trabalhador - RENAST). The present article analyzes the history and development of SIVAT at CEREST - Piracicaba from the perspective of cultural-historical activity theory. The historical data comprise interviews, documents and observations performed by the researchers. Analysis showed that the studied activity underwent two cycles of expansion. During the first cycle, CEREST actions sought to adequate the targeted companies to the legislation in vigor. During the second cycle, actions aimed at introducing changes relative to organizational determinants in the targeted companies that CEREST staff identified as causes of accidents. A new modality of formative intervention, called Change Laboratory (CL), seems to be useful to attain the goal of prevention; it involves analysis of the causes of accidents, activity remodeling and implantation of solutions by developing agency in the targeted organizations.
Highlights
Workers’ Health Surveillance (Vigilância em Saúde do Trabalhador - VISAT) is one of the strategic axes of the National Policy for Workers’ Health[1], being understood as a permanent quest to broaden its scope of influence on health determinants and conditioning factors related to the work process[2].VISAT is considered a strategy for action that is continuous and systematic over time, aiming at detecting, learning about, investigating and analyzing the determinant and conditioning factors of health disorders related to the work process and environment as concerns their technological social, organizational and epidemiological aspects to plan, perform and assess interventions relative to such aspects to eradicate or control them[3]
The main hypothesis of the present study was that a systemic approach to the prevention of accidents leads to the expansion of the object of surveillance, which at an earlier time was limited to the visible risk factors, the ones considered in norms, to gradually come to include organizational issues
From the perspective of the object of surveillance, the historical events with significant impact on CEREST-Piracicaba’s experience and that drove the development of SIVAT corresponded to two subcycles per complete cycle and a total of two full cycles of expansive learning, which are summarized in tables 1 and 2 and described below
Summary
Workers’ Health Surveillance (Vigilância em Saúde do Trabalhador - VISAT) is one of the strategic axes of the National Policy for Workers’ Health[1], being understood as a permanent quest to broaden its scope of influence on health determinants and conditioning factors related to the work process[2].VISAT is considered a strategy for action that is continuous and systematic over time, aiming at detecting, learning about, investigating and analyzing the determinant and conditioning factors of health disorders related to the work process and environment as concerns their technological social, organizational and epidemiological aspects to plan, perform and assess interventions relative to such aspects to eradicate or control them[3]. The development of SIVAT at CEREST-Piracicaba is here analyzed from the perspective of the expansive development of activity systems[17,18], understood as the set of actions and interactions of the subject vis-à-vis the object and mediated by technical and social artifacts[20].
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