Shimizu Helena Eri, Bezerra Josierton Cruz, Arantes Luciano José, Merchán-Hamann Edgar, Ramalho Walter
Universidade de Brasília, Faculdade de Ciências da Saúde, Departamento de Saúde Coletiva, Campus Universitário Darcy Ribeiro, Distrito Federal, Brasília, DF, CEP 70910-900, Brazil.
Potiguar University, Av. Senador Salgado Filho, 1610, Lagoa Nova, Natal-RN, Natal, Estado do Rio Grande do Norte, CEP 59056-000, Brazil.
BMC Public Health. 2021 Apr 14;21(1):725. doi: 10.1186/s12889-021-10706-y.
Since 2004, Brazil has had a national policy for occupational health and safety. This policy means companies' tax burden is altered according to the numbers of work-related accidents and ill-health amongst their workers. In 2010, a multiplication factor was introduced to this policy, called the Accident Prevention Factor. The idea of this new multiplication factor is to encourage individual employers to take initiatives to prevent accidents and ill health in the workplace. This study was designed to investigate the incidence of work-related accidents and ill-health in Brazil according to their causes, their severity, and the economic activity in which they occur, and to compare the data before and after the introduction of the Accident Prevention Factor.
An ecological study was conducted by analyzing the time series of work-related accidents/ill-health between 2008 and 2014 from the Brazilian social security system (Previdência Social) statistical yearbooks. Incidences were calculated per cause, economic activity, and severity of the accident/ill-health. Data from before and after the introduction of the Accident Prevention Factor were compared using the Mann-Whitney test per cause and per economic activity. Statistical analyses were made using the SPSS software, with significance set at 5%.
A reduction in the incidence of work-related accidents/ill-health was found across all the groups of causes analyzed, except for the groups "external causes of morbidity and mortality" and "factors influencing health status and contact with health services." Greater reductions were found for diseases of the musculoskeletal system and connective tissue and diseases of the nervous system. Reductions in work-related accidents/ill-health were found in the different economic activities and in the different severity groups. The highest reduction after the introduction of the Accident Prevention Factor was in manufacturing and production (p < 0.05).
Overall, the incidence of accidents/ill-health was found to be on decline, except those with external causes of morbidity and mortality and those involving factors influencing health status and contact with health services. The biggest reduction was found in manufacturing and production. However, generally speaking progress still needs to be made in accident prevention and occupational health across a whole range of work environments.
自2004年以来，巴西实施了一项职业健康与安全国家政策。该政策意味着公司的税收负担会根据其员工中与工作相关的事故和健康问题的数量而改变。2010年，该政策引入了一个倍增系数，称为事故预防系数。这个新的倍增系数的目的是鼓励个体雇主采取主动措施预防工作场所的事故和健康问题。本研究旨在根据事故和健康问题的原因、严重程度以及发生事故和健康问题的经济活动，调查巴西与工作相关的事故和健康问题的发生率，并比较事故预防系数引入前后的数据。
通过分析巴西社会保障系统（Previdência Social）统计年鉴中2008年至2014年与工作相关的事故/健康问题的时间序列进行生态研究。按事故/健康问题的原因、经济活动和严重程度计算发病率。使用Mann-Whitney检验按原因和经济活动比较事故预防系数引入前后的数据。使用SPSS软件进行统计分析，显著性设定为5%。
在所分析的所有原因组中，除了“发病和死亡的外部原因”组和“影响健康状况及与医疗服务接触的因素”组外，与工作相关的事故/健康问题的发生率均有所下降。肌肉骨骼系统和结缔组织疾病以及神经系统疾病的降幅更大。在不同的经济活动和不同严重程度组中，与工作相关的事故/健康问题均有所减少。事故预防系数引入后降幅最大的是制造业和生产行业（p < 0.05）。
总体而言，除了那些有发病和死亡外部原因以及涉及影响健康状况及与医疗服务接触因素的事故/健康问题外，事故/健康问题的发生率呈下降趋势。降幅最大的是制造业和生产行业。然而，总体而言，在整个工作环境的事故预防和职业健康方面仍需取得进展。
