Vigilância do óbito por causas externas relacionadas ao trabalho: estratégia para informação e ação.

Abstract

Injuries at work are considered a major public health problem presenting great social and economic impact for the country. However, the true magnitude of this problem is unknown due to its underreporting in official statistics, especially in health information systems (SIS). The purposes of this study were to know to what extent deaths due to work related accidents are underreported, and contribute to the external causes of deaths surveillance and to the improvement of quality of information of the SIS. The study specific objective was to investigate work related fatal accidents among external causes of death occurred with the resident population of Itaberaba’s Health Region, 10 or more years old, between the years 2007 to 2013. The epidemiological profile and socio-occupational characteristics of these cases were described. Methods: it consisted in a time series descriptive study of external causes of death registered in the Mortality Information System (SIM) and the Information System of Diseases Notification (SINAN). Also, cases occurring during the year of 2013 were investigated applying the verbal autopsy technique on home interviews. The information about death circumstances obtained from the deceased relatives was compared to that registered in the information systems. The applicability of verbal autopsy as a strategy to improve the quality of information was discussed. Results: from 2007 to 2013, 1,059 cases of external causes death on Itaberaba’s region were registered on SIM database, among people 10 or more years old; only 24 cases were identified as work related accidents (2.3%); in 84.8% of cases the information about Work Accident on Death Certificate was lacking, thus registered as unknown. For the year 2013, we detected an increase of 300% on the number of cases of work related accidents identified by the verbal autopsy, compared to the information registered in SIM. Deaths due to occupational injuries occurred mostly in men, young adults, colored mulatto or black, with none or low school level. The most common occupations were farm workers, followed by workers on trade and transport. The most frequent types of violence leading to death were transport accidents and homicides. It was concluded that the verbal autopsy technique helps to elucidate the violent circumstances of external causes of death, and to correct mortality estimates and the number of fatal work related accidents. Considering and adapted the local and regional context on health services, it may be an important strategy to achieve information quality improvement, and to ensure preventive measures and health surveillance on these cases.