Collective commitment towards occupational accidents prevention: 20 years of the history of the Cerest in Piracicaba

Domenico De Masi and collaborators, in L’Emozione e la Regola, analyzed the functioning and constitution of creative groups in Europe from 1850 to 1950. They examined institutions such as the Pasteur Institute in Paris, the philosophical circle in Vienna, the Frankfurt Institute for Social Research, the Cambridge School of Biology, and the Los Alamos Manhattan Project¹, among others. These were institutions that contributed significantly to the advancement of their respective fields.

In Brazil, since its roots in the workers’ health program of the city², the Center for Worker Health Reference (Cerest) in Piracicaba is one of the most emblematic institutions in the field of Occupational Health. It has pushed the boundaries of development in the surveillance and prevention of work-related accidents.

Understanding how a service of this nature remains active and innovative for over 20 years is a mystery to all, whether they are researchers, professionals, workers, or union representatives³.

The reach of Cerest’s contribution goes beyond its role in Occupational Health, accident prevention, professional rehabilitation, and assistance. As Jackson Filho and Barreira³ noted, it represents a public action, and its practice in the implementation of public policies also contributes to the development of the field of political science.

To understand the nature of this innovative action, it is necessary to analyze it from an organizational perspective¹. It is important to comprehend how a group of professionals, while adhering to the guiding principles of the 1988 worker health surveillance and policy⁴, designed a framework of action that has historically addressed the issues and problems posed by the prevention of work-related injuries³, an runaway object as defines Vilela⁵.

This framework was not created by any group; it emerged from a group that Domenico De Masi, if he had known it, would call a creative group¹.

De Masi¹ provided elements, based on analyses of various cases, to understand the phenomenology of creative processes, both at the individual and collective levels. Individual dedication and collective engagement are present in actions driven by an “almost heroic” leadership style toward the goal (p. 20).

The resemblance to what is found in Piracicaba is clear. Jackson Filho and Barreira sought to explain the enigma of the service’s development up until 2009³. The authors demonstrate how the team, over the years, sought material, financial, and technical resources to develop social technologies, attract external actors, establish a network of stakeholders, and create negotiation spaces to intervene in various work situations and sectors of the economy. The professionalism and technical excellence that characterized the service’s actions in favor of worker protection and intervention in working conditions are associated with the dedication, group engagement, and leadership style similar to those mentioned by De Masi¹.

At the time, an innovative and democratic management/coordination model of activities was observed, which integrated various aspects of the center’s actions: surveillance, rehabilitation, assistance, information, and training³. For a long time, the team collectively prevented the establishment of a commissioned position for coordination within the center^b. This position is a result of collective decision-making aimed to avoid local political interference.

The academic contribution to the analysis and prevention of accidents has been and continues to be very important when compared to other institutions, including federal research institutions. This contribution is notable both in terms of conceptual and methodological aspects and in terms of application in various sectors of the economy². The quality of the service’s output is evidenced by the large number of articles published in scientific journals. Some of them were published in this journal^{6)- (10}.

Villela presents a timeline containing the most important achievements of the center. Among these, the following should be mentioned: the organization of sectoral negotiations³, the Work-Related Accident Surveillance and Investigation System (SIVAT) ⁽¹¹, the creation of the Work-Related Accident Forum¹² in partnership with Universidade Estadual Paulista (UNESP), and the Accident Analysis and Prevention Model¹³.

Much of this development is due to its close relationship with the academic environment, its openness to being simultaneously “studied” by researchers, and its proposal of research actions, in which Cerest plays a leading role aiming to solve problems in its practice. This relationship fosters a practice, a form of “art” that is engaged, innovative, and unique, intervening in favor of the protection and health of workers and establishing a link with knowledge production¹⁴.

Recently, the center has contributed to knowledge production in the field of prevention¹⁵, serving as the subject of analysis and development in a Change Laboratory (CL) ⁽¹⁶, which is a form of formative research/intervention based on the Theory of Historical-Cultural Activity. This not only aimed to produce knowledge and apply the method (the first within the field of worker health in Brazil) but also to expand the service’s actions and those of its technicians.

Furthermore, from its creation, the center committed itself to facilitating the dissemination of knowledge by its members in various forms and media: scientific publications, pamphlets, organization and participation in events, audiovisual production, and social media. This reaffirms its commitment to its raison d’être. The advancements can thus influence other services and strengthen the National Network of Workers Health Care (RENAST): the stronger the network, the greater the service’s ability to promote Worker Health in its region.

In other words, by acknowledging its limited role, it has stimulated and participated in networks of actors³, not exclusive to the health sector, which tirelessly seek to prevent accidents. The specialization courses in ergonomics taught in Piracicaba and coordinated by Cerest in the 2000s aimed to introduce the activity ergonomics as a reference for various professionals from different institutions and companies to favor prevention and establish a network of stakeholders in the region². Other actions, such as training of health surveillance agents in Occupational Health for various services in the state of São Paulo in 2019, the development of the online tool ZERÓBITO¹⁷, and the book “Engenharia do Trabalho,” ⁽¹⁸ are recent examples of network actions in which Cerest played a leading role.

Therefore, it can be affirmed that over its 20 years of existence, the service has been a space for experimentation, innovation, and the production of social technologies for prevention¹⁹. It has initiated or participated in various actions and movements, as mentioned above, while also fostering and promoting meeting spaces that have benefited not only the development of various actors but, above all, the field itself.

Thus, it seems valid even today, as it was known since 2013, that “the team’s success appears to be associated with a combination of its ability to innovate by seeking tools (material, conceptual, and methodological) to support action and its ability to influence the social environment to act” ⁽³ (p. 388).

The future of the service ultimately depends on its ability to keep these capabilities alive in dealing with the inherently elusive nature of preventing work-related injuries. Regarding societal recognition and, consequently, legitimacy to act, the Cerest in Piracicaba already presents them²⁰, after more than 20 years of historical commitment to accident prevention.

Cerest, which has been followed over the years by RBSO, is an asset to the city of Piracicaba, the field of Occupational Health, and the Brazilian public healthcare system.

Referências

• ¹
  De Masi D, organizador. A emoção e a regra: os grupos criativos na Europa de 1850 a 1950. Rio de Janeiro: José Olympio Editora; 1999.
• ²
  Vilela RAG, Ricardi GVF, Iguti AM. Experiência do Programa de Saúde do Trabalhador de Piracicaba: desafios da vigilância em acidentes do trabalho. Inf Epidemiol SUS [Internet]. 2001 [citado em 1 nov 2023];10(2):81-92. Disponível em: http://dx.doi.org/10.5123/S0104-16732001000200003
  » http://dx.doi.org/10.5123/S0104-16732001000200003
• ³
  Jackson Filho JM, Barreira THC. A construção da saúde do trabalhador em Piracicaba: análise da ação pública no período de 1998 a 2009. In: Simonelli AP, Rodrigues DS, organizadores. Saúde do trabalho em debate: velhas questões, novas perspectivas. Brasília (DF): Paralelo 15; 2013. p. 357-92.
• ⁴
  Brasil. Ministério da Saúde. Portaria nº 3.120, de 1 de julho de 1998. Brasília (DF): Ministério da Saúde; 1998.
• ⁵
  Vilela RAG. A prevenção de acidentes de trabalho como um objeto fugidio: uma releitura do desenvolvimento e desafios atuais do Sivat Piracicaba. In: Iguti AM, organizadora. Passado, presente e futuro: múltiplas abordagens em saúde e trabalho. Campinas: Unicamp; 2021. p. 107-39.
• ⁶
  Vilela RAG, Mendes RWB, Gonçalves CAH. Acidente do trabalho investigado pelo Cerest Piracicaba: confrontando a abordagem tradicional da segurança do trabalho. Rev Bras Saude Ocup. 2007;32(155):29-40.
• ⁷
  Takahashi MABC, Simonelli AP, Sousa HP, Mendes RWB, Alvarenga MVA. Programa de reabilitação profissional para trabalhadores com incapacidades por LER/Dort: relato de experiência do Cerest-Piracicaba, SP. Rev Bras Saude Ocup. 2010;35(121):100-11.
• ⁸
  Vilela RAG, Silva RC, Jackson Filho JM. Poder de agir e sofrimento: estudo de caso sobre agentes comunitários de saúde. Rev Bras Saude Ocup [Internet]. 2010 [citado em 1 nov 2023];35(122):289-302. Disponível em: https://doi.org/10.1590/S0303-76572010000200011
  » https://doi.org/10.1590/S0303-76572010000200011
• ⁹
  Lacorte LEC, Vilela RAG, Silva RC, Chiesa AM, Tulio ES, Franco RR, Bravo ES. Os nós da rede para erradicação do trabalho infanto-juvenil na produção de joias e bijuterias em Limeira - SP. Rev Bras Saude Ocup. 2013;38(128):199-215.
• ¹⁰
  Vilela RAG, Laat EF, Luz VG, Silva AJN, Takahashi MAC. Pressão por produção e produção de riscos: a "maratona" perigosa do corte manual da cana-de-açúcar. Rev Bras Saude Ocup. 2015;40:30-48.
• ¹¹
  Cordeiro R, Vilela RAG, Medeiros MAT, Gonçalves CGO, Bragantini CA, Varolla AJ, Stephan C. O sistema de vigilância de acidentes do trabalho de Piracicaba, São Paulo, Brasil. Cad Saude Publica. 2005;21(5):1574-83.
• ¹²
  Vilela RAG, Almeida IM, Silva AN, Gomes MH, Prado H, Buoso E, et al. Forum: social network for the surveillance and prevention of workplace accidents. Work. 2012;41(1):3123-9.
• ¹³
  Almeida IM, Vilela RAG, Silva AJN, Beltran SL. Modelo de Análise e Prevenção de Acidentes - Mapa: ferramenta para a vigilância em Saúde do Trabalhador. Cienc Saude Colet. 2014;19(12):4679-88.
• ¹⁴
  Vilela RAG, Machado JH. Vigilância em saúde do trabalhador e produção acadêmica: uma articulação indispensável. Cienc Saude Colet [Internet]. 2011 [citado em 1 nov 2023];16(8):3369-72. Disponível em: http://dx.doi.org/10.1590/S1413-81232011000900003
  » http://dx.doi.org/10.1590/S1413-81232011000900003
• ¹⁵
  Vilela RAG, Querol MAP, Beltrán-Hurtado SL, Cerveny GCO, Lopes MGR, organizadores. Desenvolvimento colaborativo para a prevenção de acidentes e doenças relacionadas ao trabalho. São Paulo: Ex-Libris; 2020.
• ¹⁶
  Silva-Macaia A, Takahashi MAC, Maeda ST, Bezerra JLC, Vilela RAG Desafios no cuidado ao acidentado de trabalho no SUS: da "rede da Ira" à construção compartilhada de uma linha de cuidados. In: Vilela RAG, Querol MAP, Beltrán-Hurtado SL, Cerveny GCO, Lopes MGR, organizadores. Desenvolvimento colaborativo para a prevenção de acidentes e doenças relacionadas ao trabalho. São Paulo: Ex-Libris; 2020. p. 233-51.
• ¹⁷
  Moriyama INH, Vilela RAG, Lopes MGR, Beltran-Hurtado SL, Macaia AAS. ZERÓBITO: desenvolvimento de uma nova ferramenta para vigilância ampliada de mortes por acidente de trabalho na região de Piracicaba/SP [Internet]. Encontro Internacional sobre o Trabalho; set 2022; João Pessoa. João Pessoa: Universidade Federal da Paraíba; 2022 [citado em 1 nov 2023]. Disponível em: https://www.even3.com.br/anais/eita2022/532017-zerobito--desenvolvimento-de-uma-nova-ferramenta-para-vigil-ncia-ampliada-de-mortes-por-acidentes-de-trabalho-na-/
• ¹⁸
  Braatz D, Rocha R, Gemma S, organizadores. Engenharia do trabalho: saúde, segurança, ergonomia e projeto. Campinas: Ex-Libris; 2021.
• ¹⁹
  Vilela RAG, Jackson Filho JM, Querol MAP, Gemma SFB, Takahashi MAC, Gomes MHP, et al. A expansão do objeto da vigilância em acidente do trabalho: história e desafios de um centro de referência em busca da prevenção. Cienc Saude Colet. 2018; 23(9):3055-66.
• ²⁰
  Jackson Filho JM, Garcia EG, David HG, Duracenko SRC, Simonelli AP. Acidentes de trabalho e atuação do Centro de Referência em Saúde do Trabalhador nas páginas do Jornal de Piracicaba entre 2007 e 2014. Interface. 2019;23:e18065.

• b
  Only recently, a leadership position within the service was established.
• Text based on a presentation given on 16 October 2023 at the XXV Municipal Week for the Prevention of Accidents at Work, promoted by the Interinstitutional Workers’ Health Commission and organized by the Piracicaba Workers’ Health Reference Center.

Publication Dates

• Publication in this collection
  15 Dec 2023
• Date of issue
  2023