ABSTRACT
ORIGINAL AR
INTRODUCTION
There has been Brazilian working class involvementinhealthissues,especiallythose relatedtoworkingconditions,sincethebegin-ningofthetwentiethcentury.Butitwasonly inthelate1970sthattradeunionsbeganto actmoresignificantlywithinthisfield.These tradeunionactionshavedevelopedintolarge initiatives,bothintechnicalandinpolitical fields,tothepointthatBedrikow1
hascon-sideredsuchactionsastheonlyachievement withinBrazilianoccupationalmedicineover thelastfewyears.
Many authors have emphasized the importance of worker strength through unionized organizations, in relation to the improvement of working procedures. Several authors have reportedon the de-cisiveness of labor movement actions in achievingmodificationswithinthefieldof work and health, either related to public compensation and labor legislation or to the direct relationship between employers andemployees.2-11
In Latin America, the trade union struggleforbetterworkingconditionsand health is of recent origin and is still influ-encedbythelackofguaranteesatwork,by excessivelypaternalisticassistanceandlackof democracyintheunions.Itisalsoinfluenced bytheprioritygiventoeconomicissues,to thedetrimentofallissuesregardinghealth and working conditions. Such influences result from pressure by employers and the state,andfromothersituational-structural factors within the economies of peripheral capitalistcountries.12-14
ItisimportanttoemphasizethatinBrazil therearetwotypesoftradeunions:unionsfor categoriesofworkersandprofessionalassocia-tions.15Therelativedelayamongunionsin
enteringintothefightforbetterworkingcon-ditionsandhealthisattributedbyMendes16to
impedanceeitherthroughdirectintervention oftheStateorthroughcooptation,thereby causingunionstokeeptheiractionsturned towards paternalistic assistance activities, especiallywithregardtohealthissues.
The unleashing of actions involving workers’ health and safety matters by the Brazilianlabormovementthatbeganinthe 1980sisattributedbyDias17-18
totheemer-gence of new unionism, grounded in the expansionofbasiccontactsthroughworking ondailyissuesinworkers’lives,andtothe appearanceofnewunionpracticesregarding healththattranslatedintoclaimsforbetter working conditions along the guidelines ofcollectivebargaining.Amongthesenew unionpracticesonhealthwastheincreasing unioninfluenceontheworkplacethrough “health weeks”, specific meetings and de-bates about the issue.Together with this was union participation in the process of modificationofthelegislation,ashappened intheEighthNationalHealthConference, theNationalConstitutionalAssemblyand the discussion of the organizational law regardinghealth.
The Inter-union Study and Research Departmentfortheworkingenvironment andhealthwasfoundedonJune14,1981, byadecisionofworkers’federationsand tradeunionsintheStateofSãoPaulo,with the purpose of assisting the labor move-mentinitsstudiesandactionsregarding working environments and conditions. This facility has improved the quality of the workers’ health movement by means ofprovidingunionswiththeoptionofbe-ingabletocalluponspecializedtechnical assistancetoguidetheirstruggles.19Such
technicalsupporthasalsobeenmadepos-siblebyunions’directhiringofspecialized professionalswhoarecommittedtowards workers’ health and responsible for the
DepartmentofEnvironmentalHealth,FaculdadedeSaúdePública,
UniversidadedeSãoPaulo,SãoPaulo,Brazil
CONTEXT:Manyauthorshaveemphasizedthe importanceofworkerstrengththroughunionized organizations, in relation to the improvement ofworkingprocedures,andhavereportedon thedecisivenessoflabormovementactionsin achievingmodificationswithinthefieldofwork andhealth.
OBJECTIVE: TodescribethewaysinwhichBrazil-ianunionshavetriedtointerveneinhealth-illness andworkprocesses,identifyingtheexistenceof commonalityinunionactionsinthisfield.
TYPEOFSTUDY:Qualitativestudy.
SETTING:PostgraduateProgram,Environmental HealthDepartment,FaculdadedeSaúdePública, UniversidadedeSãoPaulo,SãoPaulo,Brazil.
METHODS:Union health advisers and directors were interviewed. Documents relating to union action towards protecting workers’ health were collectedandanalyzed.
RESULTS: Unions articulate actions regarding workers’healthofatechnicalandpoliticalnature that involve many aspects and high complexity. Thesehavebeendividedintothematiccategories forbetteranalysis.
DISCUSSION:Union actions regarding workers’ health in Brazil are restricted to some unions, locatedmainlyinthesouthern,southeasternand northeasternregionsofthecountry.Nonetheless, the unions undertaking such actions represent manyprofessionsofgreateconomicandpolitical importance.
CONCLUSIONS:Therecentchangesinhealthand safetyatworkregulations,recognitionofprofes-sionaldiseases,creationofworkers’healthservices andprogramswithintheunifiedhealthsystem,and operationalimprovementsincompanies’special-izedsafetyandoccupationalmedicineservices, allbasicallyresultfromunionaction.Thereiscom-monalityofunionactioninthisfieldinitsseekingof technicalandpoliticalstrengtheningforallworkers andtheirgeneralandlocalrepresentation.Thishas the objective of benefiting collective bargaining betweenemployersandworkers.Inter-institutional actiononbehalfofworkers’rightsguaranteesand amplifiestheimprovementofhealthandworking conditions.
preparation of studies and investigations and the dissemination of accumulated knowledge.Thisisacontinuousprocessfor socializinginformationandrestoringand systematizing“workers’knowledge”.17
Fromalegalpointofview,workers’par-ticipationinoccupationalhealthandsafety matters is assured by Law No. 6514/77, asregulatedbyDecreeNo.3214/78from theMinistryofLabor.Thisdeterminesthe need to implement accident prevention committees within private and public en-terprises,andwithingovernmentalbodies whoseemployeesaregovernedbythecon-solidatedlaborlaws.Suchinternalaccident preventioncommitteesaremadeuppartly byemployerrepresentativesandpartlyby memberselectedbyemployees.Thesizeof thecommitteeisdeterminedaccordingto thenumberofemployeesandthedegreeof riskwithintheenterprise.Thesecommit-tees are chaired by one of the employer’s representatives.
The Italian workers’ model, as trans-lated from the book by Oddone et al.,20
has decisively influenced union actions in Brazil and Latin America.This meth-odology has led to many achievements in union intervention.21-24 The creation
of the National Institute for Health at Work,bymeansofaconventionbetween theBrazilianNationalWorkers’Federation (CentralÚnicadosTrabalhadores)andthe ItalianGeneralConfederationofWorkers, inDecember1990,hasstrengthenedthis influence.Also,unionsnottiedtoCentral ÚnicadosTrabalhadoreshavedrawngreat influencefromtheItalianworkers’model intheiractions.
Theobjectiveofthisworkwastodescribe thewaysinwhichBrazilianunionsattemptto interveneinhealth-illnessandworkprocesses, withtheidentificationofcommonfactorsin themethodsutilizedinunionactionwithin thesefields.
METHODS
The exploratory phase of this work consistedofinterviewswithunions’health advisersanduniondirectors,andcollecting documents from journalistic, union and academicsources,inrelationtounionaction forprotectingworkers’health.
Open, unstructured interviews were held with the purpose of collecting the officiallineonactiononhealthandwork fromuniondirectors.Ninedirectorsandsix advisers responsible for health issues were interviewed.Theseintervieweesrepresented
eight unions and two health and work union advisory bodies.The major themes included in the interviews concerned the methods used for informing, mobilizing andeducatingmembersoftheircategories ofworkers,andforstrengtheninglocalrep-resentation,collectivebargainingandaction within inter-institutional forums, and the structurestheunionshaveforsuchaction. These themes were chosen because they constitutethetheoreticalmodelforunion action formulated by the present authors, basedontheirownexperiences.Oneofthe authorswasformerlyanadvisertooneofthe moreimportantunionsinthecountry.
These unions were chosen by the fact thattheyhaverecognizablyactedinprotect-ing workers’ health and have been cited in publications because of such.25-29They also
represent different concepts and practices fromasocioeconomicandpoliticalpointof view within the Brazilian labor movement at a national level, in relation to important categoriesofworkers.Sixoftheunionsare affiliatedtothemajorBraziliancentralunion body,CentralÚnicadosTrabalhadores,and belongtotheirdifferentpoliticalfactions.An-otherisaffiliatedto“UnionStrength”(Força Sindical)andtheremainderareaffiliatedto the General Workers’ Federation (Central GeraldosTrabalhadores).Fourofthemare fromtheMetropolitanRegionofSãoPaulo, whichisthemostindustrializedofthecountry. The others are from Rio de Janeiro, Minas Gerais,RioGrandedoSulandBahia,which are,withSãoPaulo,themostindustrialized statesinBrazil.
Material related to union action on workers’healthwascollectedfromnon-gov-ernmentalorganizationsthatarededicated tostudyoftheBrazilianlabormovement, andfromtheauthors’personalfiles.Nine otherorganizationswerethusaddedtothe listofunionsunderexamination.Sevenare affiliated to Central Única dosTrabalha-dores,onetoForçaSindicalandtheotheris notaffiliatedtocentralunionbodies.Seven arefromthestateofSãoPaulo,onefromRio deJaneiroandtheotherfromMinasGerais. Elevenofalltheunionsstudiedrepresent categoriesofworkerswithinthesecondary sectorofeconomy(metal,chemical,textile, buildingandfoodworkers)andtheothers are from the service sector, including one representingpublicsectorworkers.
Theanalysisofthematerialcollectedwas undertaken using the method put forward by Minayo,30 with observation of the
fol-lowingsteps:
1)Data systematization: which included the interview material as well as the documentscollectedandtheobservation material.
2)Dataclassification:therepeatedreadingof textstoascertainthemainideasrelevant to the issue yielded thematic categories that were established on the basis these themeswereplentifullycitedorreferredto inthematerialcollectedandrepresented different aspects of union action in the protectionofworkers’health.Thus,the informationwasclassifiedintothefollow-ingthemes:
• Medicalcare;
• Development and communication of criticalawareness;
• Mobilization; • Education;
• Strengtheningoftheorganizationinthe workplace;
• Collectivebargaining;
• Inter-institutional action on workers’ health;
• Structuresforactiononworkers’health; • Influencesonactions.
3) Model elaboration and final analysis: the facts revealed through the results from the earlier procedures were laid outinadescriptionofBrazilianunion intervention methods on health and workissues.
RESULTS AND DISCUSSION
InBrazil,unionactiononworkers’health isrestrictedtoveryfewunions,ascanbeseen fromaninterviewwithadirectorofCentral ÚnicadosTrabalhadores:
“We have36unions acting on workers’ health,representedintheNationalHealthCol-lective.WithinCentralÚnicadosTrabalhadores, thesearethemostactiveunionsoutofthe2,300 branchunions.Today,intheCollective,wehave 17statesthatareorganizedwithStateHealth Collectives,andwhichhaverepresentativeson theNationalCollective.”
Withinunionactiononworkers’health, actionsofatechnicalandpoliticalnatureare articulated that involve many matters and haveahighdegreeofcomplexity.Forbetter analysis,thesedifferentaspectsofunionaction willbepresentedinthethematiccategories utilizedtoclassifythematerialcollected.
1. Medical care
Brazilianunionsregardinghealthissues,asin thefollowinginterviewpassage:
“Afterthedaysofthemilitarydictatorship, withtherepression,theunionwasobliged—and we should say that this was the history of all Brazilianunions,especiallyours—toprovide medical and dental care. In fact, I believe it consumed about 70% or almost 80% of the union’swholeresources.”
Healthcareextendedtotheworkerand hisfamily,asanobligationdemandedby the Brazilian union organization, is be-ing progressively replaced by actions on workers’ health. A physician working for oneoftheunionsstudiedsaidthat,after healthcarehadbeenidentifiedasaproblem tobesolvedintheunionandtherecame tobeadesireforwithdrawingitfromthe union’spractices,whatwasdonewasnot the simple winding up of all attendance but the replacement of general medi-cal care by special attention to workers’ health.Attendingdoctorswhoseactivities weredirectedtowardsassociatesandtheir dependentswerereplacedbydoctorscom-mittedtoworkers’health.
Inanotherunion,thesolutionfoundfor solving the problem of the cost of medical attendance was to create a Foundation that wouldmanagemedicalinsuranceforitsas-sociates.Inyetanotherunion,whichhadtwo medicaldepartments,oneforworkers’health action and the other for medical care, this latterwassimplywoundup,whiletheformer wasmaintained.
All the unions studied are concerned abouttheattendancethatisbeingprovided to their associates.This medical and dental activityispartoftheunions’legalstructure from the 1940s that has been progressively disrupted by changes in the law and union practices. Paternalistic assistance on health issuesisbeingsubstitutedbyunionpractices onworkers’health.
3.2. Development and communication of critical awareness
Alltheunionentitiesstudiedshowedtheir concernforinformationandthedevelopment of critical consciousness regarding health-relatedmattersandprotectionofworkerson duty, either through an interview or in the materialcollected,asisdescribedintheextract below,fromaninterviewwithadirectorof oneoftheunions:
“Communication with this professional category is made by bulletins. For example,a
problemisdetectedandsowecomplainaboutit.
Wewritealetter,wedemandthatthecompany solveit.Ourpolicyhereisreallytocomplain! Startingfromthemomentweissueawarning, theymove.”
Thebulletinisthemaincommunication instrumentwiththerankandfileoftheprofes-sionalcategory,andthisisveryeffective.The utilizationofbulletins,apartfromproviding information,providesmotivationfordebate. Bymakingtheproblemcollectiveandraising awarenessofitseffectuponworkers’health, itcanbeexpectedthatmanagementwillbe forced to solve the problem because of the publicoutcry.
Thefollowingispartofaninterviewwith the director of the Osasco Metal Workers’ Union,27whoalsodealswiththeinformation
issuebydistributingareporttoworkers:
“Amongallourdailytasks,thereisthe deliveryofaweeklyreportthateverymetal worker receives. It doesn’t matter if it’s a three-thousand-employeecompany orafive-employeecompany.”
Conversationswithworkers,inaregular and planned manner, in previously pro-grammedsituationssuchasthedayofmedical consultations,andtheutilizationofdailyor weekly radio programs, are other ways the unions use for communicating with their professionalcategories,aswasseeninsomeof theinterviews.Thesubjectsoftheinforma-tionmaterialproducedbyunionsthatwere mentionedwereverydiverse.Theyincluded informationaboutcertainrisks,suchasexpo-suretolead,benzene,asbestos,occupational accidentsandnoise,andprovidedinforma-tion regarding the law and workers’ rights, in relation to enterprises and government institutions.Analysisofthematerialcollected thatwasutilizedbyunionsinitsinformation aboutworkers’healthshowedthatthenews itemswerepresentedinaformatthatwassuit-ableforreadingduringworkbreaksorwhile commutingtoandfromwork.
3.3. Mobilization
Campaignsareaverynormalwayofmobi-lizingtheprofessionalcategoryregardingissues relatedtoworkers’health,accordingtothedata fromthecollectedmaterial.InBrazil,unions’ mostimportanteventsaresalarycampaigns.In termsoftheorganization,materialandhuman resources involved, such campaigns are only comparable with union elections, especially thoseinvolvinglargedisputes.Inoneofthe articles collected from union publications,31
unionleaderstrytogeneratethesamemobili-zationasinsalarycampaigns,butthistimefor betterhealthandworkingconditions.
Union campaigns are planned in the same way as major advertising opera-tions,withthecreationofbuzzwordsand slogansfirstofall.Followingthis,videos, stickers, manuals, pamphlets, posters and otherprintedmaterialsareproduced.Then, seminarsarescheduled,alongwithconfer-encesandmassactivities.Theobjectiveof thesecampaigns,asidefromtheproblems complainedabout,isthemodificationand elimination of harmful working environ-ments. Such campaigns always search for supportandjointactionwithsocialsectors andinstitutions,whethergovernmentalor not,whocanallythemselvestotheprocess, so as to strengthen it.The activities per-formedandadvertisingmaterialproduced arefrequentlyaddressedtothesesectors.
In the material collected, many other campaigns were identified concerning the relationshipbetweenhealthandwork.Apart fromcampaigns,unionsorganizepermanent healthcommittees.Thesehaveperiodicmeet-ingsinvolvingnotonlyuniondirectorsand technicalexperts,butmembersoftheprofes-sionalcategoriestoo,andalsoinvitedpeople. Attimesofveryseriousoccurrencesoraspart ofcampaigns,unionsorganizeprotestmarches inplaceswithgreatconcentrationsofpeople. Theobjectiveofsuchactivityisnotonlyclass mobilization,buttoairgrievancesinpublic, eitherdirectlyorbymeansofthepresscover-ageofsuchevents.
3.4. Education
Unions provide courses for members of internalaccidentpreventioncommittees,with programs aimed at providing them with the capabilities for fighting for better working conditionsandhealth.Inoneunion,education begins with preparatory meetings involving allmembersoftheinternalaccidentpreven-tion committees, followed by seminars that are divided into two degrees of complexity. Inanotherunion,coursestakeplaceannually and,intheyearbeforetheinterview,thesehad broughttogetherabout1,400people.
Thetrainingmaterialavailableforinternal accident prevention committee activists is very extensive.The production of manuals andpamphletsthatgiveguidanceonactions andpresentlegalandtechnicalmattersisvery common.
3.5. Strengthening of organizations within the workplace
was studied was the strengthening of these organizations within the workplace. In this respect, internal accident prevention com-mittees merited a special mention within unions’work.Therewerecountlesscitations in interviews and the documents collected regarding the actions of internal accident preventioncommittees.
InareporteditedbytheMetalWorkers’ UnionofSãoPaulo,32theissueisdiscussed
withtheprofessionalcategoryinthefollow-ingtranscript:
“Oneoftheinstrumentsthatworkershavein theirworkplaceforimprovingtheenvironmental conditionsattheplantwheretheyworkisthe internalaccidentpreventioncommittee.Thatis whyourUnionhasinvestedintrainingaswell ashavingdiscussionswithworkersabouthow importantparticipationisandabouttheelection ofourfellowworkerswhoarecommittednotonly tothebusinessbutalsotobringinginsolutions for the many problems found in the working environment.Ifyouareelectedasamemberof aninternalaccidentpreventioncommittee,you shouldcontacttheUniontogetnewinstructions ortobringusinformationaboutaccidentsoc-curringinyourfactory.”
An important characteristic of union undertakingsisthatenterprisesrepresent-ingmajorinterests,eitherduetoemployee numbersorpoliticalpositioninrelationto theclasssetting,havemoreunionactivities organized,withdirectorsespeciallychosen for these tasks. Part of their task is to observeandidentifyworkerswhoareout-standingintheirinterestinandpolitical commitmenttohealthandsafetyatwork, for when election time for the internal accident prevention committee comes. Following candidate registration, name publicity work for the candidate begins, supportedbytheUnion.
Someunionsproduceadvertisingmate-rial for candidate use. In others, assemblies are held in front of the factories and the candidatessupportedbytheunionhavetheir namesannouncedbyloudspeakers.Mostof thetime,candidatessupportedbyunionswin theelections.
In elections for internal accident pre- ventioncommittees,itiscommonforem-ployeeswhoarenotcommittedtoworkers’ aspirations to be registered as candidates andbeelected.Thesemayormaynotbe thebosses,buttheyactoninternalaccident preventioncommitteestodefendtheinter-estsoftheenterprise.Theunionsdenounce themandformlistsinoppositiontothese representatives, but on many occasions,
pressurecausedbythepoweroftheenter-prisedoesnotallowsuchactionforchange tohavesuccess.
The rules for the election process for internal accident prevention committees are often disrespected by employers, with candidates being fired after their registra-tion,orbeforeregistration,whentheactions ofafuturecandidatecometonotice.This problemisconstantlycomplainedaboutby unions,butfrequentlyitisonlyresolvedby thelaborcourts,longaftertheelectionhas takenplace.Activistsoninternalaccident preventioncommitteeswhoseactionshave stood out are natural candidates for rep-resenting other union matters. However, becausesuchemployeesareguaranteedper-manentemploymentduringtheirmandates, they become victims of dismissal by their companies, merely for having undertaken suchactions.
3.6. Collective bargaining
Bargainingaboutissuesrelatingtohealth andworkingconditionsisapriorityforall the unions that were studied.There have been various gains in benefits for profes-sional categories or by enterprises. In this typeofbargaining,changesintheworking environment and organization come into being,whileinnegotiationsbyprofessional categoriesthegainshavebeeninthefieldof rightsandregulations.
Oneoftheuniondirectorsinterviewed describedbargainingthattookplacewith the state telecommunications company andresultedintheshorteningoftelephone operators’ working day from eight to six hoursandtheinstallationofnoisesuppres-siondevicesonthetelephoneswitchboard. Anotheruniondirectordescribednegotia- tionsthatresultedinthecreationofanoc-cupationaldiseasesstudycommittee,made up by employers and employees, which had the function of developing projects to target reductions in the incidence of work-related diseases among the profes-sionalcategory.
All salary campaigns list workers’ healthissuesintheirclaims,andtheseare progressivelytakingonmoreimportancein bargaining,asreportedbytheuniondirec-torsinterviewed.Thisisespeciallysoduring periodsofeconomicstability,whenthereis notmuchfightingforsalaryreadjustments. Suchlistsofclaimsincludementionofthe lawsandstandardsthatareessentialforthe professionalcategory,suchastheconstitu-tionalrighttorefusetododangerouswork
and the Ministry of Labor’s norms that regulatedataprocessingwork.
3.7. Inter-institutional action on workers’ health
The unions studied maintain relations with other entities that act on workers’ health. As observed during the interviews andinthematerialcollected,inter-institu-tional relations regarding union action are extensive,andoneoftheconcernsintheseis todrawupjointpoliciesandactions.InSão Paulo,thereistheInter-institutionalForum forWorkers’Health,inwhichtheunionsare theleadingplayers,andthistakesonthefight for rights regarding workers’ health issues, especiallyagainsttheNationalSocialSecu-rityInstitute,thegovernmentagencythatis responsibleforsocialsecuritycompensations andsicknessbenefits.
Unions’satisfactionregardinginter-insti-tutionalactionvariesfromregiontoregion andfromuniontounion.Oneuniondirec-tor from Minas Gerais, when interviewed, describedthehardattitudeencounteredwhen theunionparticipatedinaninter-institutional forumwithpublicinstitutions:
“Iperceivethatwehavetoactmorestrongly with these organizations, because they have a strong inclination towards prioritizing the employer’sside.Theysaywhattheemployersare saying.Thatis,theycan’tmeettheclaimsbecause ofglobalizationorcompetition…”
AuniondirectorfromSãoPaulospoke aboutthisaction:
“Fromthemomentyoutakethedecisionto workataninter-institutionallevel,youhaveto workwiththesepeople.Forus,fromtheunion,it hasbeenabiglessonandisveryempowering,too. Wewentasfarasalockoutwiththepetrochemi-calindustryin1992andweconcludedthatitis worthworkingwiththesepeople...”
AnotheruniondirectorfromSãoPaulo, despitehisunion’spolicyofencouraginginter-institutionalaction,statedthatthepolicyis notbringingtheexpectedbenefitsinrelation toworkers’health.
3.8. Structures for action on workers’ health
Medicalcareforworkersisbeingtrans-ferredtothepublichealthsector.Sincethe endofthe1980s,thepublicsectorhasbeen establishing workers’ health programs that providesuchattention.
3.9. Influences on actions
Ininterviewsandinthematerialcol-lected,evidencehasbeensoughtregarding foreign influences on Brazilian unions’ actions on workers’ health. It was seen that the Italian workers’ model and the instrumentsproposedbyProf.AsaCristina Laurellhavehadaremarkableinfluenceon theBrazilianunionmovement.Thediffi-cultiesinapplyingthesewereconsideredin theinterviews,inparticularthoseresulting fromguaranteesofunionactionandwork organization, which are very different in the two countries. The Italian union influencewasalsoreferredtoinabulletin from the Chemicals and Petrochemicals UnionofBahia33andinaninterviewwith
auniondirector:
“ForçaSindicalisamemberoftheInter- nationalConfederationofFreeUnionOrga-nizations and, through Força Sindical, our unionparticipatesinalloftheinternational confederation’s activities concerning health issues,includingtheInternationalFederation of Metal IndustryWorkers. In October, we hadameetingwiththeFrenchForceOuvr-ière.Theywerehereandwehadaone-week coursewiththem.Itwasabouthealthissues. AcoursewiththeAmericanFederationofLa-bor/CongressofIndustrialOrganizationstook placeinWashington.Wehavehadcoursesin BoliviawithUnionGeneraldeTrabajadores and Comisiones Obreras, together with the SpanishHealthMinistry.Then,wehadthis
contacttoo.Inspiteofthefactthatwedonot haveanyrelationshipwiththeItalians,our material is all based on Italian things, too: non-delegated,homogeneousgrouprisk-maps. Ourmaterialisallalongtheselines,fromthe Italianproject.”
The Italian influence on Brazilian unions’actionsonhealthissueshadalarge contribution towards the founding of the National Institute for Health at Work, whichwasaresultfromthecollaboration between Central Única dosTrabalhadores and Confederazione Generali Italiana dei Lavoratori.VisitsbyBrazilianunionadvis-ers and directors to other countries have become more frequent, with the aim of gettingtoknowdifferentaspectsofinter-nationalunionaction.
CONCLUSIONS
Union action on workers’ health in Brazilisrestrictedtosomeunions,located mainly in the southern, southeastern and northeasternregionsofthecountry.Inspite ofthis,theunionsthatundertakeactions on health issues are those that represent professionalcategorieswithlargenumbers ofmembersandwhichhavegreateconomic andpoliticalimportance.Theseunionsare organizedaroundthemostdevelopedareas ofthecountry.Althoughsuchactionsarere-strictedtoonlyafewentities,theseunions’ characteristics give them wider scope and nationalimportance,thusamplifyingtheir impactonworkers’healthactionsdeveloped bygovernmentalandindustrialbodies,and alsohavingapositiveinfluenceonhealth-careprofessionals.
The recent changes in the health and safetyatworkregulations,therecognition
of professional diseases, the creation of workers’ health services and programs in theUnifiedHealthSystemandtheimprove- mentintheprofessionalactionsofspecial-ized services for safety and occupational medicine within industries, all basically resultfromunionaction.
Through analysis of the way in which unionactionhastakenplace,itcanbedem-onstratedthatthereiscommonalityinthe methodsofunionactioninthefieldofwork-ers’health.Onecomponentthatiscommon toallsuchactionsisthesearchfortechnical and political strengthening of all workers and their general and local representation, bymeansof:
a) Worker information, with the objective of creating critical awareness regarding thehealth/sickness-at-workprocess; b) Workermobilizationregardingaspectsof
work-healthrelationships;
c) Theeducationofunionactivistsregarding healthatwork.
Thetechnicalandpoliticalstrengthening ofunionshasabeneficialobjectiveincollective bargaining between employers and workers, andinter-institutionalactiononbehalfofwork- ers’rightsguaranteesandamplifiestheimprove-mentofhealthandworkingconditions.
TheItalianworker’smodelanditsinstru-ments,asdiscussedandpublishedespeciallyby Prof.AsaCristinaLaurell,hashadaremark-ableinfluenceonBrazilianunions’methods foractiononworkers’health,andthismodel has been transformed into regulations such as the obligation to draw up risk maps in all workplaces.The collaboration between CentralÚnicadosTrabalhadoresandConfe-derazioneGeneraliItalianadeiLavoratorihas reinforcedthisinfluence.
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RESUMO Açãodossindicatosbrasileirosnaproteçãodasaúdedotrabalhador
CONTEXTO: Váriosautoresenfatizamaimportânciadofortalecimentodotrabalhadoratravésdasorga-nizaçõessindicais,namelhoriadosprocessosdetrabalhoerelatamaaçãodecisivadomovimentosindical nastransformaçõesnocampodasaúdeetrabalho.
OBJETIVO:Descreverasformasqueossindicatosbrasileirosutilizamparaintervirnoprocessosaúde-doença etrabalho,identificandoaexistênciadeumamodalidadecomumdeatuaçãosindicalnaárea.
TIPODEESTUDO:Estudoqualitativo.
LOCAL:ProgramadePós-Graduação.DepartamentodeSaúdeAmbiental.FaculdadedeSaúdePública daUniversidadedeSãoPaulo–SãoPaulo–Brasil.
MÉTODO:Foramrealizadasentrevistascomtécnicosdesaúdedossindicatosediretoressindicais.Foram coletados documentos relacionados com a ação sindical na proteção da Saúde do Trabalhador e o materialanalisado.
RESULTADOS:NaaçãosindicalemSaúdedoTrabalhadorexistemaçõesarticuladasdenaturezatécnica epolíticaqueenvolvemmuitosaspectoseumaltograudecomplexidade.Paraqueaanálisesejamelhor, essesdiferentesaspectosdaaçãosindicalsãodivididosnascategoriastemáticasutilizadasparaclas-sificaromaterialcoletado.
DISCUSSÃO:AsaçõessindicaisvoltadasparaaSaúdedoTrabalhadornoBrasilestãorestritasaalguns sindicatos,localizadosprincipalmentenasregiõesSul,SudesteeNordestedoPaís.Apesardisso,os sindicatos que desenvolvem essas ações, são os que representam categorias numerosas, de grande importânciaeconômicaepolítica.
CONCLUSÕES:AsrecentesmudançasnalegislaçãodeSaúdeeSegurançanoTrabalho,oreconhecimento dasdoençasprofissionais,acriaçãodeprogramaseserviçosdeSaúdedoTrabalhadornoSistemaÚnico deSaúdeeamelhoriadaaçãoprofissionalnosServiçosEspecializadosemSegurançaeMedicinado Trabalhonasempresas,basicamenteresultamdessaatuação.Existeumamodalidadecomumdeação sindicalnaáreaeestapossuiumcomponentequeéabuscadofortalecimentotécnicoepolíticodostrab-alhadoresedasuarepresentaçãogeralelocal.Elatemumobjetivoqueébeneficiarosacordoscoletivos entrepatrõeseempregadoseaaçãointerinstitucionalemproldagarantiaeampliaçãodosdireitosdos trabalhadoresnamelhoriadascondiçõesdesaúdeetrabalho.
PALAVRAS-CHAVE:Saúdeocupacional.Medicinasocial.Sindicatosdetrabalhadores.Regulamentos.
AUTHORS INFORMATION Rodolpho Repullo Junior, MD, PhD. Adjunct Professor, De-partmentofCollectiveHealth,FaculdadedeMedicinade Jundiaí,Jundiaí,SãoPaulo,Brazil.
JorgedaRochaGomes,MD,PhD. ProfessorandChair,Depart-mentofEnvironmentalHealth,FaculdadedeSaúdePública, UniversidadedeSãoPaulo,SãoPaulo,Brazil
Addressforcorrespondence:
RodolphoRepulloJunior
DepartamentodeSaúdeColetiva FaculdadedeMedicinadeJundiaí R.FranciscoTelles,250 CaixaPostal1295
Jundiaí(SP)—Brasil—CEP13202-550 Tel.(+5511)9252-0453/(+5511)3107-8960 E-mail:[email protected]
Copyright©2005,AssociaçãoPaulistadeMedicina
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Sourcesoffunding:None
Conflictofinterest:None
Dateoffirstsubmission:December16,2003
Lastreceived:December22,2004
