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Revista Brasileira de Medicina do Trabalho logoLink to Revista Brasileira de Medicina do Trabalho
. 2024 Nov 14;22(3):e20231215. doi: 10.47626/1679-4435-2023-1215

Work accidents registered in the Brazilian social security system between 2016 and 2020: a descriptive analysis

Acidentes de trabalho registrados pela Previdência Social de 2016 a 2020: análise descritiva

Daniel Osti de Barros 1,Correspondence address:, Leopoldo Silva Oliveira 1, Josierton Cruz Bezerra 2, Eduardo Costa Sá 3
PMCID: PMC11595383  PMID: 39606761

Abstract

Introduction

More than 500,000 work accidents were registered each year in Brazil from 2016 to 2018, representing more than BRL 300 million in expenditures.

Objectives

To analyze the prevalence of work accidents in Brazil between 2016 and 2020 according to geographic region, age group, and sex and analyze the prevalence according to the cause and economic activity type.

Methods

Descriptive, cross-sectional study based on data from the Social Security Statistics Yearbook.

Results

The work accident rate between 2016 and 2019 was lower than in previous years. The Southern and Southeastern regions had the highest prevalence of work accidents (11.7/1,000 workers and 9.10/1,000 workers, respectively), while the Northeastern region had the lowest rate (6.22/1,000 workers). There was a greater reduction in work accidents among men than women. The most prevalent types of work accidents involved injuries, poisoning, and other external causes, in addition to diseases of the musculoskeletal system and connective tissue.

Conclusions

Record keeping about work accidents must be improved, given that informal workers are not considered in social security data. More accurate data can also help increase prevention efforts, and can lead to more effective occupational health and safety policies to further reduce the work accident rate.

Keywords: occupational accidents, work accidents in Brazil, occupational health, social security, prevalence

INTRODUCTION

To characterize work accidents (WA), it is necessary to understand the profile of the involved population, considering their location, race, age, education level, and other variables. The causes and consequences of WA must also be investigated. Brazilian data collected between 2008 and 2014 indicated a reduction in WA compared to previous years,1 with the highest prevalence occurring in the Southeastern and Southern regions of the country among men and among workers aged 20-49 years.2 According to data from the Brazilian social security system, more than 600,000 WA were registered each year between 2016 and 2018, at an annual cost > BRL 300 million.3 The population most affected by WA is Black men between 18 and 39 years of age. People with a higher education level had a lower frequency of WA. Therefore, the sample profile for WA is characterized by workers with a lower education who reside in Southeastern Brazil.4

Between 2008 and 2014, injuries, poisonings, and other external causes were the main causes of WA registered in the Brazilian social security system (70.8% of cases), followed by work-related musculoskeletal disorders (16%). The processing industry and commerce, including trade and repair of motor vehicles and motorcycles, were the two main economic activities in which WA occurred, representing 31.7 and 13.1% of cases, respectively.2

According to the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), determining the association between disease groups and economic activities is essential for a better understanding of WA. Studies have also shown the importance of understanding the relationship between WA and the political economy for a better understanding of worker health.5

Although these numbers are important for a better understanding of the national WA scenario, data from the Brazilian Institute of Geography and Statistics’ National Health Survey must also be considered. Compared to official records from the former Ministry of Social Security, 7 times more WA have been registered in the National Social Security Institute database. This difference suggests that the number of cases is underreported, as well as the existence of a significant number of informal workers.6 Thus, it is important to understand the prevalence of WA registered in the Brazilian social security system between 2016 and 2020 according to cause, economic activity, and sociodemographic data. Understanding the prevalence of WA can stimulate public and private sector policies, enabling a better allocation of financial and human resources to prevent WA.

The objective of this study was to analyze the prevalence of WA registered in the Brazilian social security system between 2016 and 2020 according to geographic region, age group, and sex, and to determine the prevalence according to cause and type of economic activity.

METHODS

ETHICAL ASPECTS

According to National Health Council Resolution 510/2016, since this study is based on information from publicly accessible databases, which, in themselves, do not allow personal identification, under the terms of Law 12,527, the present study was not submitted to an institutional research ethics committee or the National Research Ethics Commission.

STUDY TYPE, LOCATION, PERIOD, AND SAMPLE

This cross-sectional, descriptive study investigated the Anuário Estatístico da Previdência Social (Social Security Statistical Yearbook) from 2016 to 2020, which included the initial implementation of a new WA reporting methodology called the Nexo Técnico Epidemiológico Previdenciário (Social Security Epidemiological Technical Nexus), which began in April 2006.

STUDY PROTOCOL

Data were collected from the social security platform and the 2016-2020 statistics yearbooks3 on March 7, 2022. The collected data were copied and transferred to Excel spreadsheets, in which the prevalence of WA was calculated as the number of new cases registered, divided by the number of workers registered in the system in that location and year, multiplied by 1,000 workers. The data for the numerator were collected from the social security website, while the denominator was derived from annual consolidated Ministry of Labor and Social Security data from 2016 to 2020.3

Prevalences were calculated for the entire country and according to region, sex, and age group (≤ 19 years, 20-49 years, 50-64 years, and ≥ 65 years). Data ignored in each of these categories were not considered in the present study. The prevalence of WA was calculated between 2016 and 2020 according to ICD-10 disease group designation. The causes of WA and the major types of economic activity described in the Classificação Nacional de Atividades Econômicas (National Classification of Economic Activities) 2.0 were selected due to the impossibility of determining the function of the affected worker, since such data is not provided by the social security system. The top 5 economic activities and the ICD-10 designations with the highest WA prevalence were used in the study. Prevalence was calculated by dividing the number of registered WA in each ICD-10 disease group and each economic activity subgroup. This number was then divided by the total number of WA registered in the social security system from 2016 to 2020 and multiplied by 100.

RESULTS

Each year from 2016 to 2019, more than 500,000 WA were registered in the Brazilian social security system. The number decreased significantly in 2020 to 445,814 (Figure 1 and Table 1). Nevertheless, there was also an overall downward trend in prevalence between 2016 and 2020, with a 21.85% reduction: from 0.88/1,000 workers in 2016 to 0.69/1,000 workers in 2020 (Table 2). The total number of workers registered annually in the social security system fluctuated between 67 and 65 million, reaching a maximum of 69.4 million in 2019 and a minimum of 64.9 million in 2020 - a decrease of 4.5 million workers (Figure 2 and Table 1).

Figure 1.

Figure 1

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Distribution of workers and work accidents registered in the Brazilian social security system from 2016 to 2020.

Table 1.

Distribution of work accidents and workers registered in the Brazilian social security system according to sex, geographic region, and age group, 2016-2020

Ecological unit of analysis 2016 2017 2018 2019 2020
Brazil
Accidents 585,626 557,626 576,951 586,857 445,814
Workers 66,652,055 65,232,942 66,339,030 69,481,633 64,924,484
Sex
Male
Accidents 389,111 369,701 380,559 386,601 200,111
Workers 36,016,133 35,198,302 35,751,348 37,412,300 35,182,047
Female
Accidents 196,493 187,914 196,370 198,804 149,595
Workers 30,540,444 29,946,829 30,422,800 31,855,717 29,538,703
Region
South
Accidents 131,193 126,179 132,481 135,672 102,669
Workers 11,849,611 11,743,533 12,036,461 12,642,713 11,896,386
Southeast
Accidents 314,129 296,406 306,508 314,550 237,653
Workers 34,534,688 33,845,212 34,401,717 35,825,539 33,387,164
Midwest
Accidents 44,523 44,387 46,654 47,608 38,263
Workers 5,653,660 5,447,337 5,569,006 5,880,766 5,449,614
Northeast
Accidents 70,306 66,082 65,880 65,011 47,970
Workers 11,299,512 10,980,768 11,100,369 11,590,950 10,721,059
North
Accidents 25,475 24,572 25,428 24,016 19,286
Workers 3,166,123 3,104,318 3,115,273 3,274,139 3,117,355
Age range (years)
≤ 19
Male
Accidents 10,076 8,546 9,373 8,697 6,770
Workers 1,232,356 1,082,701 1,062,823 1,050,266 920,196
Female
Accidents 3,450 3,060 3,123 2,938 1,941
Workers 995,008 881,549 871,061 863,486 743,506
20-49
Male
Accidents 319,516 303,872 313,668 318,631 245,591
Workers 27,761,790 26,950,026 27,332,100 28,594,804 26,763,325
Female
Accidents 162,041 153,594 161,036 163,822 125,435
Workers 23,528,589 22,969,498 23,258,483 24,339,734 22,404,253
50-64
Male
Accidents 56,859 54,684 54,783 56,373 40,767
Workers 6,291,928 6,397,425 6,536,659 6,899,157 6,633,253
Female
Accidents 30,069 30,238 30,997 32,063 21,579
Workers 5,528,645 5,623,527 5,775,016 6,091,044 5,817,998
≥ 65
Male
Accidents 2,659 2,591 2,733 2,894 1,782
Workers 729,933 767,976 818,437 867,962 865,151
Female
Accidents 931 1,021 1,212 1,286 639
Workers 434,129 471,649 517,307 561,569 572,905
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Source: Brazilian Social Security Statistics Yearbook.

Table 2.

Distribution of work accidents (per 1,000 workers) registered in the Brazilian social security system according to geographic region, sex, and age group from 2016 to 2020

Ecological unit of analysis 2016 2017 2018 2019 2020 % reduction
Brazil 0.88 0.85 0.87 0.84 0.69 21.85
Region
South 11.07 10.74 11.01 10.73 8.63 22.05
Southeast 9.10 8.76 8.91 8.78 7.12 21.75
Midwest 7.88 8.15 8.38 8.10 7.02 10.84
Northeast 6.22 6.02 5.93 5.61 4.47 28.09
North 8.05 7.92 8.16 7.34 6.19 23.11
Sex
Male 10.80 10.50 10.64 10.33 5.69 47.35
Female 6.43 6.27 6.45 6.24 5.06 21.29
Age range (years)
≤ 19
Male 8.18 7.89 8.82 8.28 7.36 10.02
Female 3.47 3.47 3.59 3.40 2.61 24.71
Total 6.72 5.91 6.46 6.08 5.24 22.02
20-49
Male 11.51 11.28 11.48 11.14 9.18 20.27
Female 6.89 6.69 6.92 6.73 5.60 18.71
Total 9.39 9.16 9.38 9.11 7.55 19.60
50-64
Male 9.04 8.55 8.38 8.17 6.15 31.99
Female 5.44 5.38 5.37 5.26 3.71 31.80
Total 7.35 7.06 6.97 6.81 5.01 31.84
≥ 65
Male 3.64 3.37 3.34 3.33 2.06 43.46
Female 2.14 2.16 2.34 2.29 1.12 47.99
Total 3.08 2.91 2.95 2.92 1.68 45.45
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Source: Brazilian Social Security Statistics Yearbook.

Figure 2.

Figure 2

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Distribution of the total number of workers registered in the Brazilian social security system from 2016 to 2020.

The Southeast, the country’s main economic region, had the second highest prevalence of WA, surpassed only by the Southern region. In 2016, the prevalence was 9.10/1,000 workers and 11.07/1,000 workers in the Southeastern and Southern regions, respectively. There was a downward trend in both regions, reaching 7.12/1,000 workers in the Southeastern region and 8.63/1,000 workers in the Southern region in 2020: reductions of 21.75 and 22.05%, respectively. The Northeastern region had the greatest reduction in WA prevalence, followed by the Northern region. In 2016, the prevalence was 6.22/1,000 workers in the Northeastern region and 8.05/1,000 workers in the Northern region. In 2020, these numbers fell to 4.47/1,000 workers in the Northeastern region and 6.19/1,000 workers in the Northern region, resulting in reductions of 28.09% and 23.11% in these regions, respectively, during this period.

The Midwestern region had the smallest reduction in WA between 2016 and 2020, decreasing from 7.88/1,000 workers to 7.02/1,000 workers (-10.84%)(Tables 1 and 2).

The prevalence of WA decreased in both sexes, although the reduction was more significant among men, reducing from 10.8/1,000 workers to 5.69/1,000 workers (47.35%). Among women, the prevalence decreased from 6.43/1,000 workers to 5.06/1,000 workers (-21.29%).

Regarding age groups, the greatest reduction in WA prevalence occurred among workers aged 50-64 years and those aged ≥ 65 years, with similar reductions in both sexes. In the 50-64 age group, there was a reduction of 31.99% for men and 31.8% for women, while in the ≥ 65 group there was a reduction of 43.46% for men and 47.99% for women. In the 20-49 age group, both sexes had a similar reduction, from 11.51/1,000 workers to 9.18/1,000 workers among men (-20.27%) and 6.98/1,000 workers to 5.60/1,000 workers among women (-18.7%).

In the ≤ 19 age group, the prevalence among women decreased from 3.47/1,000 workers to 2.61/1,000 workers (-24.71%), while among men it decreased from 8.18/1,000 workers to 7.36/1,000 workers (-10.02%) (Table 2).

The five main causes of WA in absolute numbers were injuries, fractures, and trauma to the wrist and hands, back pain, dislocations, sprains, and strains in the joints and ligaments of the foot and ankle (Figure 3 and Table 3).

Figure 3.

Figure 3

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Main causes of work accidents registered in the Brazilian social security system according to the tenth revision of the International Statistical Classification of Diseases and Related Health Problems, 2016-2020.

Table 3.

Main causes of work accidents registered in the Brazilian social security system, according to the tenth revision of the International Statistical Classification of Diseases and Related Health Problems, 2016 to 2020

Disease group n % Cause of the accident n % in this group of causes
Injuries, poisonings, and other external causes 1,695,947 62.04 Wrist and hand injuries 266,400 15.71
Fractures of the wrist and hand 167,579 9.88
Dislocations, sprains, and strains of the joints and ligaments of the foot and ankle 128,314 7.57
Superficial trauma to the wrist and hand 120,082 7.08
Leg (including ankle) fractures 91,449 5.39
Osteomuscular and connective tissue diseases 265,824 9.72 Back pain 98,149 36.92
Shoulder injuries 60,965 22.93
Other joint disorders not classified elsewhere 32,749 12.32
Synovitis and tenosynovitis 27,187 10.23
Other soft tissue disorders not classified elsewhere 15,451 5.81
Factors that influence health status and contact with health services 108,500 3.97 Contact with and exposure to communicable diseases 59,991 55.29
Examination and observation for other reasons 13,621 12.55
General examination and investigation of people without complaints or reported diagnosis 11,952 11.02
Occupational exposure to risk factors 2,817 2.60
Mental and behavioral disorders 65,839 2.41 Reactions to severe stress and adjustment disorders 39,474 59.96
Other anxiety disorders 15,622 23.73
Depressive episodes 10,743 16.32
Infectious and parasitic diseases 20,448 0.75 Unspecified viral diseases 20,448 100.00
Diseases of the nervous system 20,346 0.74 Mononeuropathies of the upper limbs 20,346 100.00
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Source: Brazilian Social Security Statistics Yearbook.

According to social security system records, around 62% of WA were classified as injuries, poisonings, and other external causes. Injuries and fractures to the hands and wrists were prominent in this group (Table 3). Approximately 10% of WA were associated with diseases of the musculoskeletal system and connective tissue, especially back pain (Table 3). At a lower prevalence, around 4% of WA were due to factors that influence health status and contact with health services, especially exposure to communicable diseases. Mental and behavioral disorders comprised 2.41% of WA cases, mainly severe reactions to stress and adjustment disorders (Table 3), while 0.75% were due to infectious and parasitic diseases, with unspecified viral diseases being the most common type.

Approximately 26% of WA occurred in processing industries (Figure 4 and Table 4), among which the slaughter of pigs, poultry, and other small animals stood out (Table 4). A total of 4.16% of WA cases occurred in the commerce (including the repair of motor vehicles and motorcycles) sector, with the retail trade of general merchandise, hypermarkets and supermarkets being the most affected segment.

Figure 4.

Figure 4

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Distribution of work accidents registered in the Brazilian social security system according to the main economic activities listed in the National Classification of Economic Activities 2.0, 2016-2020.

Table 4.

Distribution of work accidents registered in the Brazilian social security system according to the main categories in the National Classification of Economic Activities 2.0, 2016-2020

Activity n % Most frequent occupations n % in this activity
Processing industries 704,708 25.78 Slaughter of pigs, poultry, and other small animals 56,963 8.08
Slaughter of livestock, except pigs 35,244 5.00
Raw sugar manufacture 29,085 4.13
Manufacture of plastic artifacts not previously specified 17,768 2.52
Manufacture of furniture, predominantly wood 16,313 2.31
Commerce, repair of motor vehicles and motorcycles 386,964 14.16 Retail trade of general merchandise, food products - hypermarkets and supermarkets 108,169 27.95
Retail trade of hardware, wood, and construction materials 25,856 6.68
Sale of motor vehicle parts and accessories 18,739 4.84
Retail trade of pharmaceutical products for human and veterinary use 12,599 3.26
Wholesale beverage trade 12,508 3.23
Health and social services 375,658 13.74 Hospital care activities 283,266 75.41
Outpatient care activities performed by doctors and dentists 23,664 6.30
Diagnostic and complementary therapy activities 22,840 6.08
Health care activities not previously specified 13,368 3.56
Health management support activities 13,053 3.47
Transportation, storage, and mail 198,293 7.25 Highway freight transportation 63,676 32.11
Postal activities 50,763 25.60
Public municipal transportation of passengers with a fixed itinerary 25,524 12.87
Storage 7,679 3.87
Metro rail passenger transport 6,372 3.21
Construction 151,409 554 Building construction 46,554 30.75
Construction for the generation and distribution of electrical energy and telecommunications 19,554 12.91
Incorporation of real estate projects 15,477 10.22
Construction of highways and railways 13,552 8.95
Electrical installations 9,317 6.15
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Source: Brazilian Social Security Statistics Yearbook.

The prevalence of WA in the field of health and social services was around 14%, with hospital care being the most common source of WA (Table 4). It is worth noting that from 2019 to 2020 the only increase in WA occurred in the health and social services sector.

A total of 7.25% of the WA occurred in the transportation, storage, and postal activities sector, especially highway freight transportation (Table 4); while 5.54% occurred in the construction sector, especially building construction.

DISCUSSION

The data indicated a general downward trend in WA registered in the Brazilian social security system (Figure 1). This trend was observed in all regions of the country, including both sexes and all age groups. These results are in line with similar findings from previous studies indicating a reduction in WA in Brazil during specific periods, such as from 1998 to 2008,7 from 2008 to 2014,2 and from 2008 to 2013.1

However, in 2019 the number of workers increased, although this increase was not accompanied by a proportional increase in WA (Table 1 and Figures 1 and 2). One explanation for this could be the increase in the tertiary sector, especially commerce, which entails a low risk of WA. The impact of the 2019 pension reform may also have had some effect, although further studies are needed for greater understanding of this event. Although the total number of WA is still high, corporate preventive measures and public policies aimed at worker health and safety have proven effective in reducing the total number of WA. However, it is important to highlight the persistence of underreporting, whether due to omission by responsible parties or to limited reporting about informal workers.6

According to our results, the main economic regions of the country also had the highest prevalence of WA: the Southeastern region had the highest absolute number of cases, while the Southern region had the highest rate. This is in line with other studies that identified a higher prevalence of deaths due to WA in the state of Minas Gerais between 1996 and 2006, which was above the national average.8 Similar values and trends were found by Bezerra et al.,2 who attributed this situation not only to the greater economic development of these regions, resulting in a greater risk of WA, but also to greater WA notification in these regions, leading to a higher reported prevalence than in other regions. Economically developed regions also have more processing industries, more commerce (including repair of motor vehicles and motorcycles), and more hospital care activities, which, together, account for > 50% of WA cases (Table 3).

We also analyzed the difference in WA between men and women, finding that, despite a reduction in both sexes, men were more affected than women between 2016 to 2019, which is in line other studies.2,9,10 This trend has been observed in other countries with similar cultures and economies to Brazil, such as Ecuador and Colombia, where the prevalence of WA was higher among men, although significant sex differences were not found in Chile.11 However, in Brazil in 2020, the WA prevalence between the sexes was quite close. This might be explained by the health measures adopted to combat the COVID-19 pandemic, which restructured the national work environment, keeping only essential economic activities in operation, especially health-related activities.

This more equitable prevalence may be attributable to the greater number of health workers, especially the hospital sector.12 This explanation is supported by other studies, such as one conducted at a teaching hospital in Curitiba, in Southern Brazil, which found that more than 80% of nurses were women.13 Furthermore, a review found an increase in COVID-19 infection among female workers, a phenomenon observed in 70% of the reviewed articles, especially those from China, the United States, and Italy.14

Regarding WA and age groups, there was a higher prevalence among workers aged 20 to 49 years, both men and women. This is due to the fact that this age group represents the bulk of the economically active population, totaling more than 49 million workers (Table 1) who are, consequently, more exposed to occupational risk.2 These results are in agreement with other studies.8,15

The highest prevalence of WA in our results was associated with injuries, poisonings, and other external causes. This covers a variety of injuries such as bruises, fractures, dislocations, and trauma. This is explained by the fact that these injuries are most often linked to the work environment, and can occur while working or when commuting to and from work. These circumstances are less prone to underreporting, as they are directly related to work activity and are more likely to result in serious injuries or fatal accidents, physically disabling workers and interrupting the production process.

Diseases of the musculoskeletal system and connective tissue were the second most frequent type. This category is directly related to work environment conditions, including infrastructure and ergonomic factors. The connection between these diseases and the work environment raises the issue of ergonomics as a potential cause of work-related health problems, although this issue is sometimes neglected.2 Among diseases of the musculoskeletal system and connective tissue, back pain stood out as the main cause of WA, representing approximately 37% of cases within this group.

The third most frequent disease group was factors that influence health status and contact with health services, representing 3.97% of WA between 2016 and 2020, an increase over 2008-2014 (2.19%).2 It is important to highlight that the main cause in this group is contact with and exposure to communicable diseases, contributing to 55.29% of WA. There is growing concern about reporting these types of WA due to the risk they pose to workers, especially workers frequently exposed to biological materials.2,16 A related group, which ranked fifth among the main causes of WA, was infectious and parasitic diseases. In this group, the only recorded cause is unspecified viral diseases, corresponding to 100% of the WA in this group. It is important to note that all records of this cause occurred in the same year that COVID-19 infection began, which reinforces the importance of reporting infectious diseases in the workplace.

The fourth most frequent disease group was mental and behavioral disorders, which, although representing a small percentage in relation to the other groups, is important due to its connection with contemporary work organization.17 The work process, often marked by a demand for increasing results, leads to a series of challenges, including work overload, social breakdown, precarious labor relations, increased risk of wage losses, and even symbolic violence, contributing to a relationship between work and depression.2,17,18 Thus, in this group, reactions to severe stress and adjustment disorders are the most frequent causes of WA, followed by other anxiety disorders and depressive episodes. To minimize these effects on worker quality of life, mental health and worker health policies must be discussed and implemented, increasing prevention measures and surveillance, while reducing the harmful effects of work conditions.

Regarding the economic activities analyzed in this study, the high prevalence of WA in the processing industry sector stands out. It is notable that these industries, which are mainly concentrated in the Southern and Southeastern regions of Brazil, also had the highest number of WA in this study. A previous study that analyzed Social Security Statistics Yearbooks data from the end of the first decade and the beginning of the second decade of the 21st century2 also found that processing industries had the highest prevalence of WA in Brazil. In addition, an Ecuadorian study found that processing industries had the highest prevalence of WA, approximately 26% of all WA.19

Within this sector, the frequency of WA in occupations related to the slaughter of pigs, poultry and other small animals should be highlighted. The high rate of accidents in these occupations highlights the precarious working conditions to which slaughterhouse employees are exposed. This includes intense work pace, the lack of ergonomic equipment design, and the high employee turnover rate.20

It is interesting to note that raw sugar manufacturing, which in previous years had the highest rate of WA in the processing industry,2 experienced a significant reduction (> 30%) in WA in relation to total cases during the study period. This reduction could be attributed to the mechanization of sugarcane harvesting, which has intensified in recent years. This process has reduced the number of workers involved in this occupation.21 Thus, it has reduced the physical, chemical, and mechanical risks for workers, although it has not completely eliminated the biological and chemical risks. In addition, new risks have emerged, such as noise and vibrations, which have impacted worker health.22 It is worth noting that the mechanization process in the sugar and alcohol sector has reduced WA by both reducing the risks associated with manual harvesting and by reducing the number of workers employed in the sector.

Regarding commerce, including the repair of motor vehicles and motorcycles, it is notable that this sector had the second highest prevalence of WA in this study. It is interesting that, although the total number of WA in this field reduced during the study period, it remained stable between 2008 and 2014.2 The WA rate in the transportation, storage, and postal activities sector was also stable between 2008 and 2014.2

The third highest prevalence of WA in this study was health and social services, especially hospital care activities. It is important to highlight the importance of activities related to human health, due to the possibility of WA related to exposure to biological agents.23 According to the literature, the majority of these accidents are related to the handling of sharp materials, such as needles and ampoules, which represent a great risk for health care professionals, especially those involved in direct patient care.24,25

Another factor that could contribute to a higher prevalence of WA in this field of activity is related to the emergence of COVID-19 infection in 2020, both globally and in Brazil. The fight against COVID-19 resulted in work overload and required both psychological and physical skills from health care professionals.26,27 It is important to note that the only increase in WA during the study period occurred in the health and social services sector between 2019 and 2020. This percentage increased from 8.71% between 2008 and 20142 to 13.74% between 2016 and 2020, which further highlights the importance of analyzing this sector of activity.

Activities related to the construction sector, especially building construction, had the fifth highest prevalence of WA in this study. The reduction in WA in this field of activity (5.4% between 2016 and 2020 vs. 7.93% between 2008 and 2014)2 might be attributable to the crisis in the Brazilian real estate sector between 2015 and 2017, leading to fewer active companies and professionals in construction.28 Furthermore, the large number of work absences in this sector during the COVID-19 pandemic in 202029 may also have contributed to this decrease. Studies in other countries have found higher rates of WA than ours, for example, Colombia (28%), Ecuador (17.47%), Argentina (15%) and Spain (14%) between 2016 and 202119, as well as between 2013 and 2017.30

STUDY LIMITATIONS

Since the present study only examined data from the Brazilian social security system, it does not consider unregistered (informal) workers. The possibility of underreporting data must be considered, even in official records. However, the social security database is an important source of data widely used in various scientific studies.

CONCLUSIONS

Although Brazil had a high prevalence of WA between 2016 and 2020, there was a trend towards reduction in overall numbers, which was more pronounced in the Southern and Southeastern regions. A downward trend was also observed among men, among workers aged 20 to 49 years, in the processing industry, and in health and social services sectors, especially occupations related to hospital care, which presented the highest absolute number of WA during the study period. It is important to note that notifications increased in this sector in 2020, which may have been related to the COVID-19 pandemic.

The COVID-19 pandemic also had a significant impact on WA related to infectious and parasitic diseases, making this disease group one of the most common types of WA in this study. The increased reporting of this type reflects greater awareness and concern about workplace safety in relation to infectious diseases in recent years.

Overall, it is crucial to improve both the quantity and quality of WA records to avoid underreporting. This will lead to a more accurate database and, consequently, allow the development of more effective prevention policies and occupational health and safety policies to reduce the number of WA.

Footnotes

Conflicts of interest: None

Financial support: None

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