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Worker Health Surveillance is a continuous and systematic process of gathering, analysis and dissemination of data on work-related events, focused on planning and implementation of measures to health promotion, prevention of risks, diseases and harms and also professional rehabilitation. Requires integration of actions and services from healthcare system to ensure comprehensive healthcare workers. Thus, this study aimed to analyse the implementation of worker health surveillance actions in Sao Carlos, Brazil.Methods qualitative study, performed in two steps:analysis of documents and policies related to health care workers,semi-structured interviews with managers and policy makers that works in health care system and has (or should have) interface with health care worker surveillance.Data collected were analysing through thematic analysis. This study was approved by research ethical committee and all ethical issues were respected.Analysis of documents and policies show the existence of a National Comprehensive Workers Health Care (Renast), which proposes the articulation of healthcare actions and sectors, in the federal, state and regional levels. Such actions should be developed in the healthcare network, guided by Nacional Policy of Workers Health. Although national policies are well structured and defined, its implementation still meets barriers and challenges, mainly at the local level. Health managers and policy makers also suffer with this reality, showing difficulties to understand their role in the health network and to comprehend the worker health surveillance as a whole.The health care services cannot implement worker health surveillance due disarticulation among governmental agencies, actions and professionals involved in the health network. As a result, we can see the invisibility of worker health surveillance in the health system, area that still remains treated as a specialty of occupational health/medicine, in a fragmented and disconnected way.