![[ Visit Client Website ]](images/banner.png)
Since April 2007, an epidemiological nexus has been a useful tool to minimize underreporting of occupational sickness. The system of administration for disability benefits presents if there is link between disease and work, by a statistic approach. The medical expert, who analyzes if the health problem was triggered or aggravated by work, has a possibility to accept or deny the epidemiological nexus. Considering this is a new enforcement mechanism this study aims to describe the prevalence of the negative on epidemiological nexus application by expert evaluations.
Methods
A cross sectional study took place in a Brazilian Social Security office in São Paulo, Brazil, between October/December 2010. A random sample of 86 medical forensic reports issued by medical experts was analyzed. The cases in which application of the epidemiological nexus is denied were classified as: worker reports that the disease has no relationship to work, not characterized as occupational disease by the expert and there isn´t specific occupational risks in the workplace.
Results
Of the sample, 60% had justification for not applying the epidemiologica nexus. In 63.3% of the time the insured reported that the injury would not have happened at work. It was considered that the complaint was not compatible with reported occupational injury in 28.6% of the cases. And the expert established that there is no evidence of occupational exposure in 8.2% of cases. In any sample there weren´t description of workplace evaluation or documentation related to the work environment.
Discussion
The epidemiological nexus enables to promote social justice in cases when the employer didn´t recognize sickness related to work conditions. Medical experts in Social Security should be trained in especific criterias and plausible justifications to accept or to deny the assigned correlation. It´s recommended evaluation tools of Occupational Medicine to bring more consistency in the causal nexus characterization.