The Integrated, participatory, and territorialized health surveillance in contexts of exposure to agrotoxics in Brazil

Abstract

The National Epidemiological Surveillance and Health Surveillance System in Brazil was established during the dictatorship and during the validity of AI-5, under a format guided by the CDC/USA, without taking into account the socio-environmental determination of health-disease processes. Although the 1988 Constitution allowed conceptual advances in health issues, which made it possible to implement specific surveillance of Waterborne and Foodborne Diseases, Workers' Health and, later, Environmental Surveillance, these systems were little different in their operational mode from traditional Health and Epidemiological Surveillance. Problems of public health concern continued to have approaches that were not very protective of health, with market interests being prioritized, allowing agrotoxics and other substances that are harmful to health. The structured model has proven wasteful and ineffective, hiding the harmful effects and harm caused by exposure to agrotoxics, obscuring the work of the professionals involved and limiting the public policies provided for by the principles and guidelines of the SUS. Given that it plays a central role in the National Policy on Workers' Health, the limitations resulting from current surveillance practices in the country need to be highlighted, so that it is possible to think of new ways to effectively address workers' health. This essay aims to contextualize this legislation in the current Brazilian situation and propose ways to develop other ways of conducting surveillance, consisting of participatory, democratic, integrated and territorialized actions and deliberative processes, in fact effective in protecting, preventing and caring for health and the environment.