Fatal work accidents in Palmas, Tocantins, Brazil: missed opportunities of information

Abstract Objective: to estimate the underreporting of fatal work accidents (FWA) in information systems of the Ministry of Health, State Secretariat of Public Security (SSP), Ministry of Labor and Social Security Secretariat, from 2007 to 2015, in Palmas, Tocantins. Methods: the data sources of the FWA cases were the Mortality Information System (SIM), the Hospital Information System of the Unified Health System (SIH-SUS), the Information System on Diseases of Compulsory Declaration (SINAN), the Annual Social Information Report (RAIS), the Information System of Communication of Work Accidents (SISCAT), police reports (PR), Cadaver Referrals (GEC) and Cadaveric Examination Reports (LEC). To calculate underreporting within each system, a single database was created with the records of all sources, eliminating repetitions. Results: 114 cases were identified. Under-reports identified were: SIM, 28.9%; SINAN, 44.7%; SSP, 55.3%; RAIS, 73.1%; SISCAT, 65.4%, for insured workers. Conclusion: the best performance in registry is from SIM. Extensive underreporting was observed in all other sources. Mortality records due to FWA are underestimated. Action to improve recording, especially at SIH-SUS, RAIS, SISCAT, and SSP, followed by SINAN and SIM, are required.