Health of subsistence fishermen and challenges for Occupational Health Surveillance.

There are approximately a million subsistence fishermen in Brazil whose activities expose them to severe occupational hazards without adequate health protection. This article conducts an analysis of working conditions and health risks faced by subsistence fishermen and outlines challenges to the implementation of Occupational Health Surveillance (VISAT) actions. The methodology is based on qualitative analysis of risks and working conditions through observation and interviews, and diagnosis of occupational illnesses with clinical evaluation. Mobile teams conducted eight years of activities together with fishing communities throughout the state of Bahia. The results revealed the challenge of surveying a traditional self-employed category with relative management autonomy. Fishermen face precarious living conditions without access to occupational health services. They are exposed to thirty work-related illnesses without protection, diagnosis, treatment and social security coverage. The conclusion reached is that there is a need for intersectorial VISAT action to reduce excessive working hours, organization of the Unified Health System (SUS) for acknowledgement of occupational illnesses and guaranteeing social security rights through actions focused on health education.