Literature review


How to cite: Junior NSO, Miziara ID, Silva-Junior JS. Work accidents due to depression in Brazil (2003-2021). Persp Med Legal Pericia Med. 2024; 9: e240206

Submitted 12/17/2023
Accepted 02/26/2024

The authors inform there is no conflict of interest.


Nilton da Silva Oliveira Junior

Ivan Dieb Miziara

Joao Silvestre Silva-Junior


INTRODUCTION: Occupational accidents (OA) can occur during work activities, leading to bodily injuries, functional disturbances, or even loss of work capacity (1). Among the types of occupational accidents, we can mention those that a) occur at the workplace and/or during working hours; b) those that happen during the commute between home and work; c) and work-related diseases resulting from exposure to working conditions (1). When there is suspicion or confirmation of an occupational accident, it is necessary to issue the Work Accident Communication (WAC), which will be presented to the medical examination if the request for incapacity benefits due to absence exceeding fifteen days is necessary (1). Depression affects a significant portion of the world population, approximately 4.5%, and about 3.8% of the population of the Americas (2). It is characterized by symptoms such as depressed mood, anhedonia, feeling of fatigue, difficulty concentrating and low self-esteem, as well as feelings of guilt and worthlessness, and may also present sleep and appetite disorders (3-5). OBJECTIVES: Present the quantity of work-related accidents reported in Brazil due to depression between 2003 and 2021. MATERIALS AND METHODS: An ecological study was conducted using public data from the Statistical Yearbook of Work Accidents of the National Social Security Institute – INSS (6). Records of work accidents diagnosed with depression (ICD-10 F32 and F33) (5) were analyzed, stratified by different types of notification: “Typical-With WAC,” “Commute-With WAC,” “Work-Related Disease-With WAC,” and “Without WAC.” RESULTS AND DISCUSSION: Regarding the total number of work accidents associated with mental disorders, the year 2010 showed the highest proportion (3.50%), while the year 2005 recorded the lowest (0.76%). Regarding cases of depression, the annual average of work accidents was 3880 (standard deviation – SD 1651), corresponding to 25.04% (SD 7.85) of all mental and behavioral disorders in the analyzed period. The year 2008 presented the highest number of cases (6206), while 2006 recorded the lowest (461). The average of “Typical-With WAC” accidents was 6.32%, and for the “Commute-With WAC” category, it was 1.15% of depression-related cases. The average of “Work-Related Disease-With WAC” cases was 21 (SD 9), i.e., 1.15% of the total. On the other hand, the average of “Work-Related Disease-Without WAC” cases was 427 (SD 105), corresponding to 17.23% of cases. It is important to mention that during the medical examination for incapacity benefits application at the INSS, the Federal Medical Examiner can establish the social security technical nexus. This nexus can be individual, professional, or work-related, and the Epidemiological Social Security Technical Nexus – ESTN (7). Annex C of Decree No. 3,048/99 (8) includes the relationship between ICD-10 diagnoses (F30-F39) (5) and various economic activities (National Classification of Economic Activities – CNAE). Thus, it was observed that most work accidents due to depression occurred in cases of workers incapacitated for work, where there was no prior issuance of the WAC, but the accident nature was established by the medical examination. Typical work accidents and commute-related accidents involving depression may likely be technical filling errors of the WAC by the notifier due to possible failure in distinguishing between the concepts of work accident and work-related disease. The Brazilian justice system has already recognized work as a co-cause for the development of depression in some cases (9). CONCLUSION: Until the year 2006, work-related accidents related to depression were predominantly classified in the “Work-Related Disease-With WAC” category. From the year 2007 onwards, most of these accidents were characterized as “Without WAC,” meaning there was no opening of the Work Accident Communication (WAC). It is important that official data reflect the reality of the problem and analyze the reason for depression notifications as work or commute accidents, aiming to conduct training to avoid errors in filling out the WAC. Prevention measures for depression at primary, secondary, and tertiary levels should be part of companies’ work routines to maintain an environment conducive to workers’ mental health.

Depressive Disorder, Occupational Health, Social Security, Sick Leave, Occupational Accidents Registry.

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