Abstract
Introduction:
throughout 40 years studies have emphasized the contamination of the city of Santo Amaro by high levels of lead and other metals. Epidemiological studies have revealed high concentrations of lead and cadmium in blood samples of fishermen, workers and in environmental compartments. In 2010, a guideline was established to rule the development of assistance actions, monitoring and health surveillance of the exposed population.
Objective:
to identify the difficulties and progress in the implementation of the strategies proposed by the guideline under the perspective of the managers and healthcare professionals.
Methods:
qualitative study, using documental research and semi-structured interviews.
Results:
the lack of commitment and the change of healthcare managers, the lack of infrastructure, the staff turnover and the non-compliance of agreements between the local and state administration have contributed to the non-execution of assistance actions and health surveillance of the exposed population.
Conclusion:
the effective implementation of the proposed actions requires unit in the conception of what would be the best strategy for the healthcare, a bigger commitment of the instances concerned with it, and the involvement of the national health service users in order to recognize the relevance of the guideline for the improvement of the population quality of life.
Keywords:
health impact assessment; primary healthcare; environmental health surveillance; lead; environmental pollutants