The Brazilian public health system (SUS) has not been able to assure self-employed workers their universal right for health. These workers have neither the employment protection, nor the institutional support that is typical in the formal labor market. The present study aimed at analyzing the risks and health problems related to the artisanal fishermen's and shellfish pickers' work in order to contribute for the development of a workers' health policy toward the self-employed. It is a case study which adopts a qualitative methodology with ethnographic, ergonomic and health surveillance approaches. The study was conducted in artisanal fishing communities between 2005 and 2010. The results showed ergonomic overload caused by exposure to different risks; precarious living conditions; invisibility of accidents and occupational diseases, such as repetitive strain injuries; lack of actions concerning prevention and health care, and the relevance of traditional knowledge within the artisanal fisheries' labor organization. The Brazilian public health system and the National Occupational Health Network should provide both occupational health surveillance actions and occupational medical exams. These organizations should also contribute to increase awareness of occupational diseases, ensuring artisanal fishermen's and self-employed workers' right for health.
worker's health; artisanal fisherman; shellfish pickers; self-employed worker