INTRODUCTION: The Regional Occupational Health Reference Center (Cerest) opened in Campinas, São Paulo State, Brazil, in 1986, as a union demand. OBJECTIVE: To analyse the trajectory of Cerest-Campinas comparing the challenges identified in a 2001 study with the 2012 reality. METHODS: Secondary analysis was carried out comparing the current moment with data from 2001. For content analysis, the authors recorded Cerest workers' reflections and testimonies in a field notebook. RESULTS: Although there are structural limitations concerning Surveillance, especially regarding marginalization of the Occupational Health Policy, there has been progress in Health Care. Neverthless, the obstacles faced in 2001 are greater nowadays. Difficulties in management and financing coupled with municipal administration problems caused a crisis culminating in a movement "In defence of Cerest" (2011). As in the previous study, a relevant fact was the degree of personal involvement of Cerest workers, as they, in spite of all difficulties, kept resisting. CONCLUSION: Cerest survives amidst contradictions, and challenges remain. The threat of its closing called back the commitment of historical actors (professionals and unions) involved, suggesting possibilities, which, depending on rearrangement of political institutional powers, can consolidate workers' health policy, in local and nationwide levels.
occupational health; occupational health services; health policy; Brazilian Unified Health System