[Evolution of worker's health in the social security medical examination in Brazil]

In order to analyze the practice of the social security medical examination starting from the introduction of the worker's health paradigms, data was gathered on the granting of social security disability benefits to assess worker illness based on notification of work-related accidents in the cement industries of Rio de Janeiro. From 2007 to 2009 there was only one notification, which involved a worker handling toxic waste instead of the energy matrix. However, the analysis revealed sources and mechanisms of illness overlooked in the social security medical examination, which is still focused on the one-cause-only logic of occupational medicine. To achieve the worker's health paradigms, changes are required to alter the way of conducting the social security medical examination, by re-establishing partnerships, training human resources, adopting epidemiological indicators, as well as setting and assessing social security goals that transcend the mere granting of disability benefits.