This article aims to analyze the extent to which Brazil's public sector has made progress in institutionalizing an integral and participative model for the healthcare of government workers, based on the principles of universality, integrality and workers' participation. Based on documents produced by the Rio de Janeiro Permanent Forum on Workers' Health, the paper analyses the process of implantation of the Integrated Public Workers' Healthcare Sub-System (SIASS) in the municipality of Rio de Janeiro over the period 2009-2016, based on the historical institutionalism. Although it was conceived as an integrated system referenced to the principles of workers' health, as from 2013 an inflexion was observed in this Subsystem, in the direction of a conservative model of occupational health, such as had been traditional and hegemonic in labor relations in Brazil.
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