Work allows individuals to satisfy their social and economic needs, produce goods and services for individual and collective well-being, and develop a meaningful existence ¹. Furthermore, it acts as a social determinant that influences the health of workers. The health of the working population is not only determined by lifestyle and personal behaviors but is also related to work conditions and the risks associated with work activities ^2,3. Hence, understanding the interrelationship between work and workers' health is necessary.

Work-related accidents can lead to alterations in physiological functions, bodily structures, or disability ^4,5. They also have implications in terms of quality-of-life costs and are associated with economic and productivity lo sees ^6,7. Morbidity and mortality related to the workplace not only result in suffering for the worker but also for their immediate family. Moreover, it can influence the well-being and health of each family member ⁶. Therefore, it is imperative to investigate the family's situation to comprehend the implications of work accidents and take preventive measures to avoid exacerbating the situation.

In Colombia, the General System of Occupational Risks (hereinafter referred to as GSORL) focuses on occupational health ⁸. The system was implemented through Law 100 of 1993 ⁹, which established the General System of Comprehensive Social Security (GSISS) based on general regimes in health, pensions, occupational risks, and complementary social services.

The GSORL encompasses procedures, regulations, and entities aimed at preventing, protecting, and attending to the affiliated working population from the effects of accidents and illnesses arising out of or in connection with work ¹⁰. Occupational health, conceived both as an object of study and as an applied technique within the system, seeks to achieve the maximum possible well-being of workers, both in the performance of their duties and in the consequences that these may generate at different levels ¹¹.

To achieve this purpose, occupational health must be addressed through three pillars: the obligation to prevent, workers' right to protection, and an assurance system with a focus on occupational health ^8,12. Based on this approach, the adverse consequences of work accidents must be countered to protect and guarantee workers' occupational health ¹³.

To address the consequences arising from a work accident within the GSORL, protective mechanisms have been established, including: medical, surgical, therapeutic, and pharmaceutical assistance, hospitalization services, dental care, medication supply, auxiliary diagnostic services, treatment, physical and vocational rehabilitation ¹⁴; economic benefits such as temporary medical incapacity subsidy payments ¹⁰, compensation for loss of earning capacity, disability pension when the loss equals or exceeds 50% ⁹, survivor's pension or pension substitution for beneficiaries ⁹; and procedural manuals for comprehensive rehabilitation and occupational reintegration ^15,16.

Comprehensive rehabilitation comprises a set of social, familial, psychological, therapeutic, educational, and training actions, of limited time, articulated, defined, and led by a multidisciplinary and interdisciplinary team, involving the human being as an active subject of their own process, the family, the work and social community, in achieving the proposed objectives, aimed at achieving changes in the worker and their environment, towards social reintegration, the development of satisfactory occupational activity, and a dignified life ^15,17.

The recognition of the aforementioned healthcare and economic benefits derived from injuries and sequelae from accidents is a right that, in turn, is an essential part of decent work ^12,18. These benefits seek to guarantee and protect the right to occupational health. Likewise, occupational health, as a branch of public health, must be safeguarded ¹².

Addressing work-related accidents becomes even more relevant considering the figures from the International Labour Organization (hereinafter ILO) ⁹. According to the ILO, 2.78 million workers lose their lives each year due to work accidents and illnesses, while 374 million suffer non-fatal work accidents, representing a public health problem ²⁰. In the case of Colombia, during the period 1994 - 2022, 11,019,937 accidents qualified as work-related were recorded in the system ²¹.

In this context, the present study aims to contribute to the occupational health of the working population by understanding participants' experiences following work accidents within the framework of the GSORL in Colombia. The purpose is to identify the barriers they face and areas for improvement, in order to ensure and protect workers' right to comprehensive rehabilitation or adequate care for the consequences resulting from the accident.

The study adopted a qualitative approach ²², focusing on understanding social and cultural phenomena. Meanings, perspectives, and experiences of the research participants were explored. Additionally, a hermeneutic-comprehensive study ²³ was conducted, through which the experiences of the participants in relation to the object of study were interpreted and understood.

As a data collection instrument, semi-structured interviews were used ²⁴. Furthermore, document review was employed as a technique to explore, collect, select, and analyze information present in documents related to the research topic ²².

The results are presented structured into the following categories of analysis:

a) Injuries resulting from workplace accidents: In the context of this study, an injury is defined as the harm to health experienced by a worker as a consequence or on the occasion of their work, after being exposed to one or more occupational risk factors ¹².

b) Sequelae of injuries caused by workplace accidents: This term refers to the medium or long-term repercussions on the health and well-being of workers who have suffered injuries. These sequelae can manifest at the physical, emotional, and psychological levels.

c) Consequences: This aspect refers to the effects that workers perceive as resulting from the workplace accident. These consequences encompass economic, emotional, psychological, occupational, and familial aspects.

d) Benefits received from the GSORL, both healthcare and economic: These refer to the medical assistance or financial support received by the worker as a consequence of the workplace accident.

Additionally, the analysis categories are presented through graphs. The analysis is displayed in terms of rootedness (G), which refers to the frequency of mentions of a theme, and density (D), representing the number of times a theme is related to others ²⁶.

The relationship between health and work is a dynamic phenomenon influenced by social determinants ^27,30. Work, by conferring dignity upon individuals, intertwines with health, contributing to well-being at both individual and collective levels ^1,19. Additionally, the socioeconomic development of humanity is conditioned by the health status of its workforce ²⁰. This linkage requires holistic strategies and approaches to maintain harmony between both.

Therefore, it is imperative to understand the implications of a work accident, both for workers and their families. Likewise, understanding the assistance provided by actors within the GSRL and determining if they are focused on comprehensive rehabilitation is crucial. The absence of a comprehensive rehabilitation approach results in an increase in medically diagnosed work-related conditions, which have a high morbidity rate, affecting individuals in their productive years ²⁰.

Moreover, within the framework of designing public policies related to comprehensive rehabilitation and managing corresponding services, understanding the expectations, meanings, perspectives, and experiences related to work accidents is fundamental. This is crucial for formulating interventions coherent with the needs of the working population and their families.

In this context, the interview results provide insight into the implications of work accidents for the interviewed working population and their families. Initially, according to the injuries reported by the workers, they resulted in sequels that directly affected the well-being of both the workers themselves and their families.

Despite these experiences, workers reported not receiving a comprehensive and suitable response to their needs in terms of medical care, economic, labor, social, or family aspects. Additionally, they express that, although they received initial functional medical care or periodic or one-time sums of money for the accident, these were not sufficient to protect and guarantee their comprehensive rehabilitation. Also, economic detriment is perceived as an effect that emerges after the accident, which aligns with other studies that have analyzed the same phenomenon ^6,7.

The findings demonstrate the relationships between physical, emotional, psychological, and labor components that emerge after a work accident. It is noted that healthcare processes lack comprehensiveness and present access barriers such as difficulty accessing health services, denial of responsibility by the GSRL, or bureaucratic procedures, hindering comprehensive and timely care.

The interview results are in line with other studies indicating that rehabilitation-related interventions are not adequately managed and are provided in a fragmented and incomplete manner, without involving the family, community, and environment ²⁸. Moreover, they focus on isolated therapeutic activities addressing deficits in functions and bodily structures, more related to clinical diagnosis.

The results could be rooted in the lack of sufficient comprehensive rehabilitation services within the GSRL ²⁹, resulting in workers not obtaining a comprehensive process addressing the individual and their diagnosis from a biopsychosocial perspective and other factors that may condition their social and occupational integration ³⁰.

Comprehensive rehabilitation within the GSRL protects the right to occupational health, ensuring that occupationally injured workers have access to necessary mechanisms for their recovery and systemic and biopsychosocial inclusion ²⁸. The WHO has recognized the importance of occupational health in protecting workers' health and has promoted the implementation of policies and programs for the prevention and rehabilitation of workers injured by work-related causes ¹⁷.

Comprehensive rehabilitation for workers with work-related injuries is an essential component to ensure the protection of occupational health and guarantee the human right to health ¹⁸. Therefore, it is imperative that all actors within the Colombian GSRL actively engage and assume responsibility in realizing the comprehensive rehabilitation model.

Occupational health in Colombia as an essential element of the fundamental right to health is inherent to the individual, and therefore, they have the right to rehabilitation and social integration ¹⁸. However, tension persists between health as a fundamental human right and its realization, as the processes and strategies used for the provision of health services, even for the GSRL, present access barriers and obstacles in the recognition and payment of economic benefits ³¹.

Following a work accident, when necessary, mechanisms aimed at comprehensive rehabilitation should be implemented. This involves adopting measures of a social, familial, psychological, therapeutic, educational, and formative nature, which should be of short duration and precisely coordinated. These measures should be supervised by a multidisciplinary team of experts encompassing various disciplines. It is crucial to actively involve the injured worker as the primary agent of their own recovery, as well as their family and the labor and social community.

Concrete goals should be established that lead to transformations both in the injured individual and their environment, with the cardinal objective of facilitating their social reintegration, achieving meaningful employment, and leading a dignified life. This would require the participation and collaboration of experts in different fields to ensure multidisciplinary and holistic care for affected workers. Therefore, it is imperative for all actors within the system to actively engage and assume responsibility in the process.

The absence of efficient and effective mechanisms for comprehensive rehabilitation following a work accident for the working population affiliated with the GSRL highlights the lack of protection and guarantee of effective enjoyment of workers' occupational health.