this study examines the contribution of workers' health referral centers (cerest) to the reporting of severe work-related injuries and those involving exposure to biological materials in the brazilian national health reporting system (sinan), under the unified national health system (sus). the study used data from the formsus and sinan databases, aggregated for the cerest coverage areas. valid data were obtained for 125 cerest (23 state and 102 regional). a majority of the cerest were assessed as fully installed. the increase in the reporting of severe work-related accidents was greater when staffing was consistent with the demand, and when teams responded to external demands, including those of the media. for exposures to biological material, cerest with good physical installations, those that responded to media demands, and those with trained personnel in the sentinel network showed a higher increase in reporting. infrastructure, staff numbers and training, and responding to external demands are important for increasing notification of work-related accidents and should be prioritized in order to reduce the major underreporting of such accidents.