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The discussion opened by Bertazzi1 is worth integrating with practical considerations. Until 1996 every physician in Italy had licence to practice health surveillance in the workplace; differences of competence between physicians were obviously present, and this undoubtedly lead to inequalities in workers’ safety and health levels.
In 1996 we observed a case of methyl bromide (CH3Br) induced toxic encephalopathy which was not recognised for a long period.
This patient was a 44 year old man with no significant past medical history. When he was 31 years old, he began working for a firm specialising in agricultural pest control. On his fourth season at this workplace, an accidental leakage from the compressed gas cylinder splashed CH3Br on to him, causing dermal burns …