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Competence at the workplace
  1. N Magnavita1,
  2. N Vanacore2
  1. 1Institute of Occupational Medicine, Catholic University School of Medicine, Rome, Italy
  2. 2Department of Neurological Sciences, “La Sapienza” University, Rome, Italy
  1. Correspondence to:
 Dr N Magnavita, Institute of Occupational Medicine, Largo Gemelli 8, 00168 Rome, Italy;

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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 …

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