Statistics from Altmetric.com
We will address the comments offered by Mundt and Boffetta1 on our manuscript describing findings from an update of mortality among California diatomaceous earth (DE) workers.2 We regard the sustained dose–response trends for lung cancer and non-malignant respiratory disease (NMRD) (tables 3 and 4, respectively) as the most important findings regarding risks associated with crystalline silica. The reduction of overall mortality for these outcomes, indicated by reduced standardised mortality ratios (SMR), is more likely to be a ‘depletion of susceptibles’ phenomenon than a ‘balancing out’ effect. We agree that a healthy worker effect is an unlikely explanation for the reduced lung cancer SMR. However, support for the …
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.