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Response to: ‘Pleural mesothelioma and occupational and non-occupational asbestos exposure: a case-control study with quantitative risk assessment’ by Ferrante et al
  1. Gary M Marsh1,2,
  2. Stacey M Benson2
  1. 1Center for Occupational Biostatistics & Epidemiology, Graduate School of Public Health University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  2. 2Cardno ChemRisk, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Gary M Marsh, Cardno ChemRisk, 20 Stanwix St. Pittsburgh, PA 15222, USA; gary.marsh{at}

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We read with interest the 2016 paper by Ferrante et al,1 who evaluated the relationship between occupational and non-occupational asbestos exposures and the risk of pleural malignant mesothelioma (PMM) among workers and residents in the Casale Monferrato area of Italy, the site of a former asbestos cement factory. We also read the subsequent letter from Boffetta,2 who identified many problematic methodological issues with the Ferrante et al1 study, most notably: limited detail regarding exposure estimation methods, lack of reproducibility, inconsistencies in findings and potential study biases. In a response, Ferrante et al3 challenged but did not resolve all issues raised by Boffetta.2 For example, Ferrante et al3 countered Boffetta's2 criticism about limited exposure estimation detail by citing a paper not referenced in their original publication.1 Furthermore, …

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