Editor—It is with a sense of “deja-vu” that I read the paper by Divine et al 1on the update of the Texaco mortality study. I was particularly struck by their conclusions about lung cancer among the maintenance trades. Although large numbers of mesotheliomas were found among these workers, the authors concluded that there was no increased risk of lung cancer because the SMRs were <100. This conclusion is similar to that of Tsaiet al 2 who, despite the findings of excess mortality from mesothelioma and increased lung cancer mortality among maintenance workers, in comparison with operators at another Texas refinery, concluded that asbestos exposures were “not sufficient to produce lung cancer”. It is also similar to that of Raabe et al 3 who stated that, although they had found an increase in lung cancer mortality among maintenance craft workers, the “temporal patterns of these SMRs and findings from other studies of similar cohorts provided evidence that the excesses were most likely to be unrelated to work in maintenance craft jobs”.

Workers in the petroleum refinery industry, when grouped together, have had a lower risk of lung cancer than members of the general population.4 This has been found …