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We appreciate the interest in our recent meta-analysis of occupational trichloroethylene (TCE) exposure and non-Hodgkin’s lymphoma (NHL) (Occup Environ Med 2007;64:352). Three criticisms were mentioned as being “serious limitations”: (1) that the alternative descriptions of the Group I occupational cohort studies (multiple industry vs aerospace, incidence vs mortality and Europe vs US studies) should have been characterised and discussed a priori; (2) that mortality and incidence data should not be combined in a meta-analysis; and (3) our interpretation that the epidemiological data are not supportive of a causal relation is wrong …
Competing interests: The authors have consulted for a number of private and governmental clients on health issues related to occupational and environmental TCE exposure.