We thank Taeger et al 1 for their comments on our manuscript that focus on a central question raised by our study,2 that is, ‘Is there a lung cancer risk in US coal miners?’. We disagree with the author's suggestion that emphasising the lung cancer excess in the abstract is inappropriate. We saw a positive and significant excess of lung cancer in our overall SMR and in the exposure-response analysis with coal mine dust. These effects were strongly significant in the last decade of follow-up. Although we did see an irregular exposure-response in categorical models, this analysis is far less powerful than the …