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Authors's response: Pleural mesothelioma and occupational and non-occupational asbestos exposure: a case–control study with quantitative risk assessment.
  1. Daniela Ferrante1,
  2. Dario Mirabelli2,3,
  3. Sara Tunesi1,
  4. Benedetto Terracini2,3,
  5. Corrado Magnani1,3
  1. 1Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, CPO Piemonte and University of Piemonte Orientale, Novara, Italy
  2. 2Unit of Cancer Epidemiology, CPO Piemonte and University of Turin, Turin, Italy
  3. 3Interdepartmental Centre G Scansetti for Studies on Asbestos and other Toxic Particulates, University of Turin, Turin, Italy
  1. Correspondence to Daniela Ferrante, Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, CPO Piemonte and University “Amedeo Avogadro” of Piemonte Orientale, V Solaroli 17, Novara 28100, Italy; daniela.ferrante{at}

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The criticisms by Boffetta1 give us the opportunity to provide more details on the methods and results of our study.2

First, the proportion of proxy respondents among controls was 7.2% (table 1) and not 93% as erroneously indicated by Boffetta. As expected, the exposure–response trend was steeper for direct interviews that provided more detailed information (see online supplementary table S3).

Casale Monferrato inhabitants are aware of asbestos-related cancer risks. However, this applies to the entire community, not only to cases, therefore it is an unproven assumption that local awareness explains our study results because of participation and recall biases. On the contrary, if exposed controls selectively entered the study because of their motivation, our findings would be biased towards the null. After study publication, we investigated demographic and social characteristics of respondents and non-respondents, observing no differences (paper in preparation). Our findings are neither isolated nor unexpected, but consistent with our previous studies on mesothelioma risk in the area, making biases an even less likely explanation.3 ,4

Exposure assessment methods were described in detail2 and were a development of largely used methods.5–7 Cornerstones were the detailed reconstruction of occupational, residential and familial life, and the blind …

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  • Funding The Casale case–control study was supported by a grant from Regione Piemonte, Ricerca Sanitaria Finalizzata 2004 (to CM) and by the Regione Piemonte, Ricerca Scientifica Applicata 2003 (to DM and CM). Analyses for the present study were supported by the Italian National Institute of Health—ISS, “Progetto Amianto” (to CM).

  • Competing interests DM and CM acted as expert witnesses for the public prosecutor in criminal trials on asbestos-related cancers.

  • Patient consent All participating subjects received written detailed information on the study, and signed consent forms for the interview and the processing of sensitive personal data.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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