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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 al 1 study, most notably: limited detail regarding exposure estimation methods, lack of reproducibility, inconsistencies in findings and potential study biases. In a response, Ferrante et al 3 challenged but did not resolve all issues raised by Boffetta.2 For example, Ferrante et al 3 countered Boffetta's2 criticism about limited exposure estimation detail by citing a paper not referenced in their original publication.1 Furthermore, …
Competing interests GMM has acted as an expert witness for defence attorneys in criminal trials on asbestos-related cancers. SB and GMM are employed by Cardno ChemRisk, a consulting firm that provides scientific advice to the government, corporations, law firms and various scientific/professional organisations. Cardno ChemRisk has been engaged by Schellenberg Wittmer to provide general consulting and expert advice on scientific matters, as well as litigation support. This paper was prepared and written exclusively by the authors, without comment by the counsel. It is likely that this work will be relied on in litigation. GMM was also on the Asbestos Panel of the Scientific Advisory Board of the US EPA. The preparation of the paper, including conduct of the literature review, review of the individual papers, integration and synthesis of the findings, the conclusions drawn and recommendations made are the exclusive professional work product of the authors and may not necessarily be those of their employer or the financial sponsor of the review.
Provenance and peer review Not commissioned; internally peer reviewed.