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Healthy worker effects explain differences in internal and external comparisons in a rubber industry cohort study
  1. Mira Hidajat1,
  2. Damien Martin McElvenny2,
  3. Peter Ritchie2,
  4. Andrew Darnton3,
  5. William Mueller2,
  6. Martie van Tongeren4,
  7. Raymond M Agius4,
  8. John W Cherrie2,
  9. Frank de Vocht1
  1. 1 Population Health Sciences, University of Bristol, Bristol, UK
  2. 2 Institute of Occupational Medicine, Edinburgh, UK
  3. 3 Statistics and Epidemiology Unit, Health and Safety Executive Bootle Headquarters, Bootle, Sefton, UK
  4. 4 Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
  1. Correspondence to Dr Frank de Vocht, Population Health Sciences, University of Bristol, Bristol, UK; frank.devocht{at}

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In his letter, Professor Sorahan1 poses an important question about our paper,2 namely, whether the results indicate that occupational exposures to agents such as rubber dust, rubber fumes and nitrosamines in the rubber industry are associated with increased risk of mortality from cancers of the bladder, lung, stomach, oesophagus, prostate, larynx, brain, pancreas, liver, and lymphatic and haematopoietic tissue. Sorahan argues that causation does not seem to be warranted since results from …

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  • Contributors All authors agreed on the final draft of this letter.

  • Funding This study was funded by Cancer Research UK (C29425/A16521).

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

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