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Letter commentary on: Lung cancer mortality in the French cohort of titanium dioxide workers: some aetiological insights
  1. John Andrew Tomenson
  1. Causation Ltd, Macclesfield SK11 7JN, UK
  1. Correspondence to Dr John Andrew Tomenson, Causation Ltd, Macclesfield SK11 7JN, UK; john_tomenson{at}

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Dear Editor,

Guseva Canu et al 1 examined exposure–response in 833 workers from one of two French plants included in a European cohort of over 14 000 male TiO2 workers.2 Dose–response was reported solely for the pooled European cohort by Boffetta et al,2 but was investigated for this small French group (see table 1).3

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Table 1

Relative risk (RR) (95% CI) of mortality from lung cancer for estimated cumulative exposure to respirable TiO2 dust

No adjustment for smoking was made in the original analyses, but little reliance can be placed on the multiple imputation results reported here. An implausible 43 (8.4%) of 512 workers with known smoking status were stated to be current smokers. Given that smoking status was only ascertained for 33 …

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  • Contributors JAT drafted the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests The author provides consultancy services to a range of customers including the Titanium Dioxide Manufacturers Association and other chemical industry groups. However, the opinions expressed in the letter are entirely those of the author.

  • Patient consent for publication Not required.

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

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