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We read with great interest the letter by Cetintepe and Ilhan1 and commentary by Lytras2 in response to our study,3 and thank them for their detailed comments.
Cetintepe and Ilhan make several observations about our study population and methodology. They suggest that the demographic homogeneity of our study population may limit the generalisability of our conclusions. While a more demographically diverse population was not available to us in our single-centre study, data from a study of a US national sample of former coal miners4 demonstrate that our study population was representative of the US coal miner population. We also note that our findings on diffusion impairment among coal miners are consistent with those from studies of coal miners from Europe5 and East Asia.6 With regard to our exclusion of subjects with lesser coal …
Footnotes
Contributors All authors contributed to the letter.
Funding The originally published research was supported by grant AFCTG-20-102 from the Alpha Foundation for the Improvement of Mining Safety and Health.
Competing interests LHTG and RAC report preparing independent medical reviews for individuals with occupational lung disease.
Provenance and peer review Commissioned; internally peer reviewed.