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Author response to Dr Wise’s letter
  1. Lidia Casas1,2,3,4,
  2. Aina Espinosa2,3,4,5,
  3. Alícia Borràs-Santos2,3,4,
  4. José Jacobs6,
  5. Esmeralda Krop6,
  6. Dick Heederik6,
  7. Benoit Nemery1,
  8. Juha Pekkanen7,8,
  9. Anne Hyvärinen7,
  10. Martin Täubel7,
  11. Jan-Paul Zock2,3,4,9
  1. 1Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium
  2. 2Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
  3. 3CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
  4. 4University Pompeu Fabra (UPF), Barcelona, Spain
  5. 5Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
  6. 6Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
  7. 7Department of Health Protection, National Institute for Health and Welfare (THL), Kuopio, Finland
  8. 8Department of Public Health, University of Helsinki, Helsinki, Finland
  9. 9Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
  1. Correspondence to Lidia Casas, Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven 3000, Belgium; lidia.casasruiz{at}

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We welcome the opportunity to respond to the concerns of Dr Wise1 from the American Chemistry Council, regarding our report on the association between childhood infections and use of bleach at home.2

Dr Wise expresses disappointment with ‘design flaws’ and ‘the speculative nature of our conclusions’. We do not agree that our study was badly designed, and the limitations have been carefully considered and discussed in our original paper. We relied on questionnaires for both exposure and outcome, but this does not imply flawed results or bad study design. Obviously, future studies are needed with better exposure and outcome assessment to further address the causal …

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