Bofetta and La Vecchia1, in their commentary, state that ‘The paper by Gilham et al, published in Occupational and Environmental Medicine, is important for a number of methodological and substantive reasons...’.2 In fact, there are methodological and substantive flaws in the paper that call into question the study results and authors' conclusions.2
The authors rely on occupational history as a key point of reference in asbestos exposure assessment. Lifetime occupational history was obtained through telephone interviews of patients with malignant mesothelioma and from general population and lung cancer controls. The implication is that these interviews were conducted directly with study subjects. However, the authors state that informed consent for postmortem sample analysis was obtained from 77% of patients with mesothelioma ‘and their next of kin’ and do not indicate if there were different rates of primary versus next-of-kin sources of the occupational history...
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