Letter to the Editor: Egilman et. al.'s Misrepresentation of the Fordyce et al. (2019) Vermont Talc Miners and Millers Cohort Study Update.

W e deplore the tone of the Egilman et al letter questioning our (Fordyce et al) scientific integrity. We also take strong exception to what appear to be intentional misrepresentations of our paper. For example, Egilman et al state, ‘‘Fordyce’s et al study report [sic] 2 mesothelioma cases in a cohort of 427 workers.’’ We went to great lengths to find every case of mesothelioma in this cohort of workers. We found a single case over the entire period of observation, from 1930 through 2012. Egilman et al count a second case based on an article by Lamm and Starr, which was not published in a peer-reviewed journal and provided no information on the single case of mesothelioma that they claimed to have found. We were unable to verify this claim after an exhaustive search of the death certificates of workers in the expanded cohort of Vermont talc workers, as described in our paper. It is simply incorrect to say that we reported two cases of mesothelioma in this cohort, a false claim that Egilman et al repeat at least three times in their letter. All of the calculations in the Egilman et al letter based on two mesothelioma deaths are, therefore, incorrect. It is also incorrect to allege that we stated that the workers in the cohort had no occupational exposure to asbestos. We did not state this, and it is not true: the