We thank the Journal for providing us the opportunity to respond to the letter from <a href="http://dx.doi.org/10.1002/ajim.22677"target="_blank">Goodman et al. [2017 Feb; 60(2):221-222]</a> regarding the conclusions of our mortality study among toluene diisocyanate (TDI)-exposed workers [Pinkerton et al., 2016 Aug; 59(8):630-643]. Goodman et al. conclude that <a href="http://dx.doi.org/10.1002/ajim.22622"target="_blank">our study</a> does not provide support for the carcinogenicity of TDI. We acknowledge that proof of a causal association between occupational exposure and cancer cannot be achieved by our study. Nonetheless, we contend that our findings add to a growing body of evidence of a causal association between TDI exposure and cancer and that dermal exposures could play an important role.
Lynne E. Pinkerton, MD, MPH, Industrywide Studies Branch, Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, 1090 Tusculum Ave, R-15, Cincinnati, OH 45226
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