Letters Section Editor: Jody W. Zylke, MD, Senior Editor.
Author Affiliations: New York City Department of Health and Mental Hygiene, Long Island City, New York (firstname.lastname@example.org).
In Reply: We were careful to note in our report that the short follow-up time and lack of occupational exposure data for workers such as firefighters limited our ability to fully assess cancer risks in the Registry cohort. Thus, we agree with Dr Nasseri's statement that there is still not enough information to irrefutably determine the carcinogenicity of the September 11 terrorist attack.
Firefighters made up only 13.6% of the rescue/recovery worker participants and only 5.3% of the entire cohort, and exclusion of the firefighters made little difference in our findings. As with most observational cohort studies drawn from voluntary participants, there is no ideal reference population outside the cohort itself.
Stellman SD, Li J. Exposure on September 11, 2001, and Cancer Risk—Reply. JAMA. 2013;309(13):1344-1345. doi:10.1001/jama.2013.2249