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October 3, 1986

Keeping in Trim: Nailed Doc Docks Nails-Reply

Author Affiliations

National Board of Occupational Safety and Health Solna, Sweden

JAMA. 1986;256(13):1727. doi:10.1001/jama.1986.03380130055024

In Reply.—  Dr Divine and Mr Amanollahi, representing the Texaco Company, have objections to our conclusions on ethylene oxide and very definite opinions on alternative conclusions.They say that we "overlooked the lack of leukemia cases and overall mortality for workers in groups A and B at plant 3." The results from groups A and B are available in our original report to the Swedish Work Environment Fund,1 and the expected number for leukemia (International Classification of Diseases, codes 204 through 207) in group A was 0.04 and in group B, 0.02; ie, cases could only have been expected if ethylene oxide had outstanding carcinogen properties at very low levels. The statistical power of the study by Morgan et al2 to detect an increased risk of leukemia was not strong, according to the authors themselves.We think there were strong reasons for aggregating the three different Swedish plants