Response to Bifulco Comments on Triassi et al. Environmental Pollution from Illegal Waste Disposal and Health Effects: A Reviewer on the “Triangle of Death”. Int. J. Environ. Res. Public Health 2015, 12, 1216–1236

We thank Bifulco [1] for his interest in reading our article and his time in writing his comments on our work [2]. Our response to his concerns are as follows: The diseases studies in the papers that we cited in our Review on the Triangle of Death, and also others we did not include because they did not meet the inclusion criteria (Scopus, etc.), have a long period of latency. Environmental exposure related diseases require a long time before a diagnosis occurs. Diagnosis is made when the diseases ascertained, but latency refers to the length of time it takes from being exposed until when the disease becomes apparent in a clinical examination. Latency can be as short as 10 years or as long as 50, but the average length of latency for the diseases we studied is about 20 years between exposure and diagnosis (average for malignant mesothelioma is 35 to 40 years between exposure and diagnosis). The application of genetics to disease susceptibility moves away from the clinic towards the population, that integrated with the observational methods of epidemiology can potentially support more effective public health measures.