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Under what circumstances could an exposure/disease association be causal without being biologically plausible?

Under what circumstances could an exposure/disease association be causal without being biologically plausible?

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Ans) Biological or social model exists to explain the association. Association does not conflict with current knowledge of natural history and biology of disease.
Many epidemiological studies have identified cause-effect relationships before biological mechanisms were identified.

- Biological Plausibility
The proposed mechanism should be make sense given what we already know about the agent, host and environment. CAVEAT just because we don't yet understand the biological mechanism does not mean that something is not causal.

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