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Pauline Slottje, MSc; Joost A. Bijlsma, MD, PhD; Nynke Smidt, PhD; Jos W. R. Twisk, PhD; Anja C. Huizink, PhD; Willem F. Lems, MD, PhD; Ingrid van Hoogstraten, PhD; Anke B. Witteveen, MSc; Willem van Mechelen, MD, PhD; Tjabe Smid, PhD

Arch Intern Med. 2005;165:2278-2285.

Background  In the aftermath of a cargo aircraft crash in Amsterdam in 1992, indications of autoimmune disorders appeared in some of the affected population.

Methods  This epidemiologic study sought to determine the possible long-term autoimmune health effects of the aircraft disaster on professional assistance workers. Exposed professional firefighters (n = 334) and police officers (n = 834) who performed at least 1 disaster-related task and hangar workers who sorted and investigated the wreckage (n = 241) were compared with reference groups of nonexposed colleagues who did not perform any disaster-related tasks (n = 194, n = 634, and n = 104, respectively). Data were collected a mean of 8.5 years after the disaster. Questionnaires were used to assess disaster-related tasks and 11 autoimmune-like symptoms. All serum samples were tested for the presence of antinuclear antibodies, rheumatoid factor, and antineutrophil cytoplasmic and anticardiolipin antibodies.

Results  Compared with nonexposed colleagues, exposed workers reported significantly more autoimmune-like symptoms. They reported the following symptoms significantly more often: tingling sensations, myalgia, loss of strength, easily fatigued, and a feeling of sand in the eyes (all groups); infection proneness (firefighters); skin abnormalities and nocturnal transpiration (police officers and hangar workers); and vasculitis-like symptoms and Raynaud discoloring (police officers). In contrast, we found no significant difference between exposed and nonexposed workers in autoantibody prevalence.

Conclusion  Occupational exposure to the aircraft disaster resulted in an excess of long-term self-reported autoimmune-like symptoms in exposed professional assistance workers, but there was no difference between exposed and nonexposed workers in the prevalence of autoantibodies.

Author Affiliations: Institute for Research in Extramural Medicine (Mss Slottje and Witteveen and Drs Bijlsma, Smidt, Twisk, Huizink, van Mechelen, and Smid), and Departments of Public and Occupational Health (Ms Slottje, Drs Smidt, Huizink, van Mechelen, and Smid), Clinical Epidemiology and Biostatistics (Dr Twisk), Rheumatology (Dr Lems), Pathology, Medical Immunology Laboratory (Dr van Hoogstraten), and Medical Psychology (Ms Witteveen), VU University Medical Center, Amsterdam; and KLM Health Services, Schiphol (Dr Smid), the Netherlands.

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