title: Symptom attribution after a plane crash: comparison between self-reported symptoms and GP records.
abstract: BACKGROUND
  On 4 October 1992, an El Al Boeing 747-F cargo aeroplane crashed on two apartment buildings in Amsterdam. Thirty-nine residents on the ground and the four crew members of the plane died. In the years after, a gradually increasing number of people attributed physical signs and symptoms to their presence at the disaster scene.
  
  
  OBJECTIVE
  To investigate the consistency between patients' symptoms attributed to the crash and GPs' diagnoses and perception of the association with the crash.
  
  
  METHODS
  Comparison between self-reported symptoms to a call centre and GPs' medical records on onset and type of symptoms, diagnoses, and GPs' perception of association with the disaster, assessed by questionnaire.
  
  
  METHODS
  Consenting patients (n = 621) contacting the call centre and their GPs.
  
  
  METHODS
  Patients were interviewed by the call centre staff and interview data were recorded on a database. Questionnaires were sent to the consenting patients' GPs, requesting their opinions on whether or not their patients' symptoms were attributable to the effects of disaster. Baseline differences and differences in reported symptoms between interviewed patients and their GP records were tested using the chi2 test.
  
  
  RESULTS
  The 553 responders reported on average 4.3 symptoms to the call centre. The majority of these symptoms (74%) were reported to the GP. Of the ten most commonly reported symptoms, fatigue, skin complaints, feeling anxious or nervous, dyspnoea, and backache featured in 80% of symptoms reported to the GP. One out of four symptoms was either reported to the GP before the disaster took place, or six or more years after (1998/1999, during a period of much media attention). Depression (7%), post-traumatic stress disorder (PTSD) (5%) and eczema (5%) were most frequently diagnosed by GPs. They related 6% of all reported symptoms to the disaster.
  
  
  CONCLUSIONS
  Most of the symptoms attributed to a disaster by patients have been reported to their GP, who related only a small proportion of these to the disaster.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht. ge.donker@inter.nl.net
authors.forename: G A
authors.initials: GA
authors.lastname: Donker
authors.forename: C J
authors.initials: CJ
authors.lastname: Yzermans
authors.forename: P
authors.initials: P
authors.lastname: Spreeuwenberg
authors.forename: J
authors.initials: J
authors.lastname: van der Zee
mesh_terms: D000060:Accidents, Aviation / Q000523:psychology*; D001291:Attitude of Health Personnel; D005194:Family Practice; D006801:Humans; D008499:Medical Records; D009426:Netherlands; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology*