title: Post-disaster physical symptoms of firefighters and police officers: role of types of exposure and post-traumatic stress symptoms.
abstract: OBJECTIVE
  To examine the relationships between exposure to the air disaster in Amsterdam and multiple physical symptoms among firefighters and police officers, and to explore the role of post-traumatic stress symptoms (PTSS) herein.
  
  
  METHODS
  Historic cohort study.
  
  
  METHODS
  On average 8.5 years post-disaster, exposed professional firefighters (N=334) and police officers (N=834) and their nonexposed colleagues (N=194 and N=634, respectively) completed questionnaires on disaster exposure and current symptoms. Logistic regression with adjustment for background characteristics was used to compare exposed and nonexposed workers. PTSS were added to these models, as was the interaction between exposure and PTSS, to explore potential mediating and modifying effects, respectively.
  
  
  RESULTS
  Exposed workers reported multiple physical symptoms significantly more often. Multiple physical symptoms seemed to have particularly affected the exposed firefighters who rescued people, and the exposed police officers who supported injured victims and workers, who were involved in the identification of or search for victims and human remains, who witnessed the immediate disaster scene or had a close one affected by the disaster. These exposure effects were essentially independent of PTSS, and no significant interactions between exposure and PTSS were found.
  
  
  CONCLUSIONS
  In conclusion, the excess in post-disaster multiple physical symptoms in exposed workers could not be attributed to PTSS.
authors.affiliation: EMGO Institute, Department of Public and Occupational Health, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, The Netherlands.
authors.forename: Pauline
authors.initials: P
authors.lastname: Slottje
authors.forename: Anke B
authors.initials: AB
authors.lastname: Witteveen
authors.forename: Jos W R
authors.initials: JW
authors.lastname: Twisk
authors.forename: Nynke
authors.initials: N
authors.lastname: Smidt
authors.forename: Anja C
authors.initials: AC
authors.lastname: Huizink
authors.forename: Willem
authors.initials: W
authors.lastname: van Mechelen
authors.forename: Tjabe
authors.initials: T
authors.lastname: Smid
mesh_terms: D000328:Adult; D005260:Female; D005390:Fires; D006304:Health Status; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D010809:Physical Fitness; D016495:Police; D018635:Rescue Work; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology*; D011795:Surveys and Questionnaires