Research into the medium and long term health consequences of disaster has mushroomed in recent years. The majority of this research has focused on direct “victims”, that is, members of the general population who have been directly exposed to disaster. Emergency workers and other occupational groups have been less studied, possibly due to the assumption that adverse health effects will be minimal for them. The study by Huizink et al in this issue¹ is therefore a particularly welcome addition to the disaster literature; the authors investigate an occupational cohort who performed rescue work during, what turned out to be, one of the strangest man-made disasters of recent times—the 1992 Amsterdam (or Bijlmermeer) Air Disaster.

Huizink et al invited a cohort of police officers and fire-fighters to participate in the study; over half the participants had done disaster related work at the time of the Amsterdam Air Disaster and were considered “exposed”. Unfortunately recruitment took place eight years after the disaster, meaning that exposure assessment had to be both highly retrospective and self-reported. Despite this limitation the authors are able to convincingly show that the prevalence of somatic symptoms (including fatigue) is increased among police officers and fire-fighters who did disaster related work compared to those that did not. This increase in symptoms is general and not limited to specific organ systems, a finding which is congruent with studies of civilian populations exposed to disaster.² Blood and urine tests were …