[The cares and anxiety of those involved in the Bijlmermeer aviation disaster did not diminish following the medical investigations].

On October 4, 1992 a cargo jet crashed in the Bijlmermeer district in Amsterdam, the Netherlands, killing 43 people and making hundreds homeless. Many years of confusion and prolonged media attention followed, including public debates and even a Parliamentary Inquiry as to the causes, exposure to various chemical, physical and biological risk factors, and related diseases. Two comprehensive large-scale medical investigations were carried out: a comparative epidemiological study analysing the long-term effects in involved and uninvolved care providers, and an individual medical examination of both residents and care providers with medical or psychological complaints. Later, an effects study was added analysing the effects of both medical investigations on the feelings of anxiety and the attribution of symptoms among the people involved. The epidemiological study revealed more physical and mental symptoms among the involved care providers. Blood, urine and saliva tests, however, revealed no differences. Although the studywas carried out with great care, the findings may have been biased to some extent by an evoked feeling of anxiety and by attention toward health problems brought about by the investigation itself. Another comment is the technical impossibility of stating, after so long a delay, that chemical exposure, e.g. to depleted uranium, could not have been a cause of adverse health effects. The effects study demonstrated that the medical investigations generally did not provide reassurance or decrease the anxiety about health problems. There was even a small increase in complaints. Residents with health problems that had been involved in the disaster still attribute their complaints to harmful chemical exposure.