The explosion at the AZF factory was one of the most significant industrial disasters in France in recent decades. The consequences were severe (30 deaths, several thousand injuries). Workers and rescue workers in the Toulouse metropolitan area were particularly exposed. Following a cross-sectional survey conducted from September 2002 to April 2003 among the population of workers and rescue workers, a cohort of volunteers was established in May 2003. The "AZF" health cohort comprises 3,006 individuals who will be followed for five years. Upon enrollment, volunteers were invited to undergo a health screening. They also completed a self-administered questionnaire exploring: career history, mental health, and sensory disorders, particularly ENT-related issues. The results presented in this report pertain to the enrollment phase. Episodes of unemployment, sick leave, or a break in career progression since September 2001 were rarely reported by cohort participants (less than 2%). No link between the occurrence of these career setbacks and indicators of exposure levels could be identified. This apparent lack of effect of the explosion on professional life is likely related to methodological limitations. The assessment of mental health using the standardized GHQ-28 self-report questionnaire reveals "psychological distress" affecting 47% of volunteers. The prevalence is significantly higher among women (60%) than among men (40%). It varies by socio-professional category, with manual workers and tradespeople being the most affected. Among men, “psychological distress” is more frequent the more they were exposed to various indicators: the impression of having inhaled toxic fumes or of buildings collapsing, the presence of psychological symptoms in the immediate aftermath of the disaster, a history of depression, periods of temporary layoffs, or a relocation of the workplace. Among women, "psychological distress" is more common when there is at least one history of depression or when a close relative was affected by the disaster. Regarding ENT conditions, the most common symptoms are hearing loss (34% of men and 27% of women) and tinnitus (25% and 19%, respectively). There is a gradient of symptoms depending on personal proximity. On audiograms, hearing deficits predominate in the high-frequency range and are more frequent the closer individuals were to the site of the explosion. This study highlights links between the industrial disaster and “psychological distress.” Its major strength lies in the use of two independent and non-concurrent data sources to measure exposure and health and occupational consequences. It underscores the need to be vigilant regarding hearing disorders, particularly among individuals who were near the site of the explosion. It constitutes only the first stage of the longitudinal study, but justifies the need to focus on medium- and long-term effects. (R.A.)