The explosion at the AZF factory had significant consequences, and workers in the Toulouse metropolitan area were particularly affected (31 deaths, including 21 workers; 1,300 businesses partially or completely destroyed). A cohort of workers (the "AZF" health cohort) was established in May 2003. The objective is to assess the medium-term consequences of the industrial disaster on mental and hearing health. Factors associated with post-traumatic stress disorder (PTSD) symptoms in men included proximity to the explosion site, the presence of physical injuries, the onset of psychological symptoms, time off work, and the occupational categories of artisans, merchants, and manual laborers. Among women, PTSDS was associated with being over 50 years of age at the time of inclusion, work stoppage, and the social categories of manual laborers and office workers. Factors associated with depressive symptoms among men included being over 50 years of age, physical injuries, psychological symptoms, and the social categories of employees and manual workers; among women, these factors included being over 50 years of age, the perception of inhaling toxic substances, damage to the home, work stoppage, and the social categories of employees and manual workers. The auditory symptoms most frequently reported by workers were tinnitus, hyperacusis, and then vertigo. Symptoms were more frequent among those who were closest to the explosion. Analysis of audiograms at baseline and at the final follow-up revealed few hearing deficits related to exposure. The results of this study highlight the links between exposure to the disaster and workers’ mental health. They underscore the need to pay attention to socioprofessional risk factors in addition to factors reflecting direct exposure.