The explosion at the AZF factory in Toulouse is one of the most significant industrial disasters in France in recent decades. The consequences of this explosion were severe both in human terms (30 deaths, several thousand injured) and in terms of property damage. Workers and rescue personnel in the Toulouse metropolitan area were particularly exposed. A cross-sectional survey using a self-administered postal questionnaire was conducted 12 months after the explosion. The objective was to assess the consequences one year after the disaster. All businesses identified in the immediate vicinity (within a 3-km radius of the AZF site) were included. In the distant zone (the rest of the municipality and the Toulouse metropolitan area), stratification of businesses by sector of activity and size allowed for the inclusion of a representative sample. All first responders from various professions in the Haute-Garonne department were also included. Among workers present in the immediate vicinity, the incidence of physical injuries was 14% for both genders and decreased with increasing distance from the explosion’s epicenter. One in five workers reported property damage at home. Regarding the professional impact, 20% of workers reported an unusable workplace and 7% reported time off work related to the explosion. The prevalence of post-traumatic stress disorder (PTSD) symptoms was higher among workers in the near zone (12% among men and 18% among women) than among those in the distant zone (5% and 9%). There was a gradient in PTSD prevalence according to occupation and socio-professional category (SPC) in the near zone, but not in the distant zone. In the near zone, PTSD was more frequent among workers who were older, more exposed (immediately or later), and who were artisans, clerical workers, or manual laborers. The impact on mental health was lower among rescue workers, with PTSD prevalence rates of approximately 5% among men and 2% among women. PTSD was not associated with age or socioeconomic status (SES). However, it was more common among police officers who participated in rescue activities involving the injured. This study highlights the lasting impact of the industrial disaster and reveals the extent of the psychological consequences among workers, particularly those from the most disadvantaged SES groups in the near zone. These results underscore the need to improve the epidemiological approach in disaster situations, particularly by taking the social dimension into account. They also indicate that special attention should be given to preparing all rescue workers to care for victims. (R.A.)