Background: Aircraft noise is an environmental stressor. A positive relationship exists between noise and high blood pressure. Shift work is an additional hazardous working condition with negative effect on the behavior attitude of workers.

Objective: This study aimed at investigating some health hazards for shift work on workers at Cairo International Airport (CIA), Egypt, as a strategic work place, with more than one stressor.

Subjects and methods: Assessment of noise effects were carried out in four working sites at the airport besides control sites. The average noise level in the exposure sites was 106.5 dB compared with 54 dB at the control sites. The study comprised a group of 200 male workers exposed to aircraft noise and 110 male workers not exposed to noise as control group. All workers had full general medical examination after filling specially formulated questionnaire. Hearing impairment, raised blood pressure, headaches, disturbed sleep, and symptoms of anxiety were more prominent among the exposed workers than the control. Symptoms of upper respiratory tract were reported among night shifters of both groups with high tendency for smoking. Thus, night-shift workers at CIA work under more than one stressor. Hypertension and smoking might act as intermediate factors on the causal pathway of complaints, making aircraft noise and night shift acting as two synergistic stressors. Airport workers are in need for aggressive hearing conservation programs. Organization of the working hours schedule is mandatory to avoid excessive noise exposure.