Background: One of non-auditory effects of noise exposure is fluctuation of body hormones’ secretion. Also, disturbing the normal nutrition schedule can cause similar outcomes.

Aim: To investigate the combined effects of noise exposure and fasting in Ramadan month on salivary cortisol levels in nurses.

Methods: 75 nurses (39 male and 36 female nurses were exposed to noise in two hospitals) enrolled in the study. The equivalent noise level was measured in workstations and salivary cortisol was measured at the beginning (6 am) and also at the end of work shift (4 pm) before and during Ramadan month. The amount of change in the average of the values of groups were compared with each other. The paired sample t-test and liner regression were performed for statistical analysis.

Results: The equivalent noise exposure levels were below 76.5 dB-A in both hospitals. The mean salivary cortisol levels in morning and evening samples in normal feeding with noise exposure showed a significant difference between groups. But in fasting (Ramadan) and noise exposure a significant difference was not observed.

Conclusion: This study showed that exposure to low and moderate levels of noise (≤76 dB) when combined with fasting can cause more stress in the body. It has a major effect on salivary cortisol levels. According to the results noise exposure in Ramadan month (fasting period) should be seriously controlled and reduced to safe levels in order to insure controlling cumulative side effects of noise and