Blooms of the benthic dinoflagellate Ostreopsis have been related to sporadic acute respiratory symptoms and general malaise in people exposed to marine aerosols on some Mediterranean beaches. However, the direct link between recurrent Ostreopsis blooms and health problems has not been clearly established. In order to establish and elucidate the connection, we conducted a joint ecology and epidemiology study in an Ostreopsis hot spot. Throughout the bloom, which extended from the end of June until the end of October 2013, 81% of the human cohort that we studied experienced at least one Ostreopsis-related symptom. Paradoxically, the time when the effects were greatest was during a short time window in early August. This corresponded to the transition from the exponential growth to the stationary phase of the bloom. Negligible symptoms were reported from August to mid-October, during the stationary period of the proliferation, when O. cf. ovata maintained high concentrations of epiphytic cells. No clear patterns in the landward wind component were noted during the time when health effects were greatest. Our main hypothesis is that the irritants present in the aerosol are produced during a particular physiological phase of the Ostreopsis cells during the bloom.