Abstract: Objective To analyze the level of occupational health literacy and its determinants among four key occupational populations in Lu'an City, thereby providing an evidentiary basis for the formulation of targeted intervention policies. Methods A stratified, multi-stage cluster random sampling method was employed between 2022 and 2024 to survey frontline workers from 33 enterprises representing four key populations in Lu'an City. Data on demographic information and occupational health literacy were collected via an online questionnaire. Logistic regression analysis and a nomogram prediction model were utilized to identify influencing factors. Results The survey covered 1 087 frontline workers, who were predominantly male (76.54%) with a mean age of 38.55 ± 10.25 years. Participants were mainly from the non-metallic mineral mining and dressing industry (69.73%), small and micro-sized enterprises (44.89%), and private enterprises (55.29%). The overall occupational health literacy level was 52.53%. Literacy levels for the four dimensions, ranked from highest to lowest, were: basic knowledge of occupational health protection (89.97%), healthy work practices and behaviors (72.95%), knowledge of occupational health laws (59.25%), and basic skills for occupational health protection (28.15%). Logistic regression analysis indicated that industry category, economic ownership type, age, and educational attainment were significant determinants of overall occupational health literacy. Workers in the textile and apparel industry (OR=0.126) and the non-metallic mineral products industry (OR=0.253) had lower literacy levels compared to those in the non-metallic mineral mining and dressing industry. Private enterprise employees showed lower literacy than their counterparts in state-owned enterprises (OR=0.542). The ≥50 years age group had lower literacy than the <30 years age group (OR=0.541). Individuals with a college degree or higher had significantly greater literacy than those with a primary school education or below (OR=3.576) (all P<0.05). The nomogram model revealed that industry category and educational attainment were the most significant predictors of overall occupational health literacy. Conclusion The overall level of occupational health literacy among the four key populations in Lu'an City requires substantial improvement. Interventions should prioritize targeted training on basic occupational health protection skills and legal knowledge. These efforts should specifically focus on workers in the textile and apparel industry and individuals with lower educational levels, employing precise and differentiated strategies.

Key words: Key populations, Occupational health literacy, Influencing factors, Intervention strategies