Objective To understand the current status and influencing factors of occupational health literacy (OHL) of workers in key industries in Inner Mongolia and to provide reference for policy formulation.

Methods From May to November 2024, a stratified cluster random sampling method was used to select frontline workers from nine key industries in Inner Mongolia. The National Questionnaire for Monitoring Occupational Health Literacy of Key Populations was distributed to survey OHL levels. Logistic regression models were employed to analyze influencing factors.

Results A total of 12 484 frontline workers from nine key industries were surveyed. The overall OHL level was 49.9%. Workers in the secondary industry had a higher OHL level (53.2%) than those in the tertiary industry (46.6%). Multivariate logistic regression analysis showed that, compared with workers with an education of junior high school or below, those with an education of high school/vocational high school/technical secondary school, college diploma, and bachelor's degree or above had significantly higher OHL levels (OR = 1.340, 2.125, 3.352). Compared with workers with an average monthly income ≤ 3 000 yuan, those with an average monthly income of 3 000 to 4 999 yuan, 5 000 to 6 999 yuan, and ≥ 7 000 yuan had higher OHL levels (OR = 1.731, 2.327, 2.830). Compared with workers in coal mining and washing industries, those in petroleum, coal, and/or other fuel processing; electrical machinery and equipment manufacturing; healthcare; education; and environmental sanitation had higher OHL levels (OR = 1.296, 1.561, 5.385, 1.558, 2.667), while workers in express/delivery services had lower OHL levels (OR = 0.784). Compared with workers in state-owned units, those in public institutions or other types of units (including individual economic organizations; foreign-funded, Hong Kong, Macao, and Taiwan investment enterprises) had lower OHL levels (OR = 0.183, 0.730). Compared with workers in units with ≤ 20 employees, those in units with 20 to 299, 300 to 999, and ≥ 1 000 employees had higher OHL levels (OR = 1.460, 1.333, 1.404). All differences were statistically significant (P < 0.05).

Conclusions The OHL levels of workers in key industries in Inner Mongolia have potential for further improvement. Special attention should be given to workers in coal mining and washing, transportation, express/delivery services, and environmental sanitation industries, as well as those with low income and low education levels and those employed in micro and small enterprises. Targeted education and intervention strategies should be adopted for different populations to enhance their OHL levels.