Objective To understand the occupational health status of workers in selected industries with key occupational hazards in Guangzhou and to provide a basis for formulating occupational health protection strategies in Guangzhou.

Methods A descriptive epidemiological method was used to analyze the occupational health status of workers working with silica dust, benzene, lead, and noise during their on-the-job period in Guangzhou from 2016 to 2023.

Results There were 798 869 records of occupational health examinations during this period among the examined workers exposed to silica dust, benzene, lead, and noise in Guangzhou from January 1, 2016 to December 31, 2023. Of them, there were 14 072 examinations for silica dust exposure (1.76%), 99 046 for benzene exposure (12.40%), 10 441 for lead exposure (1.31%), and 675 310 for noise exposure(84.53%). Over the eight years, 566 suspected cases of occupational diseases were detected, with a detection rate of 0.07%. The detection rates of suspected occupational diseases were, in order, 0.09% (13/14 072) for suspected occupational silicosis, 0.07% (501/675 310) for suspected occupational noise-induced hearing loss, 0.05% (50/99 046) for suspected occupational benzene poisoning, and 0.02% (2/10 441) for suspected occupational chronic lead poisoning. A total of 13 619 cases of occupational contraindications were detected, with a detection rate of 1.70%; of these, the higher detection rates were in noise exposure (1.86%, 12 556/675 310), benzene exposure (1.11%, 1 101/99 046), and silica dust exposure (0.50%, 71/14 072). The detected abnormal rates of critical effect indicators in 2016-2023 were as follows: 8.04% for noise exposure (57 917/720 802), 1.54% for benzene exposure (1 503/97 488), 1.31% for lead exposure (79/6 028), and 0.50% for silica dust exposure (61/12 189). The detection rates of leukopenia in benzene-exposed workers and elevated blood lead levels in lead-exposed workers showed an upward trend over time (P < 0.05). Additionally, the exposed workers in manufacturing, small and medium-sized microenterprises, and domestic enterprises had higher rates of occupational health damage.

Conclusions The current health status of workers exposed to silica dust, benzene, lead, and noise in Guangzhou was generally acceptable. However, there were still some workers who had suspected occupational diseases and/or occupational contraindications, especially those exposed to noise. Therefore, it is necessary to accurately identify and prevent various occupational diseases through standardized occupational health examinations.