Objective To understand the level of occupational health literacy among workers in a ferroalloy enterprise and its influencing factors, providing a basis for formulating targeted health literacy intervention strategies and measures.

Methods From August to September 2023, 750 workers in this enterprise were surveyed to carry out occupational health literacy surveys by the "National Occupational Health Literacy Monitoring Questionnaire for Key Population, " and logistic regression models were used to analyze the influencing factors of their occupational health literacy levels.

Results A total of 726 valid surveys were completed with a response rate of 96.8%. Of these workers, 405 (55.79%) had basic occupational health literacy, 66.25% were aware of occupational health knowledge, 49.59% had basic occupational health protection skills, and 57.99% had healthy working habits and behaviors. The individuals, who were female, married, had a college degree or above, were non-smokers, were not working night shifts, and had higher average monthly incomes, had higher awareness of occupational health knowledge (all P < 0.05). The individuals, who had a college degree or above, thought their health status was generally normal, didn't work night shifts, and had higher average monthly incomes had better basic occupational health protection skills (all P < 0.05). The individuals, who were female, aged 41-50 years, had a college degree or above, were non-smokers, and didn't work in night shifts, had healthier working habits and behaviors (all P < 0.05). Multivariate logistic regression analysis showed that compared to those with a college degree or above, those with a high school education or below were 1.735 times more likely to lack basic occupational health literacy (OR = 1.735, P = 0.003); workers on night shift were 2.079 times more likely to not have basic occupational health literacy compared to those who did not work night shift (OR = 2.079, P < 0.001).

Conclusions The occupational health literacy level of workers in this ferroalloy smelting enterprise was slightly higher than the national average level of key populations reported in 2022. However, effective strategies and measures should still be formulated to improve the shift work system and conduct accessible occupational health education, especially for frontline workers with relatively low educational levels, to improve their occupational health status.