Objective To understand the current situation of occupational health literacy (OHL) among workers in enterprises in Nantong and analyze its influencing factors, providing a basis for further enhancing the OHL levels of workers.

Methods OHL levels of 3 500 workers exposed to occupational hazards in Nantong by a stratified random sampling method were surveyed from January to May 2024. Logistic regression analysis was used to compare the effects of different factors on occupational health literacy.

Results A total of 2 988 valid questionnaires were collected with an effective recovery rate of 85.37%. Among the surveyed workers, the OHL level was 68.67%. The scores of the four dimensions, from highest to lowest, were as follows: basic knowledge of occupational health protection (82.6%), healthy work style and behavior (76.2%), basic skills of occupational health protection (65.4%), and knowledge of occupational health laws (57.3%). Multivariate logistic regression analysis showed that, compared with workers with junior high school education or lower, the OHL levels of workers with technical secondary school/high school and those with a bachelor's degree or above were significantly higher, with OR values of 5.694 (95%CI: 2.175 to 14.906) and 29.105 (95%CI: 6.752 to 25.462), respectively. The OHL levels of workers in self-employed enterprises and Sino-foreign joint ventures were lower than those in foreign-invested enterprises, with OR values of 0.133 (95%CI: 0.047 to 0.380) and 0.078 (95%CI: 0.019 to 0.325), respectively. Compared with microenterprises, workers in large enterprises had higher OHL levels, with an OR value of 5.625 (95%CI: 1.686 to 18.763).

Conclusions The OHL level of workers in Nantong needs to be further improved. It is necessary to strengthen the efforts of occupational health management departments, enhance the training on occupational health knowledge for workers in micro and small enterprises, self-employed enterprises, and Sino-foreign joint ventures, and those with lower educational levels, particularly the training on basic skills of occupational health protection and occupational health laws.