Workplace exposure characteristics and risk perception of pneumoconiosis among coal mine workers in Mpumalanga Province, South Africa

Pneumoconiosis remains a major occupational health concern among coal mine workers, particularly in high-exposure settings. Understanding both workplace exposure characteristics and workers’ risk perception is essential for effective prevention and control strategies. A cross-sectional analytical study was conducted among 239 coal mine workers in Mpumalanga Province, South Africa. Data were collected using a structured questionnaire capturing socio-demographic characteristics, workplace exposure variables, and risk perception of pneumoconiosis using Likert-scale items. A composite exposure index (0 to 3) and a risk perception score (10 to 50) were generated. Descriptive statistics were computed, and associations were assessed using bivariate and multivariable logistic regression as well as ordinal logistic regression models. The majority of participants were male (71.5%) and worked in underground mining (52.3%). High workplace exposure index scores were observed in 78.2% of workers, while 74.9% demonstrated high-risk perception. However, the estimated association between workplace exposure conditions and risk perception was limited (AOR = 0.97; 95% CI: 0.47–1.98), suggesting that workplace exposure characteristics and perceived risk did not necessarily align. Higher age was associated with increased odds of elevated risk perception (AOR = 1.38; 95% CI: 1.04–1.82). Associations for exposure level, sex, and education were comparatively weaker and accompanied by confidence intervals that included the null value. In the ordinal model, female workers had higher odds of elevated risk perception (OR = 1.88; 95% CI: 1.09–3.23). The estimated association between exposure and risk perception was close to null and imprecise (AOR = 0.97; 95% CI: 0.47–1.98). Despite high levels of occupational exposure, risk perception did not consistently align with exposure among coal mine workers. The findings indicate that occupational exposure and risk perception may not always align among coal mine workers, highlighting the need for further research to better understand factors influencing perceptions of pneumoconiosis risk.