Occupational Exposure Profiles and Respiratory Health Outcomes Among Surface and Underground Miners: A Comparative Epidemiological Analysis

Occupational lung diseases remain a significant public health concern in mining populations, particularly in high-exposure environments. This study examined occupational exposure profiles and respiratory health outcomes among surface and underground miners in Mpumalanga Province. A cross-sectional analytical design was employed among 239 mine workers. Data on socio-demographic characteristics, occupational exposures, behavioural factors, and respiratory outcomes were analysed using descriptive statistics, chi-square tests, and logistic regression models. Underground miners were significantly more likely to report high dust exposure (44.9% vs. 24.1%), poor ventilation (60.6% vs. 39.3%), and longer working hours (>8 h: 68.5% vs. 50.0%) compared to surface miners. They also reported a higher prevalence of respiratory symptoms, including chronic cough (45.7% vs. 25.9%), shortness of breath (41.7% vs. 23.2%), wheezing (34.6% vs. 18.8%), and diagnosed lung disease (23.6% vs. 9.8%). Multivariable analysis showed that underground mining (AOR = 1.92; 95% CI: 1.08–3.41), smoking (AOR = 1.78; 95% CI: 1.02–3.11), and high dust exposure (AOR = 2.89; 95% CI: 1.45–5.76) were independent predictors of chronic cough. A significant interaction between smoking and underground mining (AOR = 2.74; 95% CI: 1.32–5.68) further amplified respiratory risk. Additionally, underground miners demonstrated lower levels of knowledge (48.8% vs. 66.1%) and poorer preventive practices (44.1% vs. 64.3%). These findings highlight the combined influence of occupational and behavioural factors on respiratory health and highlight the need for integrated interventions to reduce the burden of occupational lung diseases.