Background: Exposure to respirable crystalline silica dust remains a significant occupational health challenge in the Southern African Development Community region, leading to high incidences of silicosis and pulmonary tuberculosis, particularly among mining workers. This study evaluated the knowledge, attitudes, and practices (KAP) of mineworkers regarding silica dust risks across Lesotho, Malawi, Mozambique, and Zambia. Methods: A cross-sectional analytical study was conducted involving 1440 mineworkers exposed to silica dust in mines across four SADC countries. Data were collected using structured questionnaires covering socio-demographic traits and knowledge, attitude, and practices. Data analysis was conducted using Stata version 18. Results: While 91% of participants exhibited adequate knowledge and 88% demonstrated acceptable practices, 51% maintained negative safety attitudes. Knowledge scores were positively correlated with company training (r = 0.386). However, a “Training Paradox” emerged in the regression model: compulsory company training was significantly associated with a 1.20-unit decrease in practice scores, whereas external training and higher education levels (+2.98 units) predicted improved compliance. Technicians and younger workers were identified as higher-risk cohorts. Conclusions: The findings suggest that top-down mandatory training may trigger psychological reactance, undermining behavioural safety. To mitigate silica-related diseases, industry stakeholders should transition toward participatory, role-specific safety interventions that prioritize worker autonomy and cognitive engagement over administrative compliance.
Khoza et al. (2026) studied this question.