ObjectivesCoal workers’ pneumoconiosis is caused by exposure to respirable coal mine dust. The self-protection of underground coal miners (UCM) plays an irreplaceable role against this threat. The purpose of this study was to evaluate the predictors of self-protective behaviour (SPB) in Chinese UCM based on the health belief model (HBM).MethodsA cross-sectional study was conducted among 341 UCM in January 2016 in Pingdingshan City, Henan Province, People’s Republic of China. Data was collected using a self-reported questionnaire, which included questions on sociodemographic characteristics, HBM variables and SPB. An exploratory factor analysis of the principal components with varimax rotation was carried out on the HBM-related items. Pearson’s correlation and multiple linear regression analysis were used to assess the relationship between sociodemographic characteristics, HBM variables and SPB.ResultsMultiple regression analysis demonstrated the monthly income (B=0.403, p=0.001), the internal cues to action (B=0.380, p<0.001) and external cues to action (B=0.401, p<0.001) as the predictors of UCM’s SPB, accounting for 24.8% of total variance (F=34.96, p<0.001), while the cognition variables of HBM were not significantly associated with SPB.ConclusionThe results suggested that both internal and external cues to action were powerful predictors for SPB. These findings highlight that further efforts are required to provide the UCM with periodic health check-up reports and promote the active role of doctors and family members in miners’ decision-making to simulate them for better SPB.Ethics approvalAll data collection procedures received ethical approval from the Ethics Committee of Xuhui District Centre for Disease Control and Prevention (XHHEC-2016–7).