Occupational health management is still a weak point, especially in tunnels and underground works constructed by drill and blast method due to the confined working environment, although occupational health management system has been popularized in the field of tunnels and underground works. The classification, characteristics and stateofart of factors that have influence on the occupational health in tunnels and underground works constructed by drill and blast method are analyzed. A series of comprehensive countermeasures are proposed in terms of laws and standards, government supervision, safetyguarantee resources, site management and popularization and application of prevention and control technologies. It is stated that the key to ensure the effective operation of the occupational health management system lies the government management, rational cost and qualified personal protection equipment. In the field of tunnels and underground works, attention should be paid to the monitoring and analysis of the harmful factors, as well as to the application of new construction technologies and new construction equipment. 