Abstract: Background　Understanding the spectrum and characteristics of digestive system diseases among tropical island workers can help identify relevant disease prevention and control strategies, safeguard the physical and mental health of these workers, and maintain their good work capacity. Objective　To investigate the prevalence of digestive system diseases among workers in tropical island environments, analyze associated risk factors, construct predictive models, and preliminarily explore strategies for the prevention and control of digestive system diseases. Methods　From June to December in 2023, a stratified cluster random sampling method was used to select workers living on a tropical island in a certain region. A questionnaire survey was conducted among the sampled individuals to analyze the gastrointestinal symptoms and disease spectrum of the island workers, explore the risk factors associated with disease occurrence, construct a prediction model, and evaluate its performance. Results　Of the 1 050 questionnaires distributed, 1 030 valid responses were collected (effective response rate: 98.1%). All corresponding workers were male, with the majority (90.29%) aged from 18 to 30 years. Among them, 512 individuals (49.7%) reported experiencing routine digestive symptoms. The most prevalent symptoms were diarrhea (23.8%), constipation (15.2%), abdominal distension (14.4%), loss of appetite (13.6%), and abdominal pain (13.3%). A total of 251 workers (24.4%) were diagnosed with digestive system diseases, primarily chronic gastritis (7.8%), acute gastritis (6.7%), acute enteritis (5.6%), chronic enteritis (4.2%), and functional dyspepsia (3.8%). Logistic regression analysis identified the following as significant independent risk factors for digestive diseases (all P < 0.05): age (OR=2.50, 95% CI: 1.22 - 5.11), family history of digestive diseases (OR=2.48, 95% CI: 1.53 - 4.00), usual anxiety/tension (OR=4.62, 95% CI: 2.00 - 10.69), abdominal cold exposure during fieldwork (OR=1.68, 95% CI: 1.03 - 2.75), unclean diet during fieldwork (OR=1.71, 95% CI: 1.10 - 2.67), and anxiety during fieldwork (OR=2.28, 95% CI: 1.45 - 3.58). A nomogram prediction model constructed based on these factors demonstrated acceptable predictive efficacy. Conclusion　There is a high prevalence of gastrointestinal symptoms and moderate digestive disease incidence in workers on certain tropical island. Primary medical services should prioritize personnel with family history of digestive disorders, anxiety states, older adults and should strengthen health education initiatives, avoid unhygienic dietary practices and abdominal cold exposure.