<p>Shuttle car operators in underground coal mines are exposed to high levels of whole-body vibration (WBV), increasing their risk of developing musculoskeletal disorders (MSDs). This study assessed WBV exposure and MSDs prevalence among shuttle car operators in Indian underground mines to evaluate health risks and guide preventive strategies. WBV exposure of the shuttle car operators were measured using triaxial accelerometers mounted on operator seats across five underground mines. Epidemiological data were collected from 50 WBV-exposed operators and 50 unexposed controls. WBV exposure was quantified using A(8) and VDV(8) metrics, and MSDs prevalence was determined using the Standard Nordic Musculoskeletal Questionnaire (SNMQ). The WBV exposure parameters A(8) and VDV(8) were further analyzed and correlated with self-reported MSDs severity ratings to identify robust predictors of health outcomes. Based on A(8), 26% and 64% of operators fell into "likely" and "potential" health risk categories, respectively; VDV(8) classified 54% as "likely" and 44% as "potential" health-risk. According to the EU Directive, 82% exceeded A (8) and 70% surpassed VDV(8) Exposure Action Values. MSDs prevalence was higher among exposed operators (38%) than controls (20%), with lower back pain being predominant (18% vs. 10%). The Chi-square test and correlation analysis identified VDV(8) as a better health risk predictor compared to A(8). The findings highlight a significantly elevated prevalence of MSDs among WBV-exposed shuttle car operators, with VDV(8) emerging as a more sensitive predictor of health risk than A(8). The study further highlights the need for proactive WBV control through policy-driven health measures to enhance the safety and well-being of shuttle car operators in underground mining environments.</p>