The aim of this research is to inform conceptual approaches to health and safety (H&S) training for mineworkers in South Africa. The study focuses specifically on those mineworkers who have the least formal education or training, termed elementary workers (unskilled) and machinery operators and drivers (semi-skilled). It is an integrative literature review of sources drawn from mine health and safety in South Africa; self-efficacy; adult education and training (AET); education and training in mining; and relevant health promotion studies. The sources selected refer to work in the Southern African mine H&S context, or comparable situations. Compelling ideas and formulations for training are suggested in the literature of the different disciplines reviewed. A core concept considered is self-efficacy and the concept has substantial support in the literature. Both the term and concept of ‘self-efficacy’ have been used in South African and mining studies, but often without proper consideration of the sources of self-efficacy and its task- and context-specificity. The review reveals a lack of evidence of effective advocacy and training around generic mining occupational hazards, such as lung disease. H&S training is most evidently linked to operator training, which is aligned with unit-standards. However, substantial numbers of mineworkers lack adequate formal education for such training programmes, or the informal skills to be included via recognition of prior learning (RPL) processes. The proposed role of H&S representatives appears demanding, but the associated skills training outlined in public unit standards, lacks essential elements. The findings identify key considerations for an underpinning approach to H&S training for elementary mineworkers. These are: new learning required; risk perception and management; existing and associated logics; team ethos; maintaining new learning and practice; and a dialogic aspect to programmes. Additional findings suggest that the convergent effects of different policies result in the training of the least educated mineworkers being marginalised. The study concludes with six propositions that relate to the research and development of H&S training for mineworkers, public evidence of training, policy effects and the predicament of mineworkers who lack formal education.