To reduce the occupational health risks of communication base station maintenance personnel and improve their physical and mental health, a moderated mediation model was built in this study. It was based on COR to explore the psychosocial factors affecting these personnel's physical and mental health. First, the action path of prosocial work orientation on occupational health risks was analyzed based on the COR, and four theoretical hypotheses were proposed. Second, a hypothetical model encompassing prosocial work orientation, meaningful work, neuroticism, and occupational health risks was established. Finally, SPSS and PROCESS were employed to analyze 3 559 valid sample data from a large communication company to verify whether the hypotheses held true, and corresponding management implications were put forward based on the data. The results show that prosocial work orientation significantly negatively predicts occupational health risks. Meaningful work plays a partial mediating role in the relationship between prosocial work orientation and occupational health risks. Neuroticism not only positively moderates the negative relationship between meaningful work and occupational health risks but also further positively moderates the strength of the aforementioned mediating path—specifically, the mediating effect is stronger among individuals with high neuroticism.