This study examined the relationship between quarry dust exposure intensity, exposure duration, and disease burden among quarry workers in Akamkpa Local Government Area, Cross River State, Nigeria. A descriptive cross-sectional survey design was adopted using a quantitative research approach. Data were collected from 359 quarry workers selected through multistage sampling across major quarry sites in the study area. Structured questionnaires were used to gather information on socio-demographic characteristics, occupational categories, daily exposure in hours, weekly and monthly exposure patterns, cumulative years of exposure, and self-reported health conditions. Data were analyzed using descriptive statistics and crosstabulation. Findings revealed that a majority of workers (60.4 percent) spent 5 to 8 hours daily at quarry sites, while 17.3 percent were exposed for more than 8 hours. Exposure was highest during morning and afternoon shifts, which represent peak operational and dust-generating periods. Occupational analysis showed that high-risk groups such as drillers, blasters, and crusher operators experienced the highest exposure intensity and cumulative exposure over time. Respiratory conditions, particularly catarrh, cough, and nasal infection, were the most frequently reported illnesses across all exposure categories. The results further demonstrated a clear increase in disease burden with longer and more intense exposure, indicating a dose–response relationship between quarry dust exposure and adverse health outcomes. The study concludes that prolonged and high-intensity exposure to quarry dust significantly increases the burden of respiratory and related occupational diseases among quarry workers. It recommends strict enforcement of occupational safety measures, consistent use of personal protective equipment, reduction of working hours in high-dust zones through shift rotation, and regular medical surveillance to mitigate exposure-related health risks in quarry environments.