Introduction As policymakers become increasingly interested in taking gender/sex differences into account in their primary prevention approaches to occupational health and safety, there is a need to summarize the existing research evidence to find where health outcome differences associated with occupational hazard exposures exist between men and women.

Objective To understand similarities and differences between men and women in health outcomes related to occupational hazard exposures, across different occupations and in the same occupations.

Methods A systematic literature review was conducted on peer-reviewed prospective epidemiological studies published from 2009 to 2019, with no language restrictions. The methodological quality of studies was assessed, with medium to high scoring studies included in the evidence synthesis. Selected studies were qualitatively analysed and compared according to the magnitude of health risks for men and women for each occupational exposure category across occupations and in the same occupations.

Results 105 studies were reviewed. Across occupations, men were at higher risk of kidney disease from occupational heat stress, and injury/disability from physical and biological/chemical hazards. Women were at higher risk of injury/disability, musculoskeletal disorders from biomechanical strain, and poor mental health from workplace stress. In the same occupations, women in the healthcare industry were at greater risk of cancers and injury compared to men in the same jobs. Both men and women exposed to work stress in the same white collar and blue jobs were at risk of injury and heart disease. Men and women working in chemical manufacturing were at risk for different cancers.

Conclusion Men and women have different health risks from exposures to occupational hazards, with differences not solely due to the gendered distribution of occupations. These results may be useful to policy makers seeking to reduce gender inequalities in occupational health, and to researchers wishing to analyse these determinants in greater depth.