Abstract Background: In the past 15 years the use of evidence of effectiveness of an intervention has become more generally accepted in clinical medicine. In occupational health, evaluation of interventions has not been a widespread concept. Here, we will explore the possibilities for evaluation of effectiveness in occupational health and apply the basics of evidence-based medicine to occupational health. Methods: We will examine the nature of evidence used in clinical medicine and the applicability and availability in occupational health. We will give examples how the evidence can be put in practice, and how the Cochrane Collaboration can contribute. Results: Evidence as in evidence-based medicine is made up by the results of evaluation studies. The transfer of results of trials into practice will be along the line of systematic reviews and guidelines for occupational health professionals. Current practice for many occupational health interventions is more based on expert opinion and tradition than on scientific evidence. The Cochrane Occupational Health Field can play a valuable role in summarizing the results of primary studies into systematic reviews of occupational health interventions. Conclusions: Evidence-based medicine models are applicable to occupational health. A shift towards other interventions that are better underpinned by evidence is needed. Lack of evidence can also draw attention to areas where primary research is needed.