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Occupational injuries are a major problem worldwide and affect all countries, particularly developing ones. In recent decades, the application of approaches such as the Occupational Health and Safety Management System (OHSMS) has led to the successful control of workplace injuries in high-income countries. The Occupational Health and Safety Assessment Series (OHSAS) 18001 as a worldrecognized OHSMS has gained considerable acceptance by a large number of organizations. However, few studies have examined the effectiveness of OHSAS 18001 on safety performance in certified organizations. This study consisted of four sub-studies, and was conducted to explore the effect of OHSAS 18001 on the occupational injury, safety climate, and Occupational Health and Safety (OHS) practices in OHSAS 18001-certified companies compared with a control group in Iran. OHSAS 18001 practices were also examined in the certified companies, where interviews were conducted to explore the influencing factors on the effectiveness of OHSAS 18001. A negative binomial regression indicated no significant effect of OHSAS 18001 certification on the occupational injury rate. The second sub-study applied a new safety climate questionnaire, and a hierarchical regression indicated that the safety climate was influenced by the implementation of OHSAS 18001 and safety training. The third sub-study pointed to the better OHS practices of the certified companies compared with the control ones. The results also showed that adopting the OHSAS 18001 standard improved the documentation for the management of OHS, but did not lead to continuous …