Introduction Grading the certainty of evidence is an indispensable component of systematic reviews, and appropriate recommendations are available for intervention research and environmental epidemiology, but not for occupational epidemiology. Thus, we propose recommendations for grading the certainty of evidence of occupational epidemiological systematic reviews. This project is part of a working group, which develops Good Practice Recommendations for Occupational Epidemiological Systematic Reviews.

Methods The derivation of recommendations is based on an informal consensus process with experts working in the field of occupational epidemiology and being experienced in the conduct of systematic reviews (n = 6). The literature basis is the JCA series: GRADE guidelines, the Cochrane Handbook for Systematic Reviews of Interventions, the GRADEpro Guideline Development Tool, the Navigation Guide and topic-specific articles.

Results Recommendations concern general aspects (baseline level, degrees of down-/upgrading GRADE domains, evidence levels of the overall assessment, Summary of Findings-table), domains for downgrading (risk of bias, imprecision, indirectness, inconsistency, publication bias), and domains for upgrading (large magnitude of effect, exposure-response relationship, residual confounding) the certainty of evidence.

Conclusion These recommendations shall support review authors in the field of occupational epidemiology in the process of grading the certainty of evidence in systematic reviews and may further help to apply evidence-based methods in occupational research.