Occupational light vehicle (OLV) use is the leading cause of work related traumatic deaths in Westernised countries. Previous research has focused primarily on narrow contexts of OLV-use such as corporate fleet vehicles. We have proposed a comprehensive systems model for OLV-use to provide a framework for identifying research needs and proposing policy and practice interventions. This model presents the worker as the locus of injury at the centre of work- and road-related determinants of injury. Using this model, we reviewed existing knowledge and found most studies focused only on company car drivers, neglecting OLV-users in non-traditional employment arrangements and those using other vehicle types. Environmental exposures, work design factors and risk and protective factors for the wider OLV-user population are inadequately researched. Neither road- nor work-related policy appropriately addresses OLV-use, and population surveillance relies largely on inadequate workers compensation insurance data. This review demonstrates that there are significant gaps in understanding the problem of OLV-use and a need for further research integrating public health, insurance and road safety responses. The model provides a framework for understanding the theory of OLV-use OHS and guidance for urgently needed intervention research, policy and practice.