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The Small and Medium Enterprises (SME) employ the vast majority of the work force in Canada, Australia, USA and the European Union. SME achieve significantly lower Occupational Health and Safety (OHS) outcomes than those of larger companies. This article has two objectives. The first will be to explain the OSH outcomes of SMEs. The second will be to determine the existence of a specific OHS model for SMEs. This article is based on a literature review. It analyzes the scientific findings of the last 20 years. The selected items have been searched by keyword on international databases. The references, cited by the authors, were examined. The work climate and the role of the manager, are among the factors that explain the outcomes of the SMEs. A specific OHS model for SME, based on the acceptance of risk, the role of "expert" worker and of the intermediaries, emerges. This OHS model would depend on the resilience required to operate the business model. It could also be relevant for larger enterprises. The business model would be a criterion to introduce in future research. [ABSTRACT FROM AUTHOR]