"The evolution of Industry 4.0 and the emerging paradigm of Industry 5.0 have introduced disruptive technologies that are reshaping modern manufacturing environments. Among these, Digital Twin (DT) and Industrial Metaverse (IM) technologies are increasingly recognized for their potential to enhance Occupational Health and Safety (OHS). However, a comprehensive understanding of how these technologies integrate to support OHS in manufacturing remains limited. This study systematically explores the transformative role of DT and IM in creating immersive, intelligent, and human-centric safety ecosystems. Following the PRISMA guidelines, a Systematic Literature Review (SLR) of 75 peer-reviewed studies from the SCOPUS and Web of Science databases was conducted. The review identifies key enabling technologies such as Virtual Reality (VR), Augmented Reality (AR), Extended Reality (XR), Internet of Things (IoT), Artificial Intelligence (AI), Cyber-Physical Systems (CPS), and Collaborative Robots (COBOTS), and highlights their applications in real-time monitoring, immersive safety training, and predictive hazard mitigation. A conceptual framework is proposed, illustrating a synergistic digital ecosystem that integrates predictive analytics, real-time monitoring, and immersive training to enhance the OHS. The findings highlight both the transformative benefits and the key adoption challenges of these technologies, including technical complexities, data security, privacy, ethical concerns, and organizational resistance. This study provides a foundational framework for future research and practical implementation in Industry 5.0."

This work is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).

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