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• Exoskeletons were implemented to improve OSH, but often defaulted toward enhancing productivity. • The level of immanence of exoskeletons was low; reinforcing existing organizational dynamics rather than transforming them. • Worker autonomy play a key ethical role: high autonomy supported positive OSH outcomes and self-care practices. • A general lack of ethical reflection across workplaces limited the consistent realization of intended OSH benefits. • Ethically and organizationally informed technology implementation is needed to achieve sustainable improvements in OSH. Introduction: Exoskeletons are increasingly tested and implemented at workplaces, with ambitions connected to improving occupational safety and health (OSH), but with inconsistent impact. While exoskeleton research is increasing, few studies have empirically analyzed ethical implications of implementing exoskeletons at work. Method: This study employs an analytical framework for analyzing ethical perspectives of employing exoskeletons at work. We use this to analyze experiences and perspectives of 55 workers and managers employing exoskeletons in warehouse work, masonry, and carpentry. Results: Results show exoskeletons are implemented with purposes of improving OSH while maintaining productivity − but are likely to emphasize existing organizational dynamics and default towards improved productivity with less attention to OSH. This was not, however, the case in carpentry, where influence-based organization and benefits connected to exoskeletons prompted positive OSH assessments. Interestingly, usage of exoskeletons in carpentry indicate the technology may contribute to improving wishes to care for oneself. However, the study shows an overall scarcity of ethical reflections, which may explain inconsistent impact on OSH. These concerns include how exoskeletons reconstitute work by increasing heavy lifting, whether implementation ‘takes care of workers’ despite their wishes, worker influence and autonomy, and questions of whether managers and workers would actually like to use exoskeletons or recommend their usage. Practical applications: The study contributes to literature on ethics in technology implementation by developing empirically applicable methods for analysis and demonstrating that ethically informed, sociologically and organizationally oriented approaches could improve understanding and implementation of new technologies in organizations to achieve more consistently positive OSH outcomes.