Objectives Internationally, brick kilns employ tens of thousands of children. Due to the extreme poverty facing families who work in this industry, child labour in this sector has been challenging to eliminate. This study assesses the association between brick kiln work and self-reported injuries among children working in brick kilns in Afghanistan, Bangladesh, Nepal, and Pakistan.

Method A mixed-methods approach developed by an international team was translated and tailored for each country. Working children (aged 11–17) were identified from 1–3 brick kiln sites. Non-working controls, matched for age, sex, and socioeconomic status were identified from nearby communities. Trained interviewers administered semi-structured questionnaires to all consenting respondents.

Results 917 working children and 788 controls participated in the study. Overall, 65.1% of cases and 29.5% of controls reported experiencing a minor cut or bruises in the last month. The estimated odds ratio (OR) of recent injury was 3.60 (95% CI: 2.84–4.56) comparing working children to community controls (adjusted for age category, sex, and country). Nearly half (48.8%) of cases and 30.5% of controls reported a “bad cut”, broken bone, sprain, or burn in the last year, resulting in an adjusted OR of 2.44 (95% CI: 1.97–3.03) comparing working children to controls.

Conclusions While the hazardous nature of brick kiln work may be evident, this study was designed to provide evidence for parents, brick kiln operators, and policy-makers who seek to remove children from this work. Additionally, this work demonstrates a model for action-oriented, occupational health and safety research in challenging environments.