Background Poor occupational health and safety damages many lives and livelihoods which impedes economic growth and cause extreme poverty. The significance of occupational health and safety is particularly strong in countries like Bangladesh where it is not adequately addressed or explored.

Methods This qualitative study draws data from 15 Life History interviews with workplace exposed disabled, 10 in-depth interviews with high risk environment workers; and key informant interviews with five senior management officials of risky workplaces.

Results The research found that the poorest people tend to take risky work. Availability of cheap unskilled and semi-skilled labour also contributes to encourage employer to employ without complying with safety and health standards. By accepting risky employment, workers are exposure to gradual or sudden impairment of functions, which in many cases limit their future opportunities making them disabled or left them to die because of the increased risk of illness, injury and/or disability. The cost of dealing with the illness in the absence of insurance forces households to spend its resources on medical care depleting its assets and incurring debts. This further led to exclusion, loss of income, dragged further into poverty and eventually to extreme poverty which also transmit intergenerationally. Bribery and illegal practices helped employers to escape such compliances. On the other hand the lack of willingness of the employers to provide an environment in compliance with standards also seem to be a misunderstanding of the benefits of having a safe working environment. Sub-contracting was found to be a potentially harmful practice of the business/industry owners which makes workers more vulnerable.

Conclusions Relations between occupational injury and impairment and how this leads the households into extreme poverty are both interesting and understudied issue in Bangladesh. Further research studies and strong reporting mechanism is also instrumental to cover the paucity in evidence required for the changes in policies and practice. The paper concludes that occupational health and safety in Bangladesh should be a higher priority in discussions of economic growth and extreme poverty.