Child labor remains one of the most controversial challenges at the end of the 20th century. Approximately 250 million children in developing countries work either full- or part-time. Child labor is not confined to less-developed countries, as economic transitions bring shifts in the prevalence and nature of child labor. Throughout the world, occupational injury and mortality rates for children exceed those of adults. Yet, data on the extent of child labor and the associated burden of injury and disability are often of poor quality. An estimated 6 million work-related injuries occur among children that result in 2.5 million disabilities and 32,000 fatalities each year. Using data derived from the Global Burden of Diseases Study (GBDS), estimates of child occupational mortality rates by region were found to be comparable with adult mortality rates, indicating that the conditions in which children work are as dangerous as, or more dangerous than, those in which adults work. Using either the human capital or willingness-to-pay calculations, estimates of economic impact of child labor-related mortality can be made. Depending on the estimate method used, the annual cost of child labor-related mortality in India, for example, lies between 101 million and 2.43 billion U.S. dollars. Intervention to reduce the societal and economic impact of child labor can be directed at either reducing the supply and demand for child labor or by maximizing the best possible health outcomes for children. Addressing properly the global problems of child labor requires an aggressive research agenda directed toward improving the quality of the data, improving monitoring and surveillance, understanding implications of the changing nature of work, understanding social and institutional issues, and identifying innovative intervention solutions. (Contains 84 references.) (HTH)