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Background Construction workers have health hazards inherent to the nature of work and at further risk for poverty due to poor living conditions. We investigated perceived illness among workers and family members in the past year and the economic consequences of morbidities in terms of Catastrophic Health Expenditure (CHE). Methods In this cross-sectional multicenter study, we recruited construction workers of both sexes from construction sites of two Indian cities. We collected details on illnesses requiring a healthcare visit in the past year, expenditure and related details. Results Of 1263 participants recruited, data on illness during the past year were reported by 1110 participants; 37% (n = 302) reported illness among themselves or family members requiring a healthcare visit. We constructed a regression model to ascertain demographic and living condition determinants of illness (R^2 = 54%, p