The study assessed the current challenges of occupational health and safety practices andrnthe extent of occupational health hazards of the textile workers as well as the costrnimplication of these work-related incidents and diseases among ATF. Four mainrncategories of Akaki textile and garment factory workers were targeted in AACA. Thernsample consisted of 240 workers taking respondents randomly from each of the four workrncategories according to their workers number proportionately. The study indicated thatrnwork in the factory severely affected workerâ€™s health, as most activities are insecure,rnhazardous and take place in unhealthy and unsafe environment. In the study area thernparticular nature of work in the integrated textile manufacturing created various types ofrnhealth hazards among the selected respondents such as headache, eye and skin infection,rnback and chest pain, asthma, loss of interest and mental fatigue. Results of the studyrnshowed that the highest 32 percent of the workers reported that they were affected byrnphysical hazards, followed by 26 percent by chemical hazards and the total economicrncost of work related injuries and illness among the four work departments for the lastrnEthiopian budget year(2013/2014) was Birr. 13,090. From the foregoing, a majorrnrecommendation is that both government and employing authority should ensure thatrnthey adhere strictly to International Labour Organization safety and working conditionsrnor standard in order to increase productivity through improved welfare and health ofrnworkers