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SA Orthopaedic Journal

On-line version ISSN 2309-8309
Print version ISSN 1681-150X

Abstract

STEWART, A; BIDDULPH, G  and  FIRTH, GB. The aetiology of acute traumatic occupational hand injuries seen at a South African state hospital. SA orthop. j. [online]. 2017, vol.16, n.4, pp.49-53. ISSN 2309-8309.  http://dx.doi.org/10.17159/2309-8309/2017/v16n4a8.

BACKGROUND: Acute traumatic occupational hand injuries are the second most common cause of all traumatic hand injuries worldwide and the most commonly injured body part during occupational accidents. Traumatic hand injuries account for approximately one-third of all traumatic injuries seen at state hospitals in South Africa. The aetiology of occupational hand injures in South Africa is unknown. AIM: The purpose of this research was to highlight the patient demographics and types of hand injuries sustained on duty and to identify the most common causes and risk factors for these injuries METHODS: An observational cross-sectional study was done at a state hospital in Johannesburg, South Africa, between January and July 2016. A total of 35 patients over the age of 18 years were interviewed using a specially designed questionnaire. RESULTS: The patients were predominantly male (88.5 %) between the ages of 20 and 61 years (average 35), 54% had dropped out of school before Grade 11. The average monthly income was low (R1 000-R9 000 pm) and 85% were the primary breadwinner in the household. Only 51 % of the patients had 'formal' employment, the rest were either self-employed, contract workers or had intermittent 'piece' jobs. The majority of injuries occurred to machine operators, general manual labourers and construction workers. Eighty per cent of the patients had never received any occupation-specific training. Seventy-one per cent of the patients were not using any protective gloves at the time of injury. The most common sources of injury were power tools, powered machines and building material. Lacerations, crush injuries and fractures were the most common type of injury seen, involving predominantly the index, middle and ring finger. Twenty-eight per cent sustained minor injuries, 34% moderate, 20% severe and 17% major as defined by the Hand Injury Severity Score. CONCLUSION: Patients with traumatic work-related hand injuries are poorly trained and often are not provided with protective gloves. They typically injure their index, middle and ring fingers using either a power tool, powered machine or by handling building material. The injuries sustained are most commonly lacerations, fractures and crush injuries. As a result, occupational health and safety must be improved to reduce the socio-economic burden of these injuries. Novel ways of improving safety in the informal labour market are required. Level of evidence: Level 4

Keywords : hand injuries; occupational injuries; occupational health and safety; angle grinder; HISS score.

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