Epidemiology of occupational acute traumatic hand injuries: a literature review

The purpose of this review was to summarize the literature on occupational, acute, traumatic hand injury and suggest directions for future research. I n 1996, the leading occupational injury treated in United States' hospital emergency departments was an acute hand injury (e.g. laceration, crush or f racture). These injuries affected 30% of an estimated 3.3 million injured w orkers (990,000). Cuts and lacerations of the fingers ranked third after ba ck and leg strains in the number of lost workday cases in the USA in 1994. The incidence rate of hand injuries studied in seven manufacturing environm ents around the world ranged from 4 to 11 per 100 workers per year. Workers aged 24 years or less had the highest risk of hand injury. Men had higher rates of severe hand injury than women. Despite the high frequency and significant amount of lost work time associa ted with these injuries, they are poorly understood from an etiological per spective. There is only one case-control study of occupational hand injury in the literature. That study suggested an important role for both fixed (a ge) and transient risk factors (doing an unusual task) at the time of the i njury. More analytic epidemiological research is needed to identify potenti ally modifiable risk or protective factors (e.g. glove use) for acute hand injuries. In this regard, the case-crossover design, a relatively new epide miological approach using cases as their own controls, could prove an effic ient method for determining transient, modifiable risk factors for acute, o ccupational hand injury. (C) 2001 Elsevier Science Ltd. All rights reserved .